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- Cure - To diagnose and render treatment MODULE 1: LEGAL MEDICINE - Minor injuries are ignored...

- Cure - To diagnose and render treatment MODULE 1: LEGAL MEDICINE - Minor injuries are ignored - DOH Terminologies: Medicolegal Officer Legal Medicine - Cause Forensic Medicine - To testify before all courts or tribunal Medical Jurisprudence - All are recorded - DOJ Scope of Legal Medicine Branches of Law where Legal Medicine may be applied Transcends all where medical and paramedical sciences are applied as demanded by law for the Civil Law administration of justice. Determination of civil personality (Art 40-41) - Wounds Limitation of a person’s capacity to act (Art. 39) - Death Marriage and Legal Separation - Trauma Paternity and Filiation - Violence Testamentary capacity Major Duties of the Medicolegal Officer and Criminal Law Investigating Team Circumstances affecting Criminal Liability Crimes against Persons Determine the cause and manner of death. Crimes against Chastity Identification of an unknown individual. Collection of evidence from the body. Remedial Law Documentation of injuries or lack of them. Physical and mental examination of a person Deduction of how such injuries occurred. Proceedings for the hospitalization of an insane Documentation of any natural disease, if present. person Testify and provide expert opinion if the case goes Rules on Evidence to trial. SC Adm. Circ 06-11-05 Nature of the Study Special Law Dangerous Drugs Act Ability to acquire facts and draw conclusions Youth and Child Welfare Code therefrom. Insurance Law Must possess powers to impart to others verbally or Code of Sanitation in writing all those he has observed. Labor Code Titles: Glimpses from the Past Medical Jurist (most important) Medical Examiner Medico-legal Officer Antistius Coroner Conducted the autopsy on Julius Caesar Who may perform autopsies? Paulus Zacchias (1659) “Questiones Medico-Legales” 1) Medical officers of Law Enforcement agencies Father of Forensic Medicine - PNP Legal aspects of wounds - NBI Detection of secret homicide - Code of Ethics - Revised Administrative Code Orfila (1853) - Code of Sanitation Traite’ des Poison Father of Modern Forensic Toxicology 2) Medical staff of accredited hospitals as Mineral, vegetable and animal poisons authorized by law - It is the duty of every physician when called upon by the judicial authorities to assist in the administration of justice. MEDICAL EVIDENCE Physician 1) Autoptic or Real  Addressed to the senses of the court. - Advances in Ballistics Vision, smell, hearing, taste and touch. - Low-velocity and high-velocity blood splatter and identification of hits LIMITATIONS: - Standardizing crime scene procedures - Indecency or Impropriety - Teleforensic - Repulsive objects - Audio and video-enhancement technology - Miniaturization and microchip technologies 2) Testimonial Evidence - Fingerprinting technology A physician may be commanded to appear in court. - Polygraph His testimony must be given orally and under oath or affirmation. 1) DNA a. Ordinary CODIS – combined DNA Index System b. Expert PCR – Polymerase Chain Reaction - Opinion Rule mtDNA – Mitochondrial DNA - Expert Evidence STR – Short Tandem Repeats - Privileged Communication - Cold Case Files - Hearsay Rule - Ancestry - Dying Declaration - Serial Crimes - 9/11 3) Experimental Evidence - Mass killings A medical witness may be allowed in court - Mass graves to confirm his allegation or as a - Coffee cup corroborative proof to an opinion he - Licked postage stamps previously stated. - Single hair roots Ex: lethality of poisons, drowning 2) Image Enhancement Technology 4) Documentary Evidence Imprints Impressions Indentations on soft medium such as mud, snow or Preservation of Evidence sand Oblique light Photographs Polarized light Sketching UVL Description Infrared Manikin Method Alternate light source Preservation in the mind of a witness Special Methods 3) Fingerprinting Technology - Embalming AFIS - Automated Fingerprint Identification System - Refrigeration Rapid retrieval of fingerprint files all over the world - Stains Offenders Data Base - Sealed Containers for poisons 4) Computer Crime and Electronic Evidence E-mail correspondence FORENSIC UPDATES Instant chats Retrieve deleted files Forensics Internet Child Exploitation The application of science to matters of law. Analysis of information suitable for use in a court of 5) Ballistics law. (J.Brenner) Reconstruction courses - DNA analysis is unlocking the mysteries of human identity. 