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Court medical expert

Forensic expert - a specialist with a medical background, helping to investigate crimes within their competence.

The history of forensic medicine is rooted in tsarist Russia. Under Peter the Great, "knowledgeable persons" were involved in order to investigate the scene of the incident. The responsibility of "knowledgeable persons" for non-appearance without a good reason under the law of 1864 was limited to a fine. Then at the disposal of police doctors there were no morgues and laboratories, but the corresponding departments began to appear in the universities.

Who is a forensic expert?

Forensic medical examination - the practice of forensic medicine. Forensic medical examination is closely related to other branches of medicine: hygiene, bacteriology, biochemistry.

Sometimes criminologists can not do without knowledge of law. And then they come to the aid of specialists from other branches of science and crafts. The forensic expert determines the weapon of murder and the cause of death. First conducts an external examination of the corpse. During this stage, the number and nature of damage, their shape is established.

The main part of the report contains the results of sectional and additional studies. In conclusion, a forensic expert writes out a death certificate stating the cause of death.

When should I go to a forensic medical expert?

A forensic expert may be needed after the rape, to assess the degree of loss of labor after the infliction of bodily harm. Not only biological fluids are sent to the study, but also clothing with stains of saliva, urine, rust, and earth. Of particular value is inspection of clothing when firing, clothing remains flame and soot, traces of which on the wound itself may not be. Clothing is a valuable piece of evidence. After an accident on the clothes remain lubricants and sand, traces of protectors.

The forensic medical expert determines whether it was possible to inflict such damage on the alleged weapon (tool), and what mechanism was involved in the damage. The mutual disposition of the victim and the one who attacked is also determined. Forensic medical examination establishes the diseases that he already had before the commission of the violent actions, the limitation of the damage, determines the species belonging to the hair, blood, sperm found at the crime scene.

The forensic medical expert determines the victim's death, the mental state of the accused in the commission of the unlawful act, the mental state of the victim, and whether he can give evidence.

Forensic medical examination can be conducted only by doctors. The defendant in the case, the victim, the relative of the victim, the investigator, the accused, the investigator or the defense counsel can not act as an expert. In this case, he must give himself up or be forcibly removed from the case.

If an expert is appointed during the trial process, he can either confirm the conclusion that he was given before the trial, during the investigation by himself, or by another expert, or refute it, to make his edits.

Let's talk a little about the medical ethics of the expert. The work of a forensic expert assumes constant interaction with law enforcement officers. He daily communicates with victims, relatives of victims at the most tragic moments, deals with such damages that the doctor does not see every specialty every day, with murders, suicides and rapes. And in all this situation, the forensic medical expert is obliged to keep a cool and rational approach. During the trial, the forensic expert may change his opinion on the basis of newly discovered materials, facts, new circumstances, testimonies and evidence. Responds to criticism expert politely and convincingly, that is, for this profession, high moral qualities are very important.

An expert may be present at the following investigative measures: examination of the place of the incident, examination, seizure and inspection of objects.

The specialist participating in the case has the right to save wages at the place of work, or to remuneration.

The expert carefully examines the medical documentation, complaints, protocols of interrogation and examination of the crime scene, confrontation rates, LCC meetings.

If an expert commission conducts the examination, after analysis of all documentary and other materials, a meeting is held where each of the experts acquaints the other members of the commission with their conclusions. The expert may take the initiative and note his observations on the case. The answers to the questions of the investigation or the court must be specific and have an unambiguous interpretation, the answers should not contain terms that are not understandable to a person without medical education. If you can not do without them, they should be explained.

What tests do you need to pass to a forensic expert?

The forensic expert is guided in his work by the results of instrumental and laboratory studies: radiography, echography, microscopy, bacteriological studies, radiometric, angiographic studies, tomography, skin, sperm and hair studies.

Since the beginning of the 21st century, magnetic resonance imaging and computed tomography have been used universally to solve various medical diagnostic problems. Let's consider how CT helps to clarify the etiology of a person's injuries while conducting FMS, as the person suffers from trauma most often, especially deliberately inflicted on domestic soil.

Damage to craniofacial bones is a direct threat to health and life, since all the holes in the skull have a message directly to the brain. The problem of craniocerebral trauma went beyond the medical field and became socio-economic. Patients with TBI have to undergo prolonged treatment, which affects the economy due to the fact that they are people of the most efficient age, most often 25-40 years old and male.

The bones of the face are very complex, so their damage can be very diverse. Also the cause of the diagnostic difficulties is in the variety of forms of tools for causing injuries.

