One thing that I keep going obsessing about is the autopsy. I keep thinking how is there no cause of death. One article I read (from July) stated it was a preliminary autopsy and it would be several months before the comprehensive autopsy information would be available. So I've went and read up a bit, I've learned that a preliminary report is usually available within 24-48 hours of the autopsy, it's called a "provisional anatomical diagnosis" and it takes approx 6 weeks to 2 months for the full results to come back. If the autopsy was performed the first week of July then we. Should have the full findings by now, and perhaps we do,a d perhaps they are the "undetermined" results.
I've read an autopsy consists of external (hair, nail samples, body radiographer, wounds examined, body cleaned, weighed, gender sex etc documented, then an internal exam is performed of all internal organs to look for signs of injury, illness, disease, etc, in addition, tests are performed including toxicology like stomach contents and chemical poisons, and bio chemical and genetic analysis. I know these would include some of the isotope, pollen, and DNA samples we've heard of and are awaiting further testing.
If her autopsy has indeed shown, as a final conclusion, as "undetermined", that leaves to the conclusion that she died in a manner they cannot determine. I reviewed the top ten causes of death, per most recent published by the CDC, year 2013. They are list from 1-10 most common to least for child ages 1-4: unintentional injury, congenital abnormality, homicide, malignant neoplasm, heart disease, influenza/pneumonia, chronic lower respiratory disease, septicemia, benign neoplasm, perinatal period.
Of those, which would possibly not show on an autopsy? With research (listed below) so far I'm concluding so far: unintentional injury, congenital abnormality, and homicide, heart disease (if a birth defect of heart is heart disease I'm not a medical professional, if heart disease is only the type caused by buildup of plaque and high blood pressure then ignore this I'm not well versed here). I haven't went farther down the list, but due to length of forensic findings, wanted to share findings of the top 5 causes of death.
*******One interesting very common aspect I found in the forensic autopsy findings is that they tend to use a combination of findings or lack thereof IN ADDITION TO the information available from family/friends/first responders who discover the victim to determine cause of death. When one half of the information is missing (no family to tell how person was found or feeling/complaining in hours/days leading up to cause of death), it makes determine of death much more difficult and thus "UNDETERMINED" is used if no autopsy findings can be found.
Causes of death that often or never cannot be determined on autopsy include (especially without info from family/friends):
*SIDS (birth-5 years can be victims of SIDS).
*Cardiac scenarios like R and T syndrome or Ward-Ramano Syndrome, both are present from birth, cause irregularities with the heart beating, and can make the heart strip immediately, cannot often be found by diagnostic tests by docs, cannot be found in autopsy.
*rare occasions hereditary diseases (ward-ramano), hazardous enviro conditions (unsafe water?), unusual toxic exposure (carbon dioxide or methane gas), unsafe consumer products (cribs), are the cause, and with information provided from scene this is the determination.
* although it is rare on occasion an "undetermined" is listed on autopsy. The pathology is reserved, often for decades. In some situations, these results are later used to determine new diseases (as in the case of undetermined deaths from the 1950s, pulled decades later when HIV was determined and AIDS was discovered to be cause of death of those from the 1950s).
There are several undetermined manners of accidental, homicidal, suicide, and natural death that will often or always show no signs of death on autopsy. No evidence will be found externally or internally. Some include:
*asphyxia - choking for example, if choking I'm removed prior to death and no one available to relay choking occurrence.
* smothering - ex: plastic bag over head. Pillow used pushed down over head or face pushed down into pillow.
* mechanical asphyxia - pressure outside body prevents breathing (car accidents/riots/stuck in well/drug or alcohol induced and asleep face down). But in drug/alcohol induced the toxicology will show toxins, car accident will possibly show other injuries, etc, and other factors will often traumas will be known or show on the body as evidence. Therefore this is unlikely in this case.
* BURKING - sitting on chest of individual and hands over nose mouth, combined causes suffocation and asphyxia. No trauma will be seen in many children or in drunk/drugged adult.
* suffocating gases - carbon monoxide and methane exposure that limits oxygen exposure and causes death will not show on autopsy as cause of death. Carbon monoxide will show on toxicology but is naturally occurring in blood tests therefore without info to determine exposure to excess co2, cannot be determined. Methane in natural gas like cooking/heating, will show in blood test but only exposure to not cause of death.
Source: Google books: Forensic Pathology pages 231-245.
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