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Arun Kumar Jaiswani, Rajesh Dere, Hemant Kukde, Mahesh Sabale, R. R. Savardekar

Identity is the recognition of individuality of a person, live or dead and is important for both
legal and humanitarian reasons. In the present case, a completely charred unclaimed body was
brought to the department of Forensic Medicine for medico-legal autopsy with the manner of death
unknown. On autopsy, a metal implant with lot number mentioned over it was found in the right femur
which led to positive identification of the human remains and the cause of death was established.
With the advances in modern medicine, the use of surgically implanted devices has become
increasingly common in human skeleton system. The presence of an orthopedic device is an
individual characteristic which not only differentiates one set of remains with the other but also
provides investigator a useful piece of information about the deceased. The case highlights the
importance of meticulous autopsy and utility of multiple lot numbers of body implantable devices in
cases where the identification remains obscure.

Identification, Metal Implant, Charred, Radiography, Lot Numbers, Serial Numbers.

An obvious example would be sex

Identity is the recognition of
individuality of a person, live or dead and is
important for both legal and humanitarian
reasons. The establishment of certain broad
groupings, such as sex, stature, ancestry and
age may be determined solely from the
available bodily remains, though corroboration
may be obtained from other evidence.
1
Assistant Professor,
Department of Forensic Medicine & Toxicology,
Govt. Medical College, Nagpur.
3
Associate Prof,
Department of Forensic Medicine,
LTMMC & GH, Sion, Mumbai,
4
Assistant Professor,
Department of Forensic Medicine, Govt. Medical
College, Akola,
5
Professor,
Department of Forensic Medicine & Toxicology,
Lokmanya Tilak Municipal Medical College and
General Hospital, Mumbai
2
Professor,
Department of Forensic Medicine & Toxicology,
Seth GS and KEM Hospital, Mumbai
E Mail: arunjaiswani@gmail.com
L. M. No: 1275/2016
DOR: 01/03/2017 DOA: 18/09/2017
DOI: 10.5958/0974-0848.2017.00063.X
determination from clothing and jewellery,
though even this may not be absolutely
1
reliable. When establishing the identity of an
unidentified corpse, fingerprints, dental
findings, and DNA polymorphism are generally
used. However, these findings are of no use
when no antemortem data are available for
comparison, such as registered fingerprints,
dental records or DNA samples from
2
individuals presumed to be close relatives.
Establishing positive identification in
cases involving extensive thermal alteration is
often difficult given the fragmentary condition
of the remains and the fragile nature of the
material which may hamper the use of
3
standard identification techniques. Prosthetic
implants can survive a variety of situations like
decomposition, mutilation, burial and
cremation and their use for identification has
4-9
been established in various studies so far.
Medical devices play a role not only in
screening, diagnosing and treating patients but
also in restoring patients to normal lives and in
regularly monitoring health indicators to
prevent diseases. From a forensic perspective,
the growing prevalence of these devices in the
humans requires understanding the
circumstances leading to device implantation
and how these devices can aid in the
identification of an unknown decedent.
 A charred body was found in the
bushes at a secluded spot with manner of
death not known. As the deceased could not
be identified, the police demanded to perform
the identification procedures on the deceased.
Crime scene examination showed charred
body with evidence of decomposition & burnt
leaves and stems on and around the deceased
( ). No evidence of container having
inflammable petrochemical product or other
weapon was found at and around the crime
scene. It was concluded that the manner of
death was homicidal. Body was brought to
Sion hospital for post-mortem examination to
establish the identity and cause of death.
: incidents, whether as a result of forces of
Body was lying in prone position with
limbs flexed at joints and evidence of charring
and decomposition with foul smelling present
( ). Features were unrecognizable &
orbits were empty. Evidence of skeletonization
was present with bones from skull, limbs and
trunk exposed. Evidence of larvae of maggots
and flies were present on the buttock region.
Scalp was burnt leaving a patch of unburnt
area of grey scalp hair. Fingerprints were