A group of scientists examined 25 people with craniocerebral trauma in the radiation diagnosis department of the Regional Clinical Hospital in Kharkov. In the study of the nasal cavity, the method fully justified itself: in 5-10 minutes it was possible to completely visualize bone fragments, nasal septum and soft tissue injuries, to detect changes in thin bone structures, and on invisible X-rays. Excellent detectable with CT also hematomas and small foreign objects. The problem often also lies in the fact that the x-ray does not show the fractures of the cheekbones. In this case, CT has a special diagnostic value. Among these 25 people, there were cases of combined trauma, for example, depressed by a fracture of the upper jaw and a fracture of the nose bones with detachment of the cartilage.

CT is 40 times more sensitive than X-ray. At least 10 slices are done. CT is an expensive, but maximally informative, study for craniocerebral trauma.

The methods of research are at the disposal of a forensic expert: histological, radiographic, photographic, and investigational.

Widely used methods are typical of many sciences: as we know, science can not exist without observation, calculation and modeling. And medical science uses methods that are peculiar only to it: morphological, clinical and physico-optical. Mathematical and statistical methods are used.

How to verify the veracity of the conclusion you receive? Each thesis should be argued, the arguments should not contradict each other - in short, an expert opinion should be drawn up in compliance with the rules of formal logic.

What does a forensic expert do?

Forensic medical examination is a study on issues related to medicine that arise with the investigator or the court.

Recently, the number of injuries to the craniofacial area has increased. They often cause complications and permanent disability. Among the injuries with sharp objects, cut wounds inflicted with knife and beating prevail. Fracture of the fixed upper jaw is usually combined with fractures of the malar bone. Such injuries have especially severe consequences, if there have already been traumas of the face or head injuries. The description of the shape of the wound and the state of the edges, as a rule, are absent in the map because of the high workload of the doctor, constant rush. We came to another important function of forensic medical expert - he explains to district and hospital doctors the order of registration of medical documentation. In this there is nothing strange. When a doctor faces obvious intentional damage, he will certainly cooperate with law enforcement agencies. In order to facilitate their work, the correct filling of the card is necessary.

To avoid this kind of mistakes, the expert always conducts an independent examination in the hospital, and does not believe the doctor's indications. After the operation and during the healing, the appearance of the lesion may be very different from the original one. Records doctors often lead very illegible. And sometimes terms are used in Latin.

For doctors of trauma centers, methodical recommendations are being developed, but there is as yet no single tactic for additional research, especially for trauma to the face.

What diseases are treated by a forensic expert?

The forensic expert determines the nature of injuries in case of stillbirth, medical malpractice, poisoning. The forensic expert determines the fact of self-harm, the simulation of tuberculosis, epilepsy, heart attack, mental illness. Often, the accused cause themselves injuries, cause burns with tobacco, hot iron, so that the court is delayed. Sometimes they cause dermatitis, similar to scabies, eye diseases, ear inflammation.

Advice of a forensic expert

Forensic medical examination in cases of professional crimes of medical personnel has a number of specific features. It is appointed after an official check. It is carried out by the doctors of another hospital. Employees of another medical institution must first draw up an act in which they indicate defects in diagnosis or treatment that entail consequences for the health of the patient. The crimes connected with negligence of doctors, are classified so: 

  1. Intentional professional crimes. 
  2. Actions by negligence. 
  3. Medical errors in the diagnosis, treatment and violation of the ethics of a medical worker.

Forensic medical examination in cases of unprofessional medical practices answers a number of questions: what diseases the patient had, whether the diagnosis was correctly diagnosed, whether it was possible to diagnose correctly, what was done and if not done, why it was done correctly treatment, whether it led to the development of side effects, whether the patient had contraindications to taking this medication, etc.

Every citizen should know what to do to protect himself from the negligence of the doctor. How do you know if a medical error has been committed against you or your loved ones? 

  1. The person became worse after the help rendered. 
  2. For a long time after medical care there are no signs of improvement. 
  3. There was a disability or death after the provision of medical care.

We advise you to always keep the checks received at the pharmacy and all documentation, medical history, discharge, medical card. This can help you defend your rights in case of a medical error. Remember - there is no statute of limitations in cases of medical errors. The case of medical errors can last a long time - about 2 years.

Also in the practice of a forensic expert there are often damages caused by careless handling of hunting weapons. Hunting has been developing rapidly over the past few decades, but, unfortunately, not all hunter-lovers cautiously handle hunting weapons. To investigate such cases, special knowledge of physics is required. In this case, the expert's task is to determine the serviceability of the weapon, whether it is suitable for shooting, and what effort it takes to make a shot. Also, the cause of the shot is established, and weapons experts are sometimes invited separately.