6) Blood Splatter Analysis - Image enhancement technologies are Distance from the blood source to the target enabling investigators to read clues such Direction of travel and impact angles as fingerprints, footprints and bite marks. Nature of the force used to cause the bloodshed - Data mining of databases, such the The object used to cause the bloodshed Combined DNA Index System (CODIS) and Sequencing of multiple bloodshed events the Automated Fingerprint Identification Interpretation of contact or transfer patterns Systems (AFIS) help crack cases that would have been unsolvable a few years 7) Teletronics ago. Faster communication - Computer crime and Electronic evidence Area surveillance  Death 8) Polygragh “dauthaz” – Proto-Germanic Admissibility in evidence “doth” – old saxon “dood” – dutch Forensic Sciences Termination of life complete cessation of all the vital functions without possibility of resuscitation (Solis). The application of scientific facts to legal problems. Death is the end. The period that comes after a The field of science that is used in the judicial sentence. process. The permanent ending of vital processes in a cell or tissue (English Dictionary). Forensic Medicine Cessation of life in a previously viable organism (Simpson). Branch of Medicine that applies the principles and Cessation of life, ceasing to exist, total stoppage of knowledge of the medical sciences to problems in the circulation of the blood, and cessation of the the field of law. animal and vital functions (Spitz; Black’s Law The use of medicine to determine the cause or time Dictionary). of death, or for other legal purposes. Medico-Legal Importance LIVING DEAD Civil personality is extinguished. Medical examination Autopsy Properties are transferred to heirs. Death of a partner is a cause of dissolution of External injuries Cause partnership agreement. Death of a principal or agent is a mode of Internal injuries Manner extinguishing an agency. Mechanism Criminal liability is extinguished. Civil case is dismissed. Mechanical ventilation and other resuscitative External Injuries devices. Increasing demand for organ transplantation. Erythema Induced coma (sedative) Edema Contusion Brain Death (Criteria for Diagnosis) Hematoma Deep coma not due to depressant drugs, metabolic Abrasion or endocrine disorders. Laceration On mechanical ventilation because of absent or Avulsion inadequate respiration. Incision A firm diagnosis of the basic pathology must be known to be due to irremediable brain damage. Internal Injuries Diagnostic tests for brainstem death must be unequivocally positive. Injuries that happen deeper than the skin. Deep, Irreversible COMA Muscle, bone, organ involvement ABSENT Electrical Activity (EEG) ABSENT Brainstem Reflexes (Cranial nerve Death stimulation proves to be futile) COMPLETE cessation of all vital functions ( Coma RESPIRATORY, CARDIAC & NEUROLOGIC From the Greek word “KOMA” functions) and most importantly WITHOUT the State of unconsciousness in which a person cannot possibility of resuscitation. be awakened or fails to respond to painful stimuli. Lacks the normal sleep-wake pattern/cycle. Kinds of DEATH No voluntary actions could be initiated. - Somatic Death A score of 3 - 8 on the Glasgow Coma Scale (Point - Cellular Death 3; DEEP COMA). - Apparent Death Consciousness Functioning cerebral cortex and brainstem [Ascending Reticular Activating System MODULE 2: MEDICO-LEGAL ASPECT OF DEATH (ARAS)]. ARAS works to arouse and wake the brain. Glasgow Coma Scale Estimation of Time of Death based on the cooling of the Neurological Scale body A reliable and objective way of recording the state of consciousness. (Normal Temperature) 98.4 ˚F (37˚C) – (Rectal Initially used for head injury. temperature) divided by 1.5 = Approximate number of hours Recently accepted as APPLICABLE for Acute after death Medical and Chronic ICU patients. ★ Rectal temperature represents the core body of temperature. KINDS OF DEATH Noticeable Changes in the Eyes 1. Somatic Death COMPLETE, PERSISTENT, and Loss of corneal/pupillary reflex (also noted in GA, CONTINUOUS cessation of the vital LA, Apoplexy, Uremia, Epilepsy, Narcotic functions of the brain, heart, and lungs. Poisoning) Clouding of the cornea 2. Cellular Death Flaccidity of the eyeball Death of the individual cells (3 - 6 hours Pupils is at rest before completion of cells death). Optic disc pale “Tache noir de la sclerotique” (French; black spot of 3. Apparent Death the sclera) State of suspended animation. Stoppage of the heart (cardiac arrest; Action of Heat on the Skin drowning). Dry blister Signs that DEATH has arrived: No sign of inflammation Cessation of heart action and circulation Postmortem Interval Cessation of respiration Scientific name of time of death. Cooling of the body Insensibility of the body and loss of the power to Forensic Value move Noticeable changes in the skin and eyes Determination of time of death Action of heat on the skin Set the time of murder Eliminate or suggest suspects ★ The fall of temperature of 15 - 20˚F is a certain sign Confirm or disprove an alibi of death (Solis, Pedro P., M.D). Property inheritance/insurance claims Human Temperature Variation Effects Factors used in determining the Time of Death Normal internal body Livor Mortis 37 °C (98.6 °F) temperature (varies Rigor Mortis between 36.12–37.5 °C Algor Mortis (97.02–99.50 °F)). Decomposition Chemical changes in vitreous Death; Serious brain Stomach contents damage; Convulsions; 43 °C (109 °F) Shock; and Entomology Cardio-respiratory Scene markers collapse. Mild to moderate shivering ESTIMATING THE TIME OF DEATH (body temperature may 36 °C (97 °F) drop this low during sleep) RATE METHOD CONCURRENCE May be a normal body METHOD temperature. Measuring the change Comparing the occurrence 24–26 °C (75–79 °F) or Death occurs due to produced by a process of events which took place less irregular heart beat or which takes place at a at known times with the respiratory arrest. known rate. time of occurrence of death. Example: Example: amount and a wrist watch  Time of persistence depends on: distribution of rigor stopped by a blow mortis during an assault - Condition of the body and temperature of change in body extent of digestion the environment. temperature of the last known Fully developed rigidity persists for a variable degree of meal period and then slowly softens and disappears with putrefaction of the decomposition. body Cadaveric Spasm Instantaneous appearance of rigor mortis. LIVOR MORTIS Onset appearing within minutes. Object will be firmly clenched in the hand. Latin: livor—”bluish color,” mortis—”of death.” Lividity, Postmorten Hypostasis. Forensic Value Reddish purple discoloration of the skin of the Can indicate whether a body has been moved. dependent areas of the body. Purple due to unoxygenated blood pigment hemoglobin. ALGOR MORTIS Due to settling of blood into the capillaries as they become dilated. Latin: algor—”coldness”; mortis—”of death.” Depends on gravity. Body cooling Absent in areas where the weight produces Measurement of body core temp. – intraabdominal pressure and occludes the capillaries thus prevents temp. accumulation of blood. - Intra-hepatic/sub-hepatic Evident within 30 minutes to 2 hours after death. - Rectal Between 4 – 8 hours, if the body is turned over, Chemical thermometer/thermocouple probe lividity will shift to the newly dependent areas. Blanching by pressure and not fully fixed. Forensic Value “Fixed” reaching its maximum coloration. Most useful single indicator of the time of death At 8 to 12 hours if decomposition is accelerated. during the first 24 hours post mortem. At 24 to 36 hours if delayed by cool temperature. The use of body temperature estimations to assess Fixation occurs due to obstruction of capillaries by time of death applies only to cool and temperate gelled blood or constriction by the body fat. climates since in tropical regions there may be a minimal fall in body temperature post mortem. Forensic Value Distribution of Livor Mortis may serve as evidence DECOMPOSITION to indicate whether a body has been moved several hours after death. Cherry red/pinkish lividity: Putrefaction → Safonification → Mummification - Carbon Monoxide poisoning - Cyanide poisoning Autolysis - Exposure to cold temp., icy waters, snow Breakdown of cells and organs through aseptic chemical process by intracellular enzymes. RIGOR MORTIS Putrefaction Decomposition due to bacteria and fermentation. Latin: rigor – “stiffness”, mortis – “of death” Rigidity First 24 - 36 hrs after death Stiffening of the body after death. - Greenish discoloration of RLQ abdomen. Due to the disappearance of ATP in the muscles. - Greenish discoloration of head, neck, shoulders. Evident within 2 – 4 hrs after death. - Purge fluid Completed approximately 6 - 12 hrs after death. - Swelling of the face due to bacterial gas formation. May last from: - Marbling - Tropical countries – 18 - 36 hrs - summer; 24 - 48 hrs - cold weather 60 - 72 hrs after death - Temperate countries – 2 - 3 days - Generalized bloating “Broken” by passive stretching of muscles. - Post mortem bullae After disappearance of rigor mortis, muscle - Skin slippage – “glove” becomes soft and flaccid due to dissolution of - Hair slippage muscle proteins. Any disease or environmental factor that raises Saponification body temp. accelerates development of rigor ★ Adipocere mortis.  Results from hydrolysis and hydrogenation environment. of adipose tissue. Produces greyish white to brown waxy, 1 to 3 years temperate climates fatty substance, firm but brittle. Gives off earthy, cheesy, ammoniacal odor Thousand of years freezing recognized by dogs trained to discover human remains. GASTRIC EMPTYING/STAGE OF DIGESTION Forensic Value Identification – conserves some bodily forms. Establishing the time interval between eating and Determining cause of death – death by firearm. death and finding the time the deceased last ate. The preserved fatty organs may reveal the bullet’s Estimations of how long it takes to digest a meal: trajectory. Spitz and Fisher Small meal – 1 hr Mummification Large meal – 3-5 hrs Natural or artificial conservation by dehydration and Adelson (size and content of meal) exsiccation