Book Excerpt: Overview of the Examination of a Dismembered Body
Written by Guy Rutty (GR) & Bruno Morgan   

Originally published: Fall 2017 Issue (Volume 15, Number 3)
View the Digital Edition here

Post-mortem dismemberment of a body after a homicide is relatively rare within the United Kingdom, and therefore, those investigating the case, including the forensic pathologist, may not have encountered it before. However, an experienced forensic team will often encounter anatomical dissociation of body parts from major trauma, such as decapitation and limb loss caused by road traffic incidents and surgical removal of limbs (either in the operating theatre or even during pre-hospital emergency treatment) (Reichs, 1998; Byard and Gilbert, 2004; Tsokos et al., 2004; Racette et al., 2007; Symes, 2008; Randall, 2009; Dogan et al., 2010; Morild and Lilleng, 2012). The examination of the body after removal of body parts, either as the method of homicide (e.g. decapitation of a hostage) or to dispose of the body after the homicide, requires a different approach. The wound margins, soft tissues, bones and cartilages may bear witness to the event and hopefully demonstrate vital forensic evidence—evidence that can very easily be altered or lost if care is not taken in the handling and examination of the body or body parts (Rutty and Hainsworth, 2014).

 
This chapter provides an approach to the pathological examination of a dismembered body, developed from GR’s 20 years of experience in the examination of dissociated body parts, ranging from those resulting from therapeutic procedures and accidental loss to those resulting from homicide deaths. For the purpose of this chapter, the authors will present an approach to the examination of a single dismembered body part, the arm. By taking this approach, we will demonstrate how much information can be provided from a single limb in relation to the “who, where, when and how”, required by the investigation team, such as the police or the coroner. The same approach is applicable to any body part and can be repeated with each new discovery, until all body parts have been found and examined.
 
Dismembering a Body
 
To investigate dismemberment, one needs to consider how victims of homicides are generally dismembered. One might think that those who dismember bodies have a basic knowledge of butchery methods, but this is actually uncommon in GR’s experience. Pathologists know through experience that removing an arm or a leg through the joints is technically demanding and disarticulating a head through the cervical spine is even harder. Thus, it is unusual for the body’s limbs to be dismembered neatly through the joints.
 
The body is commonly dismembered into six pieces (Rutty and Hainsworth, 2014). This is normally achieved by removing the head and neck at approximately the level of the 4th or 5th cervical vertebrae, both arms through the proximal third of the humerus, and both legs through the upper part of the shaft of the femur, leaving the torso and pelvis as a single piece. In addition to this, the chest and abdomen may be opened and eviscerated. Skin, subcutaneous tissue and muscle may also be removed in square or oblong segments, often as an attempt to remove tattoos, digits, genitalia and breasts to hinder identification (Figure 1).
 

Figure 1—A section of skin and subcutaneous tissue removed during the dismemberment process.
 
Hand saws are the usual instrument of choice for dismembering a body; however, GR has experienced a case involving an electric saw, which is likely to become more common with increasing commercial availability. If such an instrument is used, it is important to consider the effect on cutting depth of the saw by the presence of any protective guard. The most efficient instrument experienced by GR was a pair of garden long-arm ratchet anvil loppers. Through experimentation, GR found that these were able to cut through skin, soft tissue, muscle and bone in a rapid and efficient manner, facilitated by the ratchet locking device.
 
Those familiar with autopsy or surgery will know that the skin is often the hardest tissue to cut. Therefore, sawing through a bone without first removing the skin and muscle is difficult. This basic error may result in the presence of multiple saw marks on the skin from attempted cuts, which are of evidential value when trying to identify the instrument used. The teeth of the blade will often snag in the flesh, and the cuts may contain evidence such as fabric from clothes or the work surface. Care must be taken to preserve these marks and photograph them, perpendicular to the skin, with a suitable visible measurement scale. As the operator is unlikely to be skilled, the blades may be blunt or may break, requiring more than one saw or other tool to be used. Broken blades should be searched for, as they may be encountered inside the remains (Figure 2).
 
a b
Figure 2—Figure 2 (a) Antero-lateral and (b) posterior views of a blade of a saw retained within the pelvis of a dismembered body. (Courtesy of Dr. Alison Brough, East Midlands Forensic Pathology Unit, University of Leicester, Leicester.)
 
