A medical evidence review by an LNC plays a key role in murder cases. If you’re a fan of true-crime programs or novels, you may be familiar with the terms motive, means, and opportunity. They used to establish intent, or are they used to establish something else? What are those three motivations for murder?
Introducing Teresa Devitt-Lynch MSN RN AFN-BC, AFN-C, SANE-A , a certified adult Sexual Assault Nurse Examiner and board certified Advanced Forensic Nurse. The proprietor of the INTREPID Forensic Healthcare Consulting firm, she provides criminal case consultation and expert witness services for military and civilian courts.
Talking with different detectives and working with a lot of lawyers throughout the years, three basic motives for murder are love, money, or vengeance. Usually, most of the cases boil down to those. Although medical evidence may not be able to determine intent in murder cases fully, it can be very useful in some nonfatal incidents to just support different levels of intent.
Teresa was a recent guest on my Podcast,
I will use the content from that episode to give you an idea of what to expect at our upcoming event, The Ultimate LNC Conference: Where You Can Discover How To Get More Criminal Cases.
Medical Evidence Example
Teresa had a case several years ago in which the defendant was accused of strangling his wife, and she had some external injuries consistent with strangulation. She reported breathing problems and coughing and had a sore throat and other signs and symptoms that supported the strangulation.
The husband’s stance was that they were in a heated argument, and he was trying to keep her from swinging at him because she was the aggressor.
Now, in this situation, there were bruises on her neck that were consistent with his right or left hand being around her neck. If somebody is trying to get someone not to hit them or punch them, they certainly wouldn’t need to apply pressure around the neck with enough force and length to cause bruising on the neck. That element, that piece of medical injury or medical evidence injury, could certainly have been used. The case did settle out of court.
He took a plea deal, but certainly, that could have been utilized to show his intent to harm her versus protect himself. That is one-way medical evidence can be utilized to help establish intent.
At our conference coming up, we’re going to have a full session on strangulation, what marks are left on the neck, what legal nurse consultants should consider when looking at photographs, and how that plays out in a murder case.
Reviewing Medical Evidence
Along with the other evidence, the presentation of the scene:
Was there a sign of a struggle?
Is there trace evidence?
What body fluids?
What other pieces of evidence were found at the scene, and how can medical evidence be utilized in conjunction with that information and evidence to help reconstruct the scene?
You may have a pattern injury associated with a specific weapon. You might find a boot mark on someone’s back that could be used to match up with a specific shoe that was worn to help reconstruct that.
When you’re talking about gunshot wounds, you can determine through the presentation:
The entrance and the exit wound, whether there is soot, gunshot residue, or stippling, and the approximate distance of firing. That can help determine how far away the victim and assailant were.
Also, consider the angle of wounds:
What was the angle of a stabbing?
What’s the entrance angle and exit of a gunshot wound?
Those can help determine where people were standing during the altercation. Then, the injuries alone can help determine the mechanism of injury utilized.
Sometimes, you can associate it with a specific weapon. The type and the length of a knife may be utilized. You could, for instance, determine if it was a serrated knife versus a single-edged knife versus a double-edged knife based on the presentation or the pattern it makes as it’s being thrust into the body. So, there are many ways in which the medical evidence can help reconstruct and determine the actus reus of the case.
Other factors in helping to rule out suspects are details like:
Whether the person is right-handed or left-handed.
How tall is the person who’s being accused of the murder?
Could they conceivably have created that injury based on, say, striking somebody on the back of the head?
Ruling Out Suspects with Medical Evidence
Very rarely, except in the case of suicide, does medical evidence determine who did it. You don’t have a bruise or a bullet wound with a label on it that says, John shot me. That doesn’t happen. You can determine that they were shot or what type of gun was used.
You can’t, by the medical evidence, determine who shot the gun or who pulled the trigger, but you might be able to determine who could not have pulled the trigger.
Ruling Out Suspects with Medical Evidence
Once, There was a gentleman who was paraplegic, and he had a gross motor function in his hands, but he did not have a fine motor function in his fingers. And he was in an electric wheelchair. He had a way to get around, but it was electric. He didn’t have to push any buttons. It was just one of those big knob things that moved him around.
He only needed gross motor skills to do that. He did not have fine motor skills. Additionally, he could not have picked up a gun. And he was being accused of shooting somebody. And apparently, they had an issue between the two of them.
In reviewing his medical records and photos and even talking to him on the phone to get more information about his daily capabilities, I saw that there was no way that this gentleman could have picked up a gun effectively. Now, mind you, he’s in a wheelchair, and he was shot. He was shot in the chest. So he was looking. They were looking at each other.
There is no way that this gentleman could have picked up a gun, much less pulled the trigger, in a time short enough for the other gentleman not to have noticed what was going on and gotten out of the way. But the prosecutor saw a picture of this man holding, I think, money or cards fanned out in his fingers. Well, his friends had put that there for him, just for the photograph, and that was his basis. Now, the charges were dropped.
Medical Evidence to Eliminate a Suspect
Medical evidence, especially related to the suspects, can be used to help rule them out. You know, if you have a woman who’s very arthritic, would she be able to hold a knife strongly enough and to be able to thrust it into somebody strongly enough to cause them significant bodily harm or death? And in this case, there was a paraplegic who was being charged with shooting with attempted murder. The gentleman did live. It was attempted murder, but there was no way that he could have done that.
While it doesn’t necessarily tell you who did it, it can sometimes tell you who could not have done it or didn’t.
Coming Up
Are you fascinated or interested in this type of criminal case? If yes, you must attend my upcoming virtual LNC Conference: Discover How To Get More Criminal Cases: How to be a Successful LNC for Homicide Cases: A Ste-by-Step Conference. Discover more about the LNC’s Impact on Legal Battles on May 30, 31, and June 1, 2024.
- Get more criminal cases
- Attract the Best Attorney Clients
- Position Yourself as the Go-To LNC
- Network With Your Colleagues
Click here to learn more and register early.
Teresa Devitt Lynch is a forensic nurse and a sexual assault nurse examiner. She’s board-certified in forensic nursing and is an educator and expert who testifies internationally and nationally.
Teresa has been a guest on my Legal Nurse Podcast and will speak at the virtual event How to be a Successful LNC on Homicide Cases: A Step-by-Step Conference, which will be held May 30, 31,and June 1, 2024.
Pat Iyer is president of The Pat Iyer Group, which develops resources to assist LNCs in obtaining more clients, making more money, and achieving their business goals and dreams.
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