Background
The present article focuses
on the contents of the stomach and how they change with time, in the context of
whether or not one can obtain useful information on the time of death. The stomach uses a combination of mechanical
action and hydrolytic enzymes such as pepsin to break food down into smaller
particles and simpler chemicals. Kong
and Singh (2008) reviewed the physiology of the stomach, including factors that
affect the rate at which the stomach empties.
A website at Colorado State has a helpful graphic showing the transit
times of material in the digestive system.
Patel et al. (2013)
Patel and coworkers
coauthored a paper which correlated the contents of the stomachs of 100
deceased individuals with known times of death and times of last meal. The authors divided the contents as follows:
Category I: semi-digested food particles
Category II: semi-digested unidentifiable food particles
Category III: empty stomach
Category I was found more
commonly in those dying within 0-2 hours after their last meal. Category II was found more commonly in those
dying within 2-6 hours after their last meal.
Category III was found more
commonly in those dying more than 6 hours after their last meal.
19 cases fell into category
I, of which 16 (84%) had consumed their final meal in 0-2 hours before death, 2
cases had eaten 2-4 hours before death (11%), and one person had eaten 4-6
hours before death (5%). For category
II, the most likely situation encountered was that the last meal was taken 2-4
hours before death (49%), but there were a number of cases in which it was 0-2
(13%), 4-6 hours (26%), or greater than 6 hours (11%). The span of 2-6 hours covered 75% of the
individuals. For category III the most
likely situation encountered was that the last meal was consumed more than 6
hour before death.
The authors discussed the
composition of the meal, noting that a carbohydrate meal leaves the stomach
most quickly, a protein meal leaves at an intermediate rate, and a fatty meal
leaves the stomach most slowly. I will
use this paper as a guide to evaluate some earlier cases.
Horowitz and Pounder (1985)
Horowitz and Pounder wrote,
“There is a significant variation in emptying rates between normal subjects,
but under controlled conditions gastric emptying of a test meal is relatively
reproducible in normal individuals.”
These authors note that many things can affect the rate of gastric
emptying, such as certain drugs, stressful stimuli, and diseases.
They wrote, “In those
occasional instances where the gastric contents provide the only practicable
means of evaluating the time of death some guidelines can be offered. First only the digestible solid component of
the meal should be assessed…Second the weight of the solid component should be
compared with the estimated weight of the known last meal…Third, the confidence
limits of any opinion should take into consideration the many possible
variables, so that the estimate given should cover a ranges of at least some
hours.” They conclude by saying,
“Estimates to within half an hour clearly cannot be justified in the light of
present knowledge of patterns of gastric emptying. For forensic purposes the stomach is a very
poor timekeeper.”
Jaffe (1989)
Dr. Frederick Jaffe authored
an article in which the abstract read in part, “Using it [stomach contents] as
a guide to the time of death, however, is theoretically unsound and presents
many practical difficulties, although it may have limited applicability in some
exceptional instances.” The article
discussed three cases. I will take the
facts as presented in this article as givens, but a few of them are in dispute. I will mention the controversial points of which I am aware without taking a position on them.
In the Steven Truscott case,
the victim ate at 5:50 PM and was in the presence of Steven Truscott between 6:30
and 8:25 PM. The pathologist put the
time of death as being between 7:15 and 7:45 but later had misgivings about
this range (Dr. Jaffe’s remarks indicate strong skepticism about this level of
precision). One source indicates that
Steven Truscott was seen at 8 PM on the grounds of a school.
In the Crimmins case, the
two children were fed at 7:30 and an abduction would have taken place about 9
hours later, if Mrs. Crimmins’ account were accurate. Yet, recognizable food was found in one of
the children’s stomachs. Assuming that
their meal was indeed manicotti and string beans (Mrs Crimmins stated that it was veal), Dr. Jaffe indicated that this
was not reasonable. This is the only
case in which Dr. Jaffe implies that stomach contents were useful in
ascertaining an approximate time of death.
Davis (1989)
Dr. Joseph Davis wrote a
letter in response to Dr. Jaffe’s article, focused on the Hendricks case. Dr. Davis discussed how the length of time
for the stomach to empty increased with increasing size of the meal. With respect to the three children he wrote,
“Although the evidence was not as close to absolute as in the Crimmins case,
which involved an 8 ½ h postprandial period, it is well within accepted
probability that a coincidental delay in gastric emptying time would not occur
in all three victims.”
Pope (2012)
During an attempted robbery
in Eugene, OR, the suspect was killed in an exchange of fire with a
barista. Examination of his stomach
contents revealed contents suggesting the consumption of a bacon cheeseburger
and French fries. The size of the French
fry was a clue that helped narrow down the identity of the fast food
restaurant. This information prompted investigators
to examine security footage from a local fast food restaurant, where they
identified the deceased suspect and a second suspect, who was later
arrested. About an hour elapsed between
the time that the two suspects were in the restaurant and the time of the
attempted robbery.
Conclusions
In the Truscott case, the
victim probably died within 2 hours of consuming her last meal, but she might
have died up to about four hours after her last meal. In addition, there is some uncertainty about
the time that Truscott was later seen.
There is no support in the literature for the narrow 30-minute
window. If the victim ate near 5:50 and Mr. Truscott left her presence before 8 PM, it is quite possible that she died afterwards. Therefore, the stomach contents
were overinterpreted in his case. In the
Hendricks case the TOD was unlikely to have been more than four hours beyond
the consumption of the last meal, and the similarity among the contents of the
three stomachs means that any factor that might have slowed digestion for one
child would probably have to have slowed it for all three. In the Crimmins case the contents of the
stomach were correctly interpreted as ruling out an abduction later than 4 AM,
and the only uncertainty is in what the children ate for dinner.
Dr. Jaffe correctly
cautioned his readers about dangers of overinterpreting stomach contents as
they relate to TOD. Yet there are
clearly examples in which information on the time of death or time of last meal
based upon contents of the stomach was helpful to investigators. It seems that stomach contents are more
useful under some circumstances than others.
The estimate will be in the form of a range of several hours. If the time of the last meal is not known,
then only a relative time of death can be ascertained. If the time of a meal is known, but the type
of food is not known, then some uncertainty exists with respect to whether or
not it is the last meal that the deceased person ate. If the time and nature (size and type of
food) of the last meal is known, then if identifiable material is found, the
last meal was probably consumed within two hours, with an outside chance that
it was consumed between two and six hours before death, unless some exceptional
circumstances are at work. If the
stomach is empty, then the time of death is likely to be more than 6 hours
after consumption of the last meal, but it could be 2-6 hours.
References
Davis JH, “Gastric Emptying
Time” (1989) American Journal of Forensic Medicine and Pathology 10(3) 271-272.
Horowitz M, Pounder DJ, “Is
the stomach a useful forensic clock?” (1985) Austr NZ J Med 15, 273-276.
Jaffe F, “Stomach Contents
and Time of Death: Reexamination of a
Persistent Question” (1989)
American Jounal of Forensic
Medicine and Pathology 10(1) 37-41.
Kong F, Sing RP
“Disintegration of Solid Foods in the Human Stomach” (2008) Journal of Food
Science 73(5) R67-R80.
Patel V, Silajiya D, Shah K,
Menat A, Tandel M, and Raloti S, “Estimation of time since death by gastric
contents” (2013) IJCRR 5(11), 125-129.
Pope L “Identification of a Second Suspect via
Stomach Contents at Autopsy” (2012) J
Assoc Crime Scene Reconstr. 18(2) 13-15.
