QIn the story I am working on, a woman is killed in a fall down some stairs. Her body is later moved and dumped in a lot. I’d like my hero to be able to deduce from looking at the body that it was moved and a probable cause of death. In Murder and Mayhem, you mention that someone can die from a fall shattering her femur, which causes internal bleeding. If the bone hasn’t punched through the skin, are there other visible signs that would indicate internal bleeding as the cause of death? Or if she died from an intracranial bleed rather than a fractured femur, are there visible indications that my investigator could see?
Lee Goldberg
Author of The Walk and Mr. Monk on the Road
Los Angeles, California
AThe injuries sustained from a fall down the stairs can look like a fall off a building or a car accident or even blunt force trauma from an attack by a strong and aggressive killer. The medical examiner could look at the wounds and at least guess the type of weapon or object that made the injuries. He might see splinters or paint or varnish from the stairs or perhaps bits of plaster or stucco from the wall in the wounds, and if these materials are analyzed and determined to be household materials, then he might suspect that the wounds were not from a lead pipe or a baseball bat but from stairs and walls. This would require chemical and microscopic analysis of the materials found in the wounds.
If the victim sustained blows to the head during the fall that were powerful enough to cause bleeding into or around the brain, then she would likely have some bruising and perhaps hematoma formation in the scalp. Even a bloody laceration. This isn’t always the case, but in a situation such as you describe it would be very likely. If the ME found significant brain trauma or bleeding at autopsy, he might conclude that blunt force head trauma was the cause of death. Then an analysis of the wound characteristics might allow him to determine that the injuries came from a fall down stairs as opposed to blunt trauma from an object.
As for determining whether the body has been moved or not, there are several things that might suggest this. She would likely suffer some form of scalp wound during a tumble down the stairs. Any large scalp wound would bleed profusely. There would be blood matted in her hair, but if no blood was found around the body, the ME would know that she had not been injured at the dump site.
The lividity pattern would also help. Lividity is the bluish-gray discoloration of a corpse in its dependent areas. If supine, the lividity would appear along the victim’s back. Lividity shifts in the first two or three hours and is fixed by about eight hours. This is a process so it takes time. In between two and eight hours some of it will become fixed in the dependent area that the body first lay in, then more will become fixed in the dependent areas of the body’s new position.
If the ME saw fixed lividity along the back of the body, yet the body is found facedown, he would know that the body was moved six to eight hours or more after death. If he found the discoloration along the back of the body and the body is lying on its back, he couldn’t tell whether the body had been moved or not. Because this position is consistent with the pattern of lividity, it could be that the body was dumped where it was found immediately after death or more than eight hours after death. The pattern would be the same in either case.
If the body was facedown for three or four hours and then was moved and placed on its back, the medical examiner would see partial lividity on the front of the body as well as on the back. Since dead folks don’t move themselves and the lividity pattern suggests that the body lay in two different positions during the first eight hours after death, the ME might conclude that someone moved the body somewhere between two and six hours after death.
So using the lividity pattern the ME might be able to determine whether the corpse had been moved or not and get a general idea as to the timing of the move.
A fracture of the femur that protrudes through the skin is called a compound fracture. If the skin is not broken, it is a simpler fracture yet still potentially deadly. Several quarts of blood can collect in the thigh with absolutely no external bleeding, and this can be enough to push the victim into shock and death. The external signs would be a massively enlarged thigh that would be much larger in diameter than the other one. Simple inspection or employing a tape measure would reveal this difference. The thigh could also show a blue-black discoloration from the blood collecting inside. If a massive amount of blood was found within the thigh at autopsy, the ME could conclude that the fracture and the bleeding were the cause of death.