[gatagato]

An important duty of coroners, medical examiners, and forensic pathologists involve s the identification (ID) of deceased individuals.
While this process does not usually present many difficulties, the consequences of misidentification can be significant and long lasting. The most common mistake involves the inadvertent
misidentification of two bodies as each other. This type of error is most likely to occur in cases of multiple deaths in a single incident, particularly if the deceased individuals are of the same gender and race, with similar ages and sizes. The
possibility of such errors is also increased in busy offices where there are many bodies entering and exiting the facility on a daily basis, particularly if there are not well-established identification
policies and procedures in place.
In many cases investigated by medicolegal death teams, initial inquiries will produce a preliminary or tentative identification.
For example, important circumstantial evidence, such as a driver’s license found in the decedent’s possession, may point toward the identity of the deceased. However, a definitive positive identification is required. This can be established by a variety of means with the most common method being visual identification by family members. Although this is most often utilized, it must be recognized that it is not a scientific method, and major mistakes have been known to occur. In addition, in a number of cases visual identification is not possible. This most often occurs when there has been facial disfigurement from trauma, fires, or putrefaction.
The most reliable methods of identification involve a more scientific approach where a unique feature of the unidentified decedent can be compared to a likely match. This requires that the features of both are compatible, with no significant features
that do not match. Examples of scientific methods of identification include fingerprint comparison, dental comparison and x-ray comparisons, and DNA typing. For each of these methods
(except for DNA typing) an antemortem (prior to death) record must exist and be available for a successful comparison to be made.
If identity cannot be established by any of the above processes, then other features may be useful in helping to make a positive identification. Examples of other features that can be used include the location and appearance of various birthmarks, scars, implanted medical devices, or tattoos. These may all have features that make them unique to a specific individual, for example, a particular tattoo with names and dates of family
members. Finally, the circumstances of the death may provide useful information, for example, a single body in a burnt out house owned by an individual who has not been seen since the
fire. Although this is the least certain method of positive identification, it is sometimes all that is available. In a minority of cases a positive identification will not be able to be made. This situation is more common in large metropolitan
areas among transient or homeless individuals when no one comes forward to identify the decedent despite the body being visually recognizable. This problem is compounded if bodies are badly decomposed or skeletonized, a situation that occurs in rural areas. When the body is not able to be identified, forensic
pathologists will perform the full range of investigations so that if a possible identity is subsequently suggested then all of the
necessary information and material for comparison will be available. Such material includes total body photographs, fingerprints, total body x-rays, dental charts and x-rays, and DNA samples (blood, hair, bone, and teeth). Forensic anthropologic
assessment of skeletonized remains can also provide useful estimates of the age, race, gender, and stature. On occasion, a forensic artist may attempt a clay facial reconstruction over
an unidentified skull, or a computer image of the face may be created, with publishing of such images to the public to find anyone who may recognize the person.


Fig. 1
Bodies recovered from fires may be burnt beyond recognition


Fig. 2
Badly decomposed bodies are typically not visually
identifiable


Fig. 3
Depending on the injury type, severity, and location, persons who are victims of severe trauma may not be visually identifiable. This was the victim of a motor vehicle collision


Fig. 4
Even if a fire victim has not been totally charred, they may be burnt beyond recognition, and so a scientific method of identification should be sought


Fig. 5
For obvious reasons, skeletal remains cannot typically be identified
visually as there has been complete loss of soft tissue features that
determined antemortem morphology


Fig. 6
Another example of severe trauma resulting in facial distortion such that visual identification was impossible
Identification of Human Remains 9 203


Fig. 7
Hospital identification bands are often
considered verification of positive identity


Fig. 8
An ‘‘identification photograph’’ may be
shown to a family member to positively
establish the identity of a decedent


Fig. 9
Many offices routinely take fingerprints on all bodies. This is an example of a ten-print fingerprint card


Fig. 10
Ink being applied to a decedent’s finger at autopsy
Identification of Human Remains 9 205


Fig. 11
A fingerprint being taken from a decedent at autopsy


Fig. 12
In certain decomposition cases, all or a majority of the skin of the hands and fingers may slip off. This image shows a hand without most
of the skin


Fig. 13
The ‘‘degloved’’ portion of skin that slipped off the hand shown in >Fig. 12


Fig. 14
Skin of the fingers and hand being applied as a ‘‘glove’’


Fig. 15
Using a gloved hand, the pathologist or assistant can place his/her own finger inside the decedent’s finger skin and produce a fingerprint
that can be used for identification purposes


