Zumwalt's Forensic Pathology

A lifetime of death: 50 case studies presented by Ross Zumwalt MD

Learn forensic pathology for AP and FP boards by studying classical cases

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Coming soon – Accompanying Study Guide for Pathology Residents and FP Fellows

To be Release July 1, 2020

Written by Sam Andrews, MD FRCPC and Edited by Ross Zumwalt MD

Relevant Topics Covered in the Book

Death Certification

The history of death certification is briefly explored before Dr. Zumwalt takes the reader through the modern standard death certificate and how to properly fill out each section. Dr. Zumwalt highlights some common mistakes and includes several "classic" case studies with example death certificates filled out.

Death Investigation

The history of death investigation is briefly discussed before Dr. Zumwalt takes the reader through the current medicolegal death investigation system in the United States. Death scene investigation is then touched on, which should culminate in an investigative narrative report.

The Forensic Autopsy

Dr. Zumwalt discusses how a forensic autopsy differs from a hospital autopsy, what constitutes a complete autopsy, and then describes in technical detail the special dissections that may be required in certain cases. These special dissections include: posterior leg dissection, anterior and posterior neck dissection, face dissection, vertebral artery dissection in situ, certical spine removal layered anterior trunk dissection, anterolateral and posterior rib arc dissection, back dissection, eye and inner ear removal, and spinal cord removal (both anteriorly and posteriorly).

Ancillary Laboratory Studies

Additional testing is often necessary to establish or confirm the cause and manner of death before, during, or after a competent forensic autopsy. Ancillary testing can include microscopic evaluation or histology, toxicology, postmortem cultures, vitreous humor testing, radiographs, computed tomography (CT), magnetic resonance imaging (MRI), metabolic testing, or molecular testing. When a thorough investigation into the circumstances of death, including a medical history and a good scene investigation followed by a complete autopsy does not adequately answer all of the medicolegal questions concerning the death, additional laboratory studies or additional investigation is essential.

Apparently Natural Death

Twelve case examples are discussed in this section, which comprises death that are from natural causes, or which on original presentation appeared to be due to natural causes.

Apparently Accidental Death

This section contains cases in which the death initially appears to be due to an injury or drug-related cause and there doesn't appear to be any intent on the part of the decedent or any other person to cause the death. Ten case examples are presented for the reader.

Apparently Suicidal Death

Nowhere is the manner of death more scrutinized by family or the public than when the opinion or the certifier is that of suicide. Dr. Zumwalt presents five cases in this section where at the beginning of the medicolegal investigation of the deaths appeared most likely to be suicidal.

Apparently Homicidal Death

Twelve cases of probable homicides are presented in this section. While homicide victims probably make up less than 10% of deaths that most forensic pathologists investigate, they have the highest public profile and often require proportionally greater amounts of time to work up, examine, and report than other manners of death.

A Manner of Death Cannot Be Determined

An undetermined manner of death determination is a natural consequence of an inability to determine the cause of death. This selection of eleven cases deals with deaths in which the manner of death is uncertain.


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About the Author

Ross E. Zumwalt

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Dr. Zumwalt is board-certified in anatomic and forensic pathology, and served as Chief Medical Investigator of the State of New Mexico from 1991 through 2014. He obtained his medical degree from the University of Illinois College of Medicine, internship and pathology residency at the Mary Imogene Bassett Hospital, Cooperstown, NY; pathology residency at the Southwestern Medical School, Dallas; forensic fellowship training at the Dallas County Medical Examiner's Office; and military service as Director of Laboratories at the Navy Regional Medical Center in Camp Lejeune, NC. He spent two years as deputy coroner in Cleveland, OH, and six years as deputy coroner in Cincinnati, OH, before coming to the Office of the Medical Investigator in 1987. He was a trustee of the American Board of Pathology from 1993 to 2004, was elected as a fellow in the American Association for the Advancement of Science (AAAS) in 2003, served on a NAS Committee on Identifying the Needs of the Forensic Science Community from 2007 to 2009, and has served as president of NAME. He has also been a member for the following professional organizations: NAME, AAFS, CAP, ASCP, USCAP, AMA, and and AAAS.

About the Editor

J. Keith Pinckard

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Dr. Pinckard is the Emeritus Editor-In-Chief of Academic Forensic Pathology, now in its ninth year of publication. He is a board-certified anatomic, clinical, and forensic pathologist, an American Board of Medicolegal Death Investigators (ABMDI) board-certified death investigator, and is the Chief Medical Examiner of Travis County (Austin, Texas). Dr. Pinckard is a Fellow of NAME, AAFS, ABMDI, and CAP and has chaired or been a member of numerous committees within those organizations. He served on the Editorial Board of the Journal of Forensic Sciences between 2006 and 2011. He has served on the NAME Board of Directors and served as the Program Chair, Secretary, and Section Chair of the Pathology/Biology Section of AAFS. He is currently the Chair of the Organization of Scientific Area Committees Subcommittee on Medicolegal Death Investigation.

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