Scene
 
An in-depth discussion about the examination and management of the crime scene is beyond the scope of this chapter. However, in short, dismembering a body will produce significant contamination of the scene and the perpetrator. This will depend on the methods used and the post-mortem interval. Blood vessels may be damaged, and body fluids may seep into carpets, through floorboards, and between tiles. Sink traps may contain cellular material, which should be examined by a pathologist with cytology experience. They should use a cytospin approach to look for cellular components, specifically those from internal organ structures, rather than looking for skin or hair, which could get into the trap by natural exfoliation or hair loss during washing and grooming.
 
Body parts may have been lifted and rested on a surface to enable sawing and to ensure stability in the process. This can leave toolmarks on a variety of surfaces, for example, on the edge of a bath.
 
As one of the primary purposes of body dismemberment is to aid removal of the body from the scene for disposal, the remains may be far removed from the scene of dismemberment, which may also be different from the scene of the killing. Disposal sites may be multiple, and their location may be meticulously planned or simply spontaneous or undertaken in panic. The discovery of a record of the disposal site(s) created by the perpetrator will assist the investigating police force to narrow down the search parameters or to accelerate the recognition of the location of remains.
 
As remains may be spread over large geographical areas, there may be a considerable time frame between the first and last remains recovered. This can result in variable alteration of the remains by the action of decomposition or animal activity (Figure 3).
 

Figure 3—A dismembered limb found in water. The limb shows the effects of immersion in water for a period of time.
 
If the death is suspicious, it is always advisable for the pathologist to visit the site where any human remains are discovered. The pathologist will be able to confirm that the remains are human and not from an animal, a prosthesis or a model. For human remains, the pathologist should participate in the discussion and formulation of the forensic strategy for retrieval, packaging, transportation and preservation of evidence with the senior investigating police officer and crime scene manager.
 
Examination of the Dismembered Body
 
It is not unusual that the pathologist will receive a single body part in the first instance, often a limb. This is simply because a single body part is the first discovered of the remains, either incidentally by a member of the public or during an organized police search for a missing person. The pathologist is then called to this scene or the body part is presented to him or her in a mortuary, to confirm that it is human and to start the investigation.
 
Medical Imaging Techniques
 
Ideally, imaging techniques should be undertaken first, without disturbing the remains or removing or disturbing any wrappings. Traditionally, this was undertaken using plain film radiology (radiographs), but today, it is more likely to be undertaken using cross-sectional imaging and particularly post-mortem computed tomography (PMCT) (Rutty et al., 2013a). This can be undertaken with the limb or body part remaining sealed within a bag. Image interpretation depends on experience, but it will ideally involve a forensically experienced team of pathologist, radiologist, anthropologist and odontologist. The odontologist may request additional imaging, including the use of cone beam computed tomography (CBCT). CBCT systems are often available for dental practices, because they are cheaper to install than full-body multi-slice computed tomography (MSCT) systems, give bony detail comparable to (or better than) MSCT and suffer less from artifacts from dense metal in dental implants. Although CBCT is not practical for soft tissue examination or whole-body imaging, it could be used for skeletal examination of body parts if MSCT is not available.
 
Image interpretation does not have to be undertaken at the site of the autopsy examination, and the use of remote radiology, for example, the viewing of the images by a forensic anthropologist to assist in age and stature estimation, can prove beneficial (Robinson et al., 2008).
 
Magnetic resonance imaging (MRI) can also be considered. Before MRI, ferromagnetic foreign bodies should be identified, as these move or heat within the strong magnetic field, damaging tissue, or, if loose, they can turn into missiles in the scan room, causing a serious hazard to staff. MRI gives information different to CT, often with better soft tissue discrimination. It can pick up subtle signs of bony trauma, such as bone bruising relating to occult fractures, but MSCT is preferred for assessing actual fracture patterns.
 
The decision of which imaging modality to use will depend on the resources available and specific questions that need to be asked. Protocols for imaging will often be drawn from clinical practice, with some modifications. For example, for MSCT, radiation dose and scan speed are not important and re-scans at multiple angles can be used to offset artifact from implanted dense metals (Morgan et al., 2014). Translating MRI protocols from clinical practice is also possible, but it is likely that a radiologist experienced in forensic MRI would be able to improve protocols in the different chemical environment of a post-mortem specimen or body (Ruder et al., 2014).
 
A dismembered limb also offers the opportunity for micro-CT. This technique works in a completely different way than standard spiral CT (more like CBCT). Therefore, it only permits a small scan volume and generally uses long scan times to achieve very high- resolution images, with detail down to microns.
 
