Introduction
A medicolegal autopsy is a challenge for an autopsy surgeon. Often, we encounter a case reported as an accident or suicide, which later is tried as a homicide following the postmortem examination. Drowning is a form of violent asphyxial death, caused by aspiration of fluid into air passages, caused by complete or partial submersion in water or other fluids.1 Significant number of water-related deaths are attributed to accidental drowning, while a smaller but still significant number represent suicidal or homicidal drowning. Even if there is a presumption that all water-related deaths are accidental drownings, other possibilities must be considered in the investigation of these types of deaths, as drowning as a cause of death is a diagnosis based on the exclusion of other potential causes.2 The case has been reported considering its unusual presentation.
Case report
The dead body of a 51-year-old male, which was recovered from a river (Figure 1, Figure 2), and initially suspected to be a case of drowning, was brought for autopsy in our centre. As per the history given by the police, the deceased, a drunkard, had been missing for around 3 days, when his body was recovered from a nearby river. The family members assumed the death was due to drowning and took the body for cremation where they observed that the head of the deceased had injuries and it appeared deformed. Suspecting homicide, they informed the police for further investigation. The body was brought to our centre for medicolegal autopsy. On examination, the body as well as the wearing apparels were wet and mud stained. Rigor mortis and postmortem staining had merged with early signs of putrefaction. No signs of asphyxia and no froth were evident. The head and face were visibly deformed and flattened with collapsed orbits (Figure 3). An abraded contusion was visible on the right side of the face. The scalp was lacerated on the left side of the head with crushed open fractures of the skull bones extending into all the cranial fossae, and the brain matter was absent. All the facial bones including the mandible were fractured resulting in lacerations of the mouth and tongue with multiple missing teeth (Figure 3).
Internal findings included fractures of multiple ribs anterolaterally on both sides. Both the lungs were lacerated with around 1000ml of blood in the thoracic cavity. The stomach contained about 50ml of brownish fluid with spirituous odour. However, toxicological analysis showed no evidence of poison or intoxicants.
From the findings, it appeared that the victim was run over by a heavy vehicle. The corroborative evidence from the scene of crime and report of the crime scene investigators were taken into account. It came to light that the place where the body was found was frequented by trucks for illegal stone mining. On reconstruction of the incident, it was evident that, the victim might have been run over by a truck while walking on the riverbank on the fateful day. Fearing discovery, the occupants of the vehicle/truck might have dumped the body in the river. The crime scene, circumstantial evidence and a meticulous autopsy helped us form an opinion as to the events leading to the death and assist the police in the right direction of investigation.
Discussion
Approximately 1.3 million people die each year as a result of road traffic crashes (World Health Statistics 2020). More than half of road traffic deaths are among the vulnerable road users: pedestrians, cyclists and motorcyclists. According to the National Crime Record Bureau (2020), the number of vehicular accidents accounted for 39.9% of all accidental deaths due to unnatural causes.3
Figure 3
Fracture of the skull and facial bones including the mandible resulting in lacerations of the mouth and tongue with multiple missing teeth.
Corpse disposal, dismemberment & evisceration of corpses are common acts after crime. If the body of crime is disposed of, it is difficult for the police and prosecuting attorney to prove the offense. It is known from extensive range of literature that the most frequent disposal method is the dumping of bodies or body parts in water.4
Schneikert5 determined a wide range of offender’s consideration and accuracy regarding dumping into three grades. Grade 1 included removing from the site of crime, covering the body with wood, leaves or throwing in water. Grade 2 included e.g. deep burying, dumping in water with weight. Grade 3 contained disposing and garbling of the body e.g. dismemberment, immuring, combusting.
The concealment of the body sometimes prevents determination of the cause and manner of death. Such cases mostly involve the dismemberment of individual body parts.6, 7 In a study conducted by De Matteis et al. on “homicide with corpse disposal” methods, the cause of death in 40% of the cases were attributed to head trauma.8
The act of dumping the body in the river itself indicates the particular effort invested by the offender in trying to make the investigation difficult and shows that the offender’s capacity to the act is not diminished.9 However, further investigation by the investigating agencies is recommended to establish whether it was a premeditated act or an accidental run over followed by disposal of the body in water.
Conclusion
Whenever a body is found in water, a proper inquest to exclude the possibility of foul play is important. Framing correctly the cause and manner of death is a challenge for an autopsy surgeon particularly in cases where the crime has been concealed by the perpetrators. In the absence of eye-witnesses, crime scene examination along with meticulous autopsy and the knowledge of common methods of concealment of crime are some factors which may contribute in establishing the cause and manner of death.
