Electrocution and the Autopsy

Abstract

Deaths due to the passage of electric current through the body are most often accidental, although suicides and homicides may occasionally occur. Electrical energy represents electron flow, or current, between two points with different potentials, measured in voltage. The amount of current is determined by the resistance of the conducting material. Electrocutions involving humans may be due to low voltages ( 1000 V), or to lightning. Deaths are caused by a direct effect of current on the heart, resulting in ventricular fibrillation, on respiratory muscles resulting in respiratory paralysis or on the brainstem respiratory centers. Deaths may also be caused by thermal effects of current, or by trauma or drowning associated with exposure to an electrical current, or to multiorgan failure complicating initial injuries. The autopsy assessment of possible electrocution is complicated by the non-specificity and subtlety of lesions. Victims may have classical targetoid electrical burns of the skin with central charring, surrounding pallor and hyperemic rims. There may also be adjacent nodules of burnt keratin due to arcing of current. Victims of lightning strikes may demonstrate the typical ferning pattern of Lichtenberg figures. Conversely, other cases, e.g., electrocutions occurring in water, may have no pathological indicators of electrical injury. For this reason, the investigation of possible electrocution requires careful evaluation of the death scene and assessment of the electrical safety of the building and any electrical equipment that had been used. Meticulous examination of all body surfaces for subtle electrical burns with histological sampling is also required.