damaged on both hands, all teeth in both jaws
were intact. Rigor mortis had passed off, joints
were stiff due to heat stiffening. On dissection,
skull bones were intact; brain matter was
liquefied, grey coloured. Hyoid bone &
laryngeal cartilages were intact, with no
evidence of any haemorrhage in the soft
tissues of neck. Remains of visceral organs
were present in the form of black decomposed
mass. On dissection of right hip, a metallic
femur implant was found at the upper end of
right femur ( ). On examination of
skull and pelvis bones, it was concluded that
the deceased was of an adult female. Implant
prosthesis was dissected out & measured:
shaft length -14cm and diameter of head (ball)
- 4.5cm. The implant prosthesis bore LOT and
serial numbers ( ) over different areas of
implant. Piece of decomposed muscle and
viscera that was preserved for chemical
analysis came out negative for any intoxicant
or poison. Tuft of unburnt scalp hairs and tooth
were preserved for DNA analysis.
The requirement to establish the identity of the
deceased tends to fall into three wide
categories:
5
1. Criminal investigations resulting from
an unexplained natural death, homicide, or
suicide. It is virtually impossible to satisfactorily
investigate a situation where one is confronted
with a corpse to which no identity can be
assigned. The investigating authority can carry
the inquiries no further, as they cannot know
whom to interview family, friends, or
colleagues. Most unidentified deceased in this
situation result in an open case investigation
with no resolution until identity can be secured.
2. Accidents and mass disaster
nature or human intervention, either accidental
or intentional.
3. War crimes and genocide.
When minimal thermal changes are
present on human remains, normal procedures
for identification can be carried out. Extensive
heat related alterations can severely disrupt
normal procedures but frequently, sufficient
evidence survives to facilitate identification.10
Orthopaedic or medical implants may be
potentially useful in such cases as they are
relatively uncommon and usually contain
individual identifying features, such as the type
of device used and its anatomical location.
4
The use of serial numbers and lot
numbers on the implant devices can allow
identification if histories of serial and lot
numbers are retained by manufacturers,
distributors, or hospitals. Serial numbers can
allow identification of a body implantable
device in an individual, even in the case of a
single serial number, whereas lot numbers can
narrow identification to a group of individuals.
11
Currently, the Indian medical device
and pharmaceutical market is largely
unregulated and medical devices can be freely
imported into the country. In India about 75%
of the device market comes from imports.
Registration ensures that the government can
(i) have a record/listing of the vendor; (ii) lay
emphasis on after-sale obligations; (iii) enforce
orders on defaulters like suspension of
licenses, and (iv) have a renewal system in
place for registration thereby maintaining
updated information.12
In the present case, the femur implant bearing
LOT & serial numbers was shown to a local
distributer who identified the manufacturer.
The manufacturer maintained a database
allowing rapid tracing of the LOT and serial
number. With the LOT and serial number the
company provided the name of the doctor to
whom it was sold and on further investigation
the doctor provided the details of the patient in
which the device was implanted. After
identifying the deceased, the investigating
authorities nabbed the perpetrators of crime
who revealed that they first strangulated her
and later burnt the body to obscure
identification.

The use of radiological techniques must be

encouraged among autopsy surgeons in
unidentified bodies.
1. Use of radiological techniques in
screening for prosthetic implants must be
encouraged amongst autopsy surgeons
where the identity of the deceased is
obscure. This can be of great help so as to
prevent invasive autopsies which often
leads to maiming of the deceased.
2. A separate radiological unit attached to the
mortuary must be set up for the
convenience.
3. Regulatory body or act should be
introduced to achieve quality control of
devices after implantation into the body,
requiring recording of the use history of
body implantable devices. The introduction
of such an act/regulatory body in India will
be of great help to judicial system
especially in cases where identification of
a person remains obscure.

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