Fig. 16
A fingerprint being produced via a degloved finger




Fig. 17 a + b
Above: An antemortem (before death) dental x-ray, received from the decedent’s dentist for comparison purposes.
Below:
A postmortem dental x-ray performed at autopsy. Comparison of this x-ray to the antemortem x-ray allowed positive identification to be
made in this case. Note the unique shapes of the fillings, which appear as radiopaque (white) areas within the teeth



Fig. 18
Besides x-rays, dental charts can be used to make positive identification. This is an example of a dental diagram created at autopsy, for
comparison with antemortem records


Fig. 19
A pattern of marked wearing of the teeth with no dental caries or fillings are characteristic features of tribal Aboriginal Australian
remains excavated from pre-European contact graves


Fig. 20
A closer view of a markedly worn molar tooth from an archaic aboriginal burial in South Australia



Fig. 21
Notching of the front teeth may be a marker of a long-term pipe smoker


Fig. 22
When a body is not viewable for funeral purposes, dental charting and radiography can be made much easier by first cutting away the
skin and soft tissues of the face, thus exposing the underlying teeth. In the example shown, a dental x-ray is being performed


Fig. 23
Another example of a case in which the soft tissues of the face have been removed in order to better visualize the teeth


Fig. 24
A maxilla (upper jaw) that has been cut away from the rest of the skull in order to better visualize, and more easily x-ray, the teeth.
It is vital that the maxilla is clearly labeled once it has been removed from the body. Loss of identifying labels created significant
problems with some of the body identifications during the South-East Asian tsunami



Fig. 25
Despite extensive traumatic disruption, as in this case from a vehicle crash, dental identification may still be possible if fragments of
teeth can be retrieved


Fig. 26
An x-ray being performed on a badly burned body


Fig. 27
Left: A close-up view of an antemortem (before death) neck x-ray, received from a hospital for comparison purposes. Right:
A close-up view of a postmortem neck x-ray corresponding to the antemortem film. Note that the unique shapes of the spinous
processes of the vertebral column in each x-ray are identical, allowing for positive identification


Fig. 28
A skull x-ray, showing the unique shape of the frontal sinuses, which represent radiolucent (darker) air pockets within the skull of the
forehead (arrows)


Fig. 29
Another example of an x-ray of the frontal sinuses revealing a unique shape that can be linked to a particular individual


Fig. 30
The top part of the skull that has been cleaned to show the typical air spaces that may be present in the frontal sinuses enabling
individual identification to be made


Fig. 31
The site of previous fractures with healing may be useful in identification. In this case a poorly healed fracture of the tibia and fibula of
the lower leg would have resulted in shortening of the leg and a history of walking with a limp


Fig. 32
Sometimes underlying diseases of bone may be present, such as Pagets disease where there is prominent thickening of the skull. This
may have resulted in the decedent suffering from deafness


Fig. 33
Skeletal remains from indigenous individuals may show a squatting notch on the lower part of the tibia (arrowheads)


Fig. 34
An x-ray showing orthopedic hardware that was useful in positively
identifying a decedent


Fig. 35
A postmortem hip x-ray in a badly decomposed woman shows the
presence of an artificial hip


Fig. 36
A photograph of the artificial hip removed at autopsy. Many such
implanted devices have unique serial numbers that can be traced,
through the manufacturer, to the individual


Fig. 37
An x-ray at autopsy may reveal orthopedic appliances such as this
knee replacement. Comparison of this x-ray with those taken during
life may assist with identification


Fig. 38
Dissection of the knee shown in the previous >Fig. 37 reveals the metal and plastic implants


Fig. 39
Once the pieces have been cleaned identifying numbers may be found. Although each piece may not have unique identifying number in
every country, the constellation of devices used in one person may be very useful in facilitating identification


Fig. 40
Implanted medical devices, such as this cardiac defibrillator within the upper left chest, can allow for positive identification to occur at
autopsy via unique serial numbers contained on the device and within the medical records


Fig. 41
Sites of previous cranial surgery may be identified on x-ray if there are metal screws or plates. In this case a healed craniotomy incision has been found in a skull at autopsy with a small metal plate


Fig. 42
Another healed craniotomy site identified in
skeletonised remains. This is not a fracture


Fig. 43
Large collections of bones may prove to be very difficult to positively identify. These were recently dug up in Berlin, Germany and date
from the Battle of Berlin at the end of the Second World War (Photograph provided courtesy of Prof Michael Tsokos, Charite´ University
Berlin, Germany)


Fig. 44
Certain individuals may have congenital deformities such as these malformed toes that are a unique identifier


Fig. 45
Some types of injuries may leave subtle markings. The iris in this case has been stained brown in the upper part from a previous
perforating metal foreign body


Fig. 46
Jewelry, such as this watch, can be quite valuable in making a positive identification particularly if it is unique or personalized (inscribed
with the individual’s name); however, it must be recognized that basing a positive identification solely on such jewelry is not considered
scientific

Fig. 47
The rings on these fingers provide useful circumstantial evidence of identity but more scientific methods to establish definitive
identification are required


Fig. 48
Piercing sites can be considered further evidence for a positive identification, but should not be the sole criteria utilized as they are not
unique


Fig. 49
Dentures, such as those shown in the photo, can
be useful in ensuring positive identification.
Caution should be exercised, however, since it is
not unheard of for elderly individuals, particularly
those in extended care facilities and those who
are demented, to use other person’s dentures

[gatagato]

Fig. 50
An intrauterine device found within the uterus at
autopsy can provide an additional piece of
information useful in making a positive
identification


Fig. 51
The history of a recent toe amputation in this
decedent was one of several factors which allowed
positive identification to be made


Fig. 52
A tattoo may represent one of several features of
a body that allows for positive identification


Fig. 53
The implantation of plastic balls under the skin of the penis with the tattoo
of a woman’s name may provide unique identifying information


Fig. 54
Penile implants in conjunction with tattoos are also useful in identification


Fig. 55
Tattoos of eyes over the buttocks are an
unusual design that may assist with
identification


Fig. 56
Tribal tattoos such as the one depicted
here from the South Pacific may indicate
that the decedent came from a particular
cultural or ethnic group


Fig. 57
Tattoos may be extremely rudimentary indicating application at home or in prison. Certain prison groups, such as those from Russia or
the former Soviet Union, may have extensive tattooing providing a history of crimes committed, convictions and subsequent
incarcerations


Fig. 58
Another primitive tattoo


Fig. 59
On occasion, certain body parts such as the umbilicus may be incorporated into a tattoo design


Fig. 60
Modern fine line tattoos may be extremely sophisticated


Fig. 61
Extensive whole body tattoos are found in certain criminal groups such as the yakuza from Japan


Fig. 62
Tattoos may survive incineration and may also be demonstrated more clearly in an area of burns if the superficial skin layers are removed


Fig. 63
Humorous tattoos tend to be individualized


Fig. 64
To assist in positioning radiotherapy
beams for the treatment of cancer small
dots may be tattooed onto the skin over
the tumor. In this case the tracheostomy
indicates that there was a cancer of the
larynx that was surgically removed. The
arrows point to radiotherapy tattoos


Fig. 65
Identifying scars may be revealed more
clearly in decomposed bodies if the
surface layer of skin is removed


Fig. 66
Scarification in individuals from Africa may be very useful in identifying the specific tribal group that the decedent belonged to.
Symmetrical designs can be seen around the umbilicus and upper abdomen


Fig. 67
Tribal scarification of the flank


Fig. 68
‘‘Sorry’’ scars on the shoulder and upper arm of an Australian Aboriginal male that were inflicted as part of traditional mourning
ceremonies


Fig. 69
Subincision of the penis is another marking that may be used to identify a traditional Australian Aboriginal male


Fig. 70
Occasionally, skeletonized remains are examined at a medioclegal
death investigation office, but there is absolutely no indication of
the identity of the decedent, either by body exam or scene/
circumstance. After forensic anthropologic examination to
characterize the race/ethnicity, gender, and approximate age of the
individual, the forensic pathologist may choose to send the skull to
a forensic artist, who then attempts to reconstruct the facial features
of the decedent (see >Fig. 71)


Fig. 71
A forensic artist’s facial reconstruction over the skull shown in >Fig. 70. A photo such as this can be published, with the hope
that someone might recognize the person. If someone believes that
the decedent might be a particular person, then scientific methods
for identity can be undertaken


Fig. 72
In mass disasters all types of identification methods may be utilized. Here, a large number of putrefying bodies have been brought in for
identification following the 2004 Boxing Day Tsunami in Thailand


Source: The Atlas of Forensic Pathology for Police, Forensic Scientists, Attorneys and Death Investigators (2012)


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[Faline]

Excellent pics and info GG. Bookmarked this

[Bastet]

Great self-education material

[durt]

thank goodness for teeth, the maggots can't eat them

Great post Gustavo

[Cumulonimbus]

Outstanding, gatogato! Excellent information

[flutter mouse]

amazing pics gatagato!!!

[Spiffyfable]

Neato!

Thank You

[denmetal80]

best post since awhile!! good work

[Bluegill]

Fucking brilliant thread GG, you never cease to amaze.