Imaging can prove valuable in a variety of ways to examine:
 
  • The external wrappings and presence of any external or internal foreign objects, for example, personal possessions and medical prostheses
  • Age, stature and sex (Brough et al., 2012)
  • Natural bone disease or abnormal joint wear
  • Historical trauma, soft tissue or bone
  • Perimortem trauma, occurring at the time of death
  • Post-mortem trauma and the sites of dismemberment, including any failed attempts at dismemberment (so-called incomplete, or false start, kerfs)
 
This process can be enhanced by the use of 3D surface imaging techniques, using photogrammetry (dense 3D geometric information from stereoscopic image overlap), or a 3D optical surface-scanning system, using lasers. PMCT image data can also be used to generate 3D surface image reconstructions, but they are usually with less detail than photographic or laser techniques. Although these “surface scanning” techniques cannot compete with an expert actually handling the tissues, they can be very useful for requesting external expert opinion or demonstrating surface marks and injuries at subsequent court proceedings.
 
Therefore, PMCT and other imaging techniques can build up a picture of who the missing person was, how they met their death and how they have been disposed of.
 
Autopsy Examination
 
Once the body part—in this case, an arm—has been subjected to radiological examination, the process of the autopsy examination can start. This, as with all autopsy examinations, should start with the careful removal of the body part from the body bag, followed by a structured external examination. A considerable amount of information can be gained, even from the examination of a single body part. A systematic approach to each find will build up a picture of the identity of the victim, along with a picture of what occurred to the victim in relation to the death and subsequent dismemberment.
 
Wrappings
 
To assist in the disposal process, the body part may be within some form of wrapping. Limbs, in particular, may be folded at their natural joints to reduce their size and to make their handling and disposal easier. There may also be other objects such as ropes and ties, weights and other materials with the body part, either on or in the wrapping (Figure 4). All of these must be handled with care, as they may retain evidential trace material, which may prove critical to a case. Plastic bin bags may be matched to the remainder of a roll or fingerprints, and DNA may be retrieved from adhesive tape used to seal the wrappings.
 

Figure 4—A dismembered body part within plastic wrapping (made anonymous), which is held together with binding.
 
Trace Evidence
 
After any imaging examination of the remains, the body part(s) should be examined in a mortuary designated for forensic practice. As stated above, any wrapping associated with the body part should be opened with care after an agreed forensic recovery strategy. GR has found that the examination and recovery of trace evidence can be facilitated by placing the limb onto a sterile or at least “clean” surface (mortuary tables and examination benches should not be considered “clean” from a trace evidential point of view) (Rutty, 2000; Rutty et al., 2000; Schwark et al., 2012).
 
In our case example, the arm should be photographed on both sides—front and back—as well as from the proximal (shoulder) and distal (hand) ends. This should be done perpendicular to the limb, with an appropriate photographic scale. All marks of interest should also be photographed with and without a scale. A standardized color balance scale should be included at the start of all photography.
 
The arm—just like the legs—should be examined for evidence of the use of bindings or restraints (Figure 5). Depending on the agreed upon forensic strategy and whether there is clothing remaining on the limb, the entire surface of the arm can be swabbed for the offender’s DNA. This can be done using dry and wet swabs to increase DNA yield, using the correct swabbing technique (Sweet et al., 1997; Pang and Cheung, 2007; Graham and Rutty, 2008). The type of swab used for the process should take into account the downstream DNA extraction method as well as the large surface of the limb to be covered. The entire surface can then be “taped” for fiber lifts. Arm hair can be plucked for comparison with other retrieved hair, for example, hair found on subsequent saws. Care should be taken to examine the cut end of the limb and any saw marks in the skin for paint or other debris that could have been deposited during the process of dismemberment. The whole limb should be inspected, for example, to look for evidence of the limb lying in a corrosive substance, which may give an indication of where the limb has been before final disposal.
 
In terms of the hands, the fingernails should be first examined for damage due to any pre-dismemberment incident and then sampled for offender’s DNA using agreed local policies by either cutting or swabbing the nails. Nails are also a good source of self-DNA, for victim identification, and can be sampled for this purpose (Allouche et al., 2008). Finger and palm prints should be lifted, either with traditional powder-based techniques or electronic capture systems, to aid identification of the victim (Rutty et al., 2007). These should be searched against all available databases, which could include both offender and immigration data sets. Natural skin lesions can be photographed on the hands, as their nature and location have been used for identification purposes in criminal investigations (Black et al., 2014a,b).
 
