More examples in Healthcare/Medical Examination Reports
Medical Examination for a Gunshot Example
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GUNSHOT NAME OF DECEDENT: This form is to be completed in addition to the ROD form in these guidelines THE DECEDENT IF POSSIBLE TO DETERMINE, AND WITHOUT TAMPERING WITH EVIDENCE, INDICATE FROM
EXTERNAL EXAMINATION, HOW MANY DEFECTS ARE VISIBLE ON THE BODY AND WHERE THEY
ARE LOCATED: REPEAT FOR ALL DEFECTS: THE FOLLOWING ARTIFACT IS/ARE PRESENT ON THE FOLLOWING DEFECT(S) - (IF DECEDENT IS STILL CLOTHED, INDICATE WHAT ARTIFACT, IF ANY, IS FOUND ON THE CLOTHING AT EACH DEFECT AS WELL) : LOCATION OF DEFECT: ABRASION RING: MUZZLE IMPRINT: STELLATE TEAR: STIPPLING: DIAMETER MEASURES SOOT DEPOSIT: DIAMETER MEASURES OTHER ARTIFACT: ARTIFACT ON CLOTHING AT THIS DEFECT SITE? IS THERE ANY EVIDENCE OF A SHORED EXIT? IF EXIT IS IDENTIFIED, WHERE WAS MISSILE LOCATED WITH REFERENCE TO THE BODY? IF NO EXIT, CAN A BULLET BE PALPATED NEAR THE SURFACE OF THE SKIN (PERFORM THIS
EXAMINATION GENTLY SO THAT NOTHING IS ALTERED)? (SOMETIMES IT MAY BE NECESSARY TO HAVE THE BODY X -RAYED TO DETERMINE IF A BULLET IS STILL INSIDE THE BODY. THIS MAY BE REQUIRED TO INSURE THAT THE SCENE CAN BE RELEASED OR WHETHER MORE INVESTIGATION IS CALLED FOR - CONTACT THE CENTRAL OFFICE.)
(OMI MUST HAVE ACCESS TO THE CLOTHING AS EACH PIECE OF CLOTHING MAY CONTAIN EVIDENCE NECESSARY FOR EXAMINATION AT AUTOPSY - INSURE THAT CLOTHING IS SECURED AND ACCOMPANIES BODY TO OMI .) FIREARM DESCRIPTION: MAKE: MODEL: CALIBER: SERIAL NUMBER: COLOR: ACTION: LENGTH OF BARREL: ADDITIONAL DESCRIPTION: AMMUNITION DESCRIPTION: TYPE OF AMMUNITION: TOTAL NUMBER OF UNFIRED CARTRIDGES: TOTAL NUMBER OF FIRED CARTRIDGE CASINGS: TOTAL NUMBER OF MISFIRED CARTRIDGES: RUSSIAN ROULETTE IF OTHERS WERE PRESENT, WHAT IS THEIR ACCOUNT OF THE INCIDENT: CLEANING THE WEAPON WHAT EVIDENCE IS AVAILABLE THAT SUGGESTS DECEDENT WAS CLEANING THE WEAPON? WHAT EXPERIENCE DID DECEDENT HAVE CLEANING THIS WEAPON? IF ALLEGATION HAS BEEN MADE THAT DECEDENT WAS MOVING THE WEAPON WHEN IT WENT
OFF, DESCRIBE ACTIVITY DECEDENT WAS INVOLVED IN AND CHECK IF CONSISTENT WITH THE
INJURY: WHAT EXPERIENCE DID THE DECEDENT HAVE WITH WEAPONS IN GENERAL? NAME OF INVESTIGATOR DMI# LEGEND U=UNFIRED CARTRIDGE - D=FIRED (DISCHARGED) CARTRIDGE CASING M=MISFIRED CARTRIDGE - E=EMPTY CHAMBERS - X=CHAMBER UNDER HAMMER 6-SHOT REVOLVER DIRECTION OF ROTATION OF CYLINDER CLOCKWISE COUNTERCLOCKWISE INDICATE CHAMBER CONTENTS: OTHER REVOLVER: DIRECTION OF ROTATION OF CYLINDER: CLOCKWISE COUNTERCLOCKWISE INDICATE CHAMBERS PRESENT: INDICATE CHAMBER CONTENTS: SEMI-AUTOMATIC PISTOL: NUMBER OF CARTRIDGES IN THE MAGAZINE: HOW MANY EXPENDED CASINGS WERE FOUND AT THE SCENE? SHOTGUN (EMPTY SHELLS FOUND: WHO OWNS THE WEAPON (NAME/CONTACT NUMBERS): WHERE IS THE WEAPON USUALLY KEPT? WHO HAS ACCESS TO THE WEAPON AND HOW? IF THE WEAPON WAS REMOVED FROM ON OR ABOUT THE DECEDENT, WHERE WAS ITS EXACT