of tissues. Light meal – ½ -2 hrs Brown to black leathery appearance, dry, brittle, Medium size meal – 3-4 hrs torn skin on prominences. Heavy meal – 4-6 hrs Dry, ventilated environments, in warm places where the body loses fluids through evaporation due to Speed of digestion varies: exposure to dry air. - Type of food More extensive and complete in desert - Solid, liquid, caloric content environments. - Individual person 11 days to 1 mo. and may last years or centuries. - Emotional/physical stress But the time necessary for mummification to take Examination of stomach contents and stage of place is not well documented because of the long digestion periods that usually occur before the body is - Limited value discovered. - Discredited Forensic Value BIOCHEMICAL CHANGES Identification of the body – well preserved. Establishing cause of death – large lesions may be preserved. Vitreous humour of the eye – linear ↑ in potassium. Collection of vitreous humour: Skeletonization - Insert 20 needle through the outer canthus Removal of soft tissue from bone. into the posterior chamber of the eye, Complete - All soft tissue is removed. aspirate with 5 or 10 cc syringe. Partial - Only portions of bones are exposed. Disarticulation takes place in a cephalo-caudal ENTOMOLOGY direction, from the center to the perhiphery. Sequence for human disarticulation in bodies Greek entomos, “that which is cut in pieces or exposed to air: engraved/segmented”, “insect.” - Head The scientific study of insects. - Sternum and clavicle The usual time for the egg to be hatched into larva - Upper limbs > lower limbs is 24 hrs so that in the presence of maggots in the - Trunk > pelvis cadaver, one can deduce that death occurred more - Ribs than 24 hrs. - Vertebra The time required for the body to become a Flies skeleton is variable due to multiple factors. Most common form of insect associated with Environment is far more potent in changing bones decomposing bodies. than time alone. Flies lay eggs in orifices of the body and in open wounds which may destroy or alter the appearance COMPLETE SKELETONIZATION of wound. After hatching, maggots grow larger until they reach 3 days in very humid environment the pupa stage which takes place 6 to 10 days. where there is great insect activity. Adults emerge in 12 to 18 days. 1 and 2 weeks in warm, damp  SCENE MARKERS distinguishable. Soft tissues largely gone. Helpful in badly decomposed bodies. Include: 1 month Body skeletonized when - Uncollected mails/newspapers exposed to air. - Whether lights are turned off or on - TV schedule opened to a time and date - How the individual is dressed Goals and Purpose of Investigation - Food that is out or dirty dishes on the sink - Sales receipts or dated slips in the pocket To help and serve the living. - When the neighbours last saw the To seek the truth objectively, intellectually, and individual without bias or emotional coloration. To document guilt and protect the innocent. Chronological Sequence of Putrefactive Changes in To determine the identity of the deceased. Tropical Region like the Philippines To determine the medical cause of death. To determine the manner of death. TIME SINCE DEATH CONDITION OF THE BODY Manner of Death 2-3 hrs Rigor mortis sets in. Natural Algor mortis Accident begins. Suicide Homicide 3-6 hrs Livor mortis Undetermined develops. Rigor mortis present all over. Livor mortis MODULE 3: PHYSICAL INJURIES 12 hrs welldeveloped and fixed. Greenish The effect of some form of stimulus on the body from within discoloration over or without: the caecum. Real when the effect is visible. Rigor mortis Apparent when stimulus is not enough. absent all over. Greenish ➔ Immediate or delayed effect. discoloration over 24 hrs the whole Vital Reactions abdomen and spreading to chest. Abdomen 1) Rubor - Redness distended with 2) Calor - Heat gases. 3) Dolor - Pain 4) Function laizza Ova of flies seen. Trunk bloated. Face discolored CLASSIFICATION OF WOUNDS 48 hrs and swollen. Blisters present. Moving maggots As to Severity: seen. a) Mortal: brain, heart, lungs, big vessels, upper Whole body spinal cord, stomach, liver, spleen, intestines. grossly swollen b) Non-mortal: injuries which are not capable of and disfigured. producing death immediately or shortly thereafter. 72 hrs Hair and nails loose. Tissues soft and As to Kind of Instrument used: discolored. a) Blunt instrument 1 week Soft viscera putrified. - Contusion - Hematoma 2 weeks Only more - Laceration resistant viscera  Through and through puncture b) Sharp Instruments wounds. 1) Incised wound The entry wound is larger and with - Produced by a sharpe-edged (cutting) or inverted edges. sharp-linear edge of the instrument (knife, The exit wound is smaller and with razor, bolo, edge of oyster shell, metal everted edges. sheet, glass, etc.). As to the Site of Application of Force in Relation to Characteristics: LOCATION of Injury - Clean cut edges - