Water-Related Death Investigation

Practical Methods and Forensic Applications

Kevin L. Erskine, Erica J. Armstrong

• Publisher: CRC Press
• Year: 2021
• ISBN:
  9781000379549
• Edition: 2
• Topic: Medicine
• Subtopic: Pathology

Nearly ten years after the first edition of Water-Related Death Investigation: Practical Methods and Forensic Applications, water death cases continue to be improperly investigated. The pathologist's report can determine the cause of death as a drowning, but the manner of death is the most challenging to prove. The report will not determine if a victim jumped into the water to commit suicide, fell into the water accidentally, or was pushed in as a homicidal act. Many drowning cases do not reflect injury to the body, so evidence collected at the scene plays a vital role.

The importance of an on-scene body assessment cannot be overemphasized. Often, the body evidence begins to change rapidly upon recovery and may not be present during an autopsy. Written statements on the scene are an effective tool to use to determine the accuracy of information given to arriving officers. These statements need to be written by the witnesses themselves as well as the reporting person. The "Show Me" technique can also help reveal discrepancies in a person's version of what occurred as well as aid in providing the most details to an incident as is humanly possible.

This second edition includes updated information on the latest technology to assist water death investigators. Parabon Snapshot can help determine the faceless identity of skeletal remains and help locate potential suspects using the science of DNA. Drones can aid in locating missing persons as well as human remains, even months after death. Updated information is provided regarding fingerprints from submerged objects, and Carbon-14 can help determine the origin of a found corpse.

Key Features:

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• Thoroughly reviews the physiological aspects of drowning

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• Reveals the investigative characteristics inherent to various scenes of water-related deaths

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• Highlights certain "red flag" indicators that may point to foul play or scene staging

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• Outlines autopsy protocols, trial preparation, and expert witness testimony

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• Provides numerous case studies and numerous illustrations to further clarify key points presented in the text

Coauthored by a Master Water Death Investigator and an experienced forensic pathologist, Water-Related Death Investigation: Practical Methods and Forensic Applications, Second Edition merges the essentials of evidence collection and field investigation with autopsy best practices and laboratory testing. It will continue to serve as a valuable resource for the various professionals involved in these cases.

1 Introduction

Erica J. Armstrong

Drowning: A Diagnosis of Exclusion

Deaths due to drowning and other water-related deaths remain both a local and worldwide problem with far-reaching human and economic consequences, prompting ongoing data collection, analysis, and research. A number of task forces made up of experts involved in water safety from around the world were established in 1997 in order to define recommendations and reduce the number of drowning victims and improve the outcome of casualties. These recommendations were discussed during a number of meetings held at the World Congress on Drowning in Amsterdam in 2002. A definition of drowning has been adopted and recommended for widespread use by the World Congress on Drowning, which defines drowning as “the process of experiencing respiratory impairment from submersion/immersion in liquid.”¹ Merriam Webster’s Collegiate Dictionary describes “to drown” in part as “to suffocate by submersion, esp. in water.”² Dorland’s Illustrated Medical Dictionary defines “drowning” as “suffocation and death resulting from filling of the lungs with water or other substance or fluid, so that gas exchange becomes impossible.”³ Drowning does not always end in fatality and can be non-fatal whereby the victim is resuscitated and recovers but may suffer medical complications as a result of lung damage, also known as secondary drowning.³ Forensic pathologists, who are involved in the determination of cause and manner of death, generally define drowning as an asphyxial death in which the body is deprived of oxygen as a result of impairment of oxygen exchange ultimately within the lungs after partial or complete submersion in a liquid, usually water, with subsequent inhalation of some quantity of the liquid deep into the airways of the lungs. Partial or complete submersion specifically involves partial or complete coverage of the external airways (nose and mouth). All of the above definitions have in common that drowning involves a compromise of respiratory function that if prolonged, can result in irreversible neurological and organ injury or death. Death may occur acutely within minutes and upward of 24 hours after submersion, or may be delayed beyond 24 hours, in which the victim can develop a number of medical complications arising from direct lung injury by the inhaled fluid or water or oxygen deprivation. This delayed death is also referred to as near drowning by forensic pathologists while the World Congress on Drowning uses the terminology to refer to victims who survive the drowning event. Forensic pathologists consider the determination of death due to drowning as a diagnosis made by the exclusion of other potential causes of death by the performance of a complete autopsy with a review of medical records, test results, and all investigative and scene information. While there are a number of autopsy findings supportive of drowning, there is no one definitive test or autopsy finding that can absolutely unequivocally define drowning, and not all individuals recovered from a body of water can be presumed to have drowned.

Bodies recovered from water are often prematurely labeled as accidental drownings; however, a significant number of drownings and other water-related deaths occur as a result of natural disease or by homicidal, suicidal, or undetermined means. For those who are involved in the investigation of drowning deaths, this is important to recognize in order to maintain an open mind and not overlook clues that may indicate circumstances other than accidental. The cause of death of an individual recovered from a body of water may actually be as a result of natural diseases, such as heart disease that causes collapse and death prior to, upon, or during submersion (i.e., while swimming). While the scene investigation suggests that the individual has accidentally drowned, the autopsy findings may show complete blockage of a coronary artery with damage to the heart muscle supplied by that blocked artery, with very little or lack of supportive findings of drowning. More importantly, while the scene where an individual recovered from a body of water may appear accidental in nature, the individual may have expired prior to submersion or upon submersion from injury or intoxication by illicit drugs or prescription medications. Accidental injury prior to or upon submersion (i.e., impact on rocks or impact with the bottom of a pool) may alone result in death or contribute to drowning. In other words, the individual is made more susceptible to drowning with the addition of an incapacitating injury.