LOCATION, WHO MOVED THE WEAPON, AND WHY? IF THE WEAPON W AS NOT TAMPERED WITH, WHAT IS ITS LOCATION WITH REFERENCE TO THE
DECEDENT? IS THERE ANY ARTIFACT ON THE GUN (ESPECIALLY AT THE MUZZLE) (EX. HAIR, BLOOD, BRAIN
MATTER, ETC.) DESCRIBE: IS THERE ANY PARAPHERNALIA ON THE WEAPON (EX. STRING, ROPE, WIRE, ETC.): IS THERE ANY REASON FOR THIS PARAPHERNALIA TO BE ON THE WEAPON? IF AN APPARATUS WAS CONSTRUCTED TO FIRE THE WEAPON FROM A DISTANCE, DESCRIBE THE
APPARATUS IN DETAIL USING DIAGRAMS & PHOTOGRAPH THE ARRANGEMENT: IS THERE ANY INDICATION THAT THE MISSILE (BULLET) WENT THROUGH ANOTHER OBJECT
PRIOR TO STRIKING THE DECEDENT (EX. PILLOW, BLANKET, ETC.)? (BE SURE TO PHOTOGRAPH INTERMEDIATE OBJECTS OR TAKE MOVEABLE EVIDENCE INTO CUSTODY FOR EXAMINATION AND PHOTOGRAPHY BY EITHER LAW ENFORCEMENT OR OMI) WHICH LAW ENFORCEMENT AGENCY IS TAKING CUSTODY OF THE WEAPON (NAME/CONTACT) THE SCENE DESCRIBE THE SCENE GENERALLY ARE THERE ANY BLOOD STAINS ON THE CLOTHING, DESCRIBE: ARE THERE ANY BLOOD STAINS ON THE VICTIM, DESCRIBE: ARE THERE ANY BLOOD STAINS OR PATTERNS ANYWHERE AROUND THE DECEDENT? IF A RIFLE IS USED, MEASURE: THE LENGTH FROM THE DECEDENT'S ARMPIT TO HIS/HER FINGERTIPS: INCHES THE LENGTH OF THE BARREL: INCHES IF THE DECEDENT IS FOUND OUTDOORS, HOW ACCESSIBLE IS THE AREA WHERE THE DECEDENT
IS FOUND TO OTHERS? IF THE INCIDENT WAS WITNESSED, WHO WAS PRESENT AND IS THEIR INFORMATION
CONSISTENT WITH THE SCENE AND THE ARTIFACT ON THE BODY (NAME/CONTACT):
EXTERNAL EXAMINATION, HOW MANY DEFECTS ARE VISIBLE ON THE BODY AND WHERE THEY
ARE LOCATED: REPEAT FOR ALL DEFECTS: THE FOLLOWING ARTIFACT IS/ARE PRESENT ON THE FOLLOWING DEFECT(S) - (IF DECEDENT IS STILL CLOTHED, INDICATE WHAT ARTIFACT, IF ANY, IS FOUND ON THE CLOTHING AT EACH DEFECT AS WELL) : LOCATION OF DEFECT: ABRASION RING: MUZZLE IMPRINT: STELLATE TEAR: STIPPLING: DIAMETER MEASURES SOOT DEPOSIT: DIAMETER MEASURES OTHER ARTIFACT: ARTIFACT ON CLOTHING AT THIS DEFECT SITE? IS THERE ANY EVIDENCE OF A SHORED EXIT? IF EXIT IS IDENTIFIED, WHERE WAS MISSILE LOCATED WITH REFERENCE TO THE BODY? IF NO EXIT, CAN A BULLET BE PALPATED NEAR THE SURFACE OF THE SKIN (PERFORM THIS
EXAMINATION GENTLY SO THAT NOTHING IS ALTERED)? (SOMETIMES IT MAY BE NECESSARY TO HAVE THE BODY X -RAYED TO DETERMINE IF A BULLET IS STILL INSIDE THE BODY. THIS MAY BE REQUIRED TO INSURE THAT THE SCENE CAN BE RELEASED OR WHETHER MORE INVESTIGATION IS CALLED FOR - CONTACT THE CENTRAL OFFICE.)