On domestic soil often there are beatings - repeated infliction of minor bodily injuries. The expert's task is to identify these injuries, mark their number and the object they were dealt with. Also in practice, there are cases of torture - more prolonged in time than beating, causing pain by plucking, burning, etc. Excruciating - a prolonged deprivation of food, drink, heat.

Victims, who are seriously harmed by health, are sent to hospital for treatment. In this case, the expert is at the hospital, shows his identity and the decision of the investigator or court to conduct an examination. He talks with the attending physician of the victim, he gives the forensic medical expert a medical record, an extract with the results of the analyzes. If the victim is conscious, a conversation is held with the victim in the ward. All the complaints of the injured expert enters into the act.

The degree of harm to health is established by the expert not only at the examination of living persons, but also in case of death. Harm to health is assessed as severe if such damages were established: 

  1. Damage to the heart. 
  2. Damage to the liver. 
  3. Massive bleeding with damage to large vessels, for example, the aorta. 
  4. Embolism with air, fat, thromboembolism. 
  5. Shock, coma, collapse, hepatic and renal failure, gangrene.

If you need to establish the loss of general and professional ability to work to save money or raise the issue of disability, do not apply to a forensic expert, but to a medical and social expert commission.

Damages received before the incident are not taken into account by the forensic medical expert. In the presence of multiple injuries, damage is added up. In order for the expert to assess the degree of loss of general and professional work capacity, provide him with an act on an accident at work or an act on an accident at home. You must submit the original documents for examination. In the event of an industrial injury, the enterprise in full must compensate you for the material costs of medicines, increased dietary intake, sanatorium treatment, including transportation costs. The amount of damage is calculated from the day you received the injury. So delaying the examination for a few months or a year should not bother you. Such cases are not carried out quickly, but if properly prepared for each meeting, the damage will be paid in full.

Experts are faced with cases of simulation, when a healthy person portrays a patient, staged an attack or rape. Often this is done to mitigate the punishment either out of revenge, or to get insurance in the event of an accident. Often, in order to exclude the neurotic nature of the simulation, the commission involving a psychologist and a psychiatrist is involved.

The simulator is usually prepared for submission, but you should know that modern methods of diagnosis can not be fooled. Examination of the simulation is carried out by experienced and patient experts. An attentive expert will ask the patient in detail (or only the depicting patient, but the essence of the examination is reduced to evidence, not guesswork) about his complaints, the beginning and course of the illness and will conduct a survey. The expert should treat the witness with respect, not express his attitude to the fact of the simulation even after it is established.

Dissimulation is the concealment of a disease. For example, a rapist hides on the body traces of resistance to the victim.

Aggravation is the weighting of the existing disease.

Artificially caused diseases are also not uncommon in the practice of a forensic expert. For example, it can be dermatitis or phlegmon, dislocation, respiratory diseases, for example, bronchitis caused by inhalation of harmful substances, colitis, fistula, hemorrhoids. And also diseases of the throat, ear, nose, vision, gynecological and urological diseases and starvation, for example, in prison. Based on many years of experience, it can be shown that the disease was caused artificially, but at the same time, as with the simulation, the expert does not show his suspicions.

To evade military service, resourceful young men sometimes engage in self-mutilation. You can prove the fact of self-harm during the investigation experiment.

Thanatology is the science of dying and dying. She studies the dynamics of dying, the agony, the causes of death. Unfortunately, 25% of experts work is work with corpses, really complicated and unpleasant, requiring aging and stress resistance. The task of a forensic expert in the examination of a corpse: 

  1. To establish, death was violent or non-violent. 
  2. What caused the death. 
  3. What kind of diagnosis caused death.

Sometimes death does not come from damage, but later. This should also establish a forensic expert. If it was violent actions on the part of another person, the person is responsible for the death from complications, and not for damage. The court determines the degree of responsibility. If a person died in the hospital from the injuries received, the person who caused the injuries also lays the responsibility. With a penetrating wound, death can come from both blood loss, and from shock, infection, or organ damage. Sometimes the cause of death is several factors.

Every day, forensic experts forensic medicine face tragedies, courageously look into the eyes of death, administer justice, protect civilians, such as us and you from danger. Thank them for that. Not all offenders are mordovorots, not particularly, let's say, gifted intellectually. Sometimes it is very difficult to unravel the tangle of contradictions in a criminal offense. Criminals for various reasons can become intelligent and educated people. If you have a desire to become a forensic expert, think about whether you can bear this responsibility. You need an impeccable reputation and professionalism. In general, of course, these are the qualities needed by any medical employee. Bravery, willpower, intuition, "expert scent" - the mandatory qualities of a forensic expert.

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Medical expert editor

Portnov Alexey Alexandrovich

Education: Kiev National Medical University. A.A. Bogomolets, Specialty - "General Medicine"

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