Fatal drowning may occur passively after an attempted revival by immersion in cold bathwater of an individual who is suspected to have taken an overdose of illicit drugs or prescription medications. Death may also result from the overdose or intoxication alone, just prior to passive submersion from slumping over or collapsing into the body of water. In this case, the performance of comprehensive toxicological testing in addition to a complete autopsy and review of all investigative information is essential for the proper determination of the cause of death and the manner in which the death came to be (i.e., accidental manner of death solely by an acute overdose/intoxication or by drowning during or as result of an overdose/intoxication). Because the autopsy findings of drowning and overdose are often similar, it may be difficult to clearly identify which was actually the cause of death.

In some cases, the determination of drowning as the cause of death is certain; however, the manner in which the death came to be is uncertain or cannot be determined. Take, for example, an individual with a debilitating neurological disorder such as multiple sclerosis who had prior to her untimely death voiced to an acquaintance her frustration and sadness with coping with her worsening condition. She was found submerged in 3 feet of debris-filled water near the shoreline of a lake in the late spring. She was accompanied by her acquaintance, who did not witness the event, reportedly due to being turned away from her during the moments leading up to submersion. There are no other witnesses. Her walking cane, which she always used by necessity, is not recovered and is otherwise not found. Autopsy findings are supportive of drowning and specific for multiple sclerosis. There are no other significant injuries, including injuries consistent with homicidal violence. Results of toxicological testing are noncontributory. The cause of death, defined as the injury or disease leading to death, most probably is drowning. The difficulty for the forensic pathologist, in this case, is in determining how the death came to be—the manner of death. Did the acquaintance push her in, leaving no marks of injury? Did she bid “farewell” and simply just walk over the edge of the pier into the lake as the acquaintance tried to restrain her from taking her life? Did she venture too close to the edge and, because of the unsteadiness caused by her illness, slip and fall in? When there is insufficient information to allow for the categorization into one of the four main categories for the manner of death (natural, accident, suicide, or homicide), the death is ruled as “undetermined” and the cause and manner of death are entered onto the death certificate. Should additional information or evidence arise at a later time (i.e., a confession from the acquaintance that after a heated argument he took her cane from her and pushed her in), the death certificate may be amended with a change in the categorization for the manner of death (i.e., from “undetermined” to “homicide”).

Identification of any body recovered from a body of water such as a lake, river, or ocean is of primary importance. The determination as to whether badly decomposed remains, whole or partial, are even human may be the first task to complete, and the condition of those remains could potentially preclude subsequent identification. Nevertheless, knowledge of the decedent’s identity may not only assist the investigator in uncovering the circumstances surrounding the death, but also bring to light information about the decedent’s medical and psychiatric history, lifestyle, and swimming ability. Knowledge of medical and psychiatric history may be the key to deciding whether natural disease or death by suicide precipitated by a psychiatric condition played a part. Without this information, and with a lack of definitive autopsy findings supportive of drowning or another cause of death, the determination as to the cause and manner of death may both be designated as undetermined. In one previous study, it was found that among the unidentified individuals in a series of 123 drowning deaths, 97% were certified as undetermined manner of death, compared to 25% in the identified group. Of the unidentified deaths without mechanical trauma, 30% were certified with an undetermined cause of death compared to only 5% in the identified group.⁴

Individuals recovered from water cannot automatically be presumed to have drowned accidentally. Individuals killed by other means, such as strangulation, sharp force injury, or blunt force injury, may be disposed of in water in the hopes that the body may not be recovered or recovered only after the onset of extensive decomposition, rendering identification and the determination of the cause of death difficult or impossible. In the case of an individual who cannot be readily identified, the most important task for both the investigator and the forensic pathologist obviously is to establish the identity. Identification can not only facilitate the investigation into the circumstances surrounding the death, but can also serve the purposes of providing notification to the family and the proper certification of death for the correct individual. Collection and preservation of evidence with the performance of a complete autopsy should quickly commence and are essential pieces of the puzzle within the whole realm of investigation of water-related deaths, particularly those of suspicious nature. Moreover, an individual may have been killed and then placed into a body of water to make it appear as if he or she drowned, with the addition of an elaborate or inconsistent story told by the perpetrator(s) or accomplice(s) as to how the decedent “accidentally” drowned: the so-called staged drowning. The autopsy may disclose recent injury in a pattern consistent with suffocation, strangulation, and other homicidal blunt and sharp force injuries inflicted prior to submersion. Homicidal violence must also be considered, particularly in suspicious drownings involving not only adults, but the more vulnerable members of our society, namely infants, children, the physically disabled, and the elderly.

The investigation of bodies found in water requires the coordinated efforts of law enforcement, medicolegal death investigators, forensic pathologists, forensic scientists, and other ancillary scientific experts. The most accurate determination of the cause and manner of death will follow the review and correlation of all available investigative and autopsy information. As previously stated, not all bodies recovered from water can be presumed to have drowned, for a variety of important reasons, which need to be considered by all involved in this type of death investigation. The forensic pathologist knows that an autopsy alone may not provide all of the answers, including the cause of death. Furthermore, when death due to accidental drowning is strongly favored, one must consider whether or not certain human and environmental factors could have predisposed an individual to drowning. The late Dr. Joseph H. Davis, a well-known forensic pathologist a...