Photography
 
Photography of any identified trace evidence, natural disease, tattoos, trauma or post-mortem change should be undertaken by first taking a general location photograph of the subject matter, followed by a close-up photograph taken perpendicular to the subject matter with an appropriate photographic scale. A standardized color and gray-scale reference chart should be photographed at the beginning of all photography. The use of clear numbered or lettered scales is encouraged to ensure that on review, the pathologist can easily identify which photograph corresponds to which injury, mark and so on.
 
The use of alternative lighting techniques can aid the examination at this stage. For example, the use of a mortuary-sited Crime-lite such as the Crime-lite ML2 (Foster and Freeman;  last visited in September 2015) can assist in identifying the presence of fiber, ballistic, and sexual-related trace evidence, as well as in enhancing the pattern of injuries.
 
Personal Effects
 
Clothing may still remain with the body part. If clothing remains, then this can be sampled for trace evidence, for example, by taking fiber lifts, before the nature of the clothing is documented, photographed, removed and packaged appropriately. Usually, clothing has been removed from the arms; however, this will be case-dependent. The size, material and manufacturer label details should be recorded and photographed, as in a conventional so-called Disaster Victim Identification or DVI approach. At this stage, the unidentified missing person may be of international origin. The Interpol Disaster Victim Identification forms
 
Personal effects may also remain with the body parts. In the case of an arm, rings, bracelets and watches may be present. Other areas of the body may also bear jewelry and have cosmetic piercings. Subcutaneous body modifications may be present to forearms.
 
General External Examination
 
The external examination of a single body part is no different than that of the entire body (Burton and Rutty, 2010). It may be more laborious, as body parts may be presented at different times, and unless the decision is made to store all the parts for a single examination, the pathologist will often have to undertake the same procedures as many as six times, if not more. This will also result in multiple reports, unless a decision is made to wait for the production of a single combined report detailing the findings of all the individual examinations.
 
The examination of dismembered body part—in this case, the arm—will include consideration of:
 
  • Congenital or dysmorphic features
  • Body modifications such as surgical operations or tattoos
  • Presence of prostheses, which may bear a unique number that can be checked within medical notes or from manufacturer’s records
  • Presence of natural disease to the skin, soft tissues, vessels, joints and bones
  • Historical scars, including surgical, injury and self-inflicted
  • Evidence of subcutaneous or intravenous drug abuse
  • Medical treatment
  • Historical or ante-mortem injury, including blunt and sharp trauma, burning, projectiles and evidence of torture
  • Post-mortem changes, including the action of predators
 
The findings of all of these subsections should be recorded in writing, drawing and photography.
 
Identification
 
The identification of the deceased individual must be established, a process that started with the radiological examination. Depending upon which body part(s) are available for examination, the PMCT findings can be used to assist with the identification process (as described by Brough et al. [2014] [Figure 6]). The gender, sex, ethnicity and age can be considered through the external examination and PMCT. However, if only a single body part is available, then it is unwise to be overconfident in the identification of, for example, the sex of an individual at this stage. In the developing human, errors can arise that can lead to the police looking for a missing male, when, in fact, one is examining a masculine female. Stature can be estimated by the removal of an intact long bone; however, one may not wish to do this because of the invasive nature of this procedure and also because there could be toolmarks on the bones, which may be affected by this procedure. PMCT can be used to measure the bones without removal. It can also consider other aspects, such as epiphyseal fusion for the estimation of chronological age.
 

Figure 6—An example of a whole-skeleton identification sheet produced by PMCT. (Courtesy of Dr. Alison Brough, East Midlands Forensic Pathology Unit, University of Leicester, Leicester.)
 

Figure 7—Pitting of the nails can be seen in individuals with psoriasis. This can prove useful in the identification process through the identification of the existence of natural disease.
 
In the case of the hand, the nails should be examined for congenital, natural and acquired disease/pathology, for example, clubbing or splinter hemorrhages (Figure 7). The presence and position of scars and naevi have been reported and used for identification purposes of the living and thus may play a role in the identification of the dead (Black et al., 2014a,b). The nails can be used for isotopic analysis for identification purposes (Meier-Augenstein, 2010).
 
Blood, if present, should be sampled for DNA identification and toxicology. Muscle and bone can also be used for both purposes. When considering which bone to sample—though one would think that the long bones would be best—published work suggests that the small bones of the hand yield the best chance of obtaining a DNA profile (Mundorff and Davoren, 2014). As highlighted above, the finger nails should also be considered a reliable source of DNA for identification purposes.
 