(OMI MUST HAVE ACCESS TO THE CLOTHING AS EACH PIECE OF CLOTHING MAY CONTAIN EVIDENCE NECESSARY FOR EXAMINATION AT AUTOPSY - INSURE THAT CLOTHING IS SECURED AND ACCOMPANIES BODY TO OMI .) FIREARM DESCRIPTION: MAKE: MODEL: CALIBER: SERIAL NUMBER: COLOR: ACTION: LENGTH OF BARREL: ADDITIONAL DESCRIPTION: AMMUNITION DESCRIPTION: TYPE OF AMMUNITION: TOTAL NUMBER OF UNFIRED CARTRIDGES: TOTAL NUMBER OF FIRED CARTRIDGE CASINGS: TOTAL NUMBER OF MISFIRED CARTRIDGES: RUSSIAN ROULETTE IF OTHERS WERE PRESENT, WHAT IS THEIR ACCOUNT OF THE INCIDENT: CLEANING THE WEAPON WHAT EVIDENCE IS AVAILABLE THAT SUGGESTS DECEDENT WAS CLEANING THE WEAPON? WHAT EXPERIENCE DID DECEDENT HAVE CLEANING THIS WEAPON? IF ALLEGATION HAS BEEN MADE THAT DECEDENT WAS MOVING THE WEAPON WHEN IT WENT
OFF, DESCRIBE ACTIVITY DECEDENT WAS INVOLVED IN AND CHECK IF CONSISTENT WITH THE
INJURY: WHAT EXPERIENCE DID THE DECEDENT HAVE WITH WEAPONS IN GENERAL? NAME OF INVESTIGATOR DMI# LEGEND U=UNFIRED CARTRIDGE - D=FIRED (DISCHARGED) CARTRIDGE CASING M=MISFIRED CARTRIDGE - E=EMPTY CHAMBERS - X=CHAMBER UNDER HAMMER 6-SHOT REVOLVER DIRECTION OF ROTATION OF CYLINDER CLOCKWISE COUNTERCLOCKWISE INDICATE CHAMBER CONTENTS: OTHER REVOLVER: DIRECTION OF ROTATION OF CYLINDER: CLOCKWISE COUNTERCLOCKWISE INDICATE CHAMBERS PRESENT: INDICATE CHAMBER CONTENTS: SEMI-AUTOMATIC PISTOL: NUMBER OF CARTRIDGES IN THE MAGAZINE: HOW MANY EXPENDED CASINGS WERE FOUND AT THE SCENE? SHOTGUN (EMPTY SHELLS FOUND: WHO OWNS THE WEAPON (NAME/CONTACT NUMBERS): WHERE IS THE WEAPON USUALLY KEPT? WHO HAS ACCESS TO THE WEAPON AND HOW? IF THE WEAPON WAS REMOVED FROM ON OR ABOUT THE DECEDENT, WHERE WAS ITS EXACT
LOCATION, WHO MOVED THE WEAPON, AND WHY? IF THE WEAPON W AS NOT TAMPERED WITH, WHAT IS ITS LOCATION WITH REFERENCE TO THE
DECEDENT? IS THERE ANY ARTIFACT ON THE GUN (ESPECIALLY AT THE MUZZLE) (EX. HAIR, BLOOD, BRAIN
MATTER, ETC.) DESCRIBE: IS THERE ANY PARAPHERNALIA ON THE WEAPON (EX. STRING, ROPE, WIRE, ETC.): IS THERE ANY REASON FOR THIS PARAPHERNALIA TO BE ON THE WEAPON? IF AN APPARATUS WAS CONSTRUCTED TO FIRE THE WEAPON FROM A DISTANCE, DESCRIBE THE
APPARATUS IN DETAIL USING DIAGRAMS & PHOTOGRAPH THE ARRANGEMENT: IS THERE ANY INDICATION THAT THE MISSILE (BULLET) WENT THROUGH ANOTHER OBJECT
PRIOR TO STRIKING THE DECEDENT (EX. PILLOW, BLANKET, ETC.)? (BE SURE TO PHOTOGRAPH INTERMEDIATE OBJECTS OR TAKE MOVEABLE EVIDENCE INTO CUSTODY FOR EXAMINATION AND PHOTOGRAPHY BY EITHER LAW ENFORCEMENT OR OMI) WHICH LAW ENFORCEMENT AGENCY IS TAKING CUSTODY OF THE WEAPON (NAME/CONTACT) THE SCENE DESCRIBE THE SCENE GENERALLY ARE THERE ANY BLOOD STAINS ON THE CLOTHING, DESCRIBE: ARE THERE ANY BLOOD STAINS ON THE VICTIM, DESCRIBE: ARE THERE ANY BLOOD STAINS OR PATTERNS ANYWHERE AROUND THE DECEDENT? IF A RIFLE IS USED, MEASURE: THE LENGTH FROM THE DECEDENT'S ARMPIT TO HIS/HER FINGERTIPS: INCHES THE LENGTH OF THE BARREL: INCHES IF THE DECEDENT IS FOUND OUTDOORS, HOW ACCESSIBLE IS THE AREA WHERE THE DECEDENT
IS FOUND TO OTHERS? IF THE INCIDENT WAS WITNESSED, WHO WAS PRESENT AND IS THEIR INFORMATION
CONSISTENT WITH THE SCENE AND THE ARTIFACT ON THE BODY (NAME/CONTACT):