Post-Mortem Interval
 
The estimation of the post-mortem interval is difficult, especially if only a single body part is available. Often, all that can be stated with confidence is that the deceased died sometime between the last time that they were seen or heard alive and when their body remains vital to life are discovered. Clearly, finding an arm does not establish the death of the victim, but the interval from amputation of the arm to its retrieval is still relevant (and will still be referred to as post-mortem interval).
 
A number of techniques may be applied to dismembered remains to estimate the post-mortem interval. This should start with an external examination and observations related to the general state of decay of the remains. If the parts are found approximately within a day since death, then it may be possible to still record temperatures from such sites as the rectum, brain and external auditory canal and still apply these temperatures to standard temperature-based algorithms. For the head, advanced imaging techniques such as PMCT and 1H-magnetic resonance spectroscopy can be applied to assess decomposition changes to the brain to attempt the estimation (Madea, 2015).
 
If maggots are present, these should be sampled in the conventional way and submitted to a forensic entomologist. Pupae should also be collected, as it may be possible to estimate a time since death by using micro-CT, which can be used as a non-destructive means of examining the internal contents of the pupae (Richards et al., 2012; Rutty et al., 2013b). Mid-shaft humerus and finger nails should be collected and submitted for isotopic analysis. By using radioactive isotopes with short half-life as well as characterizing bone’s mineral composition, a picture can be built up of when the person may have died as well as the geographical area in which they might have lived.
 
Laboratory Examinations
 
In addition to the samples discussed above, blood, muscle and bone samples can be taken for toxicological investigation. Consideration should be given to the retention of tissue for wound dating as well as muscle to consider whether or not the body has been frozen before disposal (Schäfer and Kaufmann, 1999; Miras et al., 2001; Fanton et al., 2006).
 
Bone End Removal and Preparation
 
Once all of this work has been undertaken, our attention must turn to the consideration of how the person was dismembered. The dismemberment area of skin, soft tissue, muscle and bone must be examined carefully. Any dismemberment-related injury to the skin is recorded, noting the number and direction of the injuries along with the position on the limb, for example, whether it is anterior, lateral, medial or posterior or a combination of these, as this will assist in determining the way the body was presented to the saw during the act of dismemberment. If there is more than one body part, do not attempt to fit them together at this stage, even if they look like they will fit, as this could alter the toolmarks present.
 
Without removing any tissue from the bone, the cut end of the bone should be photographed (see Chapter 7). After this, it is permissible to remove as much skin, soft tissue and muscle as necessary to expose the cut end of the bone as long as any tissue in close approximation to the cut end is not cut or scraped from the bone itself. If this is done, it will again alter toolmarks that may be present and even create new toolmarks on the bone. It is important that any marks on bone created by the post-mortem process are recorded.
 
The cut end of the bone should now be relatively free from the mass of the arm muscle, although some muscle will inevitably remain on the sample at this stage. The bone can be cut to produce a sample which bares the witness marks. This should be at a distance of at least 5 cm from the cut end to be certain that there are no missed false start kerf marks or breakaway spurs in the bone. It is wise to mark this new cut end to distinguish it from that caused by the dismemberment. GR usually puts a notch into this cut end.
 
The bone sample is now cleaned before further examination. This sample must not be fixed in formalin, as this fixative will cause a problem during the cleaning stage. There are several reported ways of cleaning these samples, including manual cleaning, water maceration, hot-water maceration, enzymatic maceration and insect consumption. The method chosen must not affect the subsequent toolmark investigation. GR’s practice is to use the method described by Mairs et al. (2004) for the removal of the residual flesh from the bone. This is effective for tissue removal and does not appear to have an adverse effect on subsequent toolmark assessment.
 
Before toolmark assessment, each “cleaned” bone sample should again be photographed, perpendicular to the bone, under appropriate lighting conditions, on a suitable background with a scale and suitable lenses to capture all the toolmarks that can be seen at this stage. These can then be collated with the 3D reconstructions generated from the PMCT imaging, and a montage of images can be created to demonstrate the sites of dismemberment, for court demonstration purposes. Oblique lighting may assist in revealing markings that are not obvious from direct light inspection.
 
Summary
 
Dismemberments, as part of a homicide, are uncommon. However, by following a systematic approach to the handling and examination of each body part, as described within this chapter, supplemented with modern-day radiological imaging techniques such as PMCT and/or micro-CT, considerable information and evidence can be gathered from the remains to assist the legal authorities in investigating the key questions of “who, where, when and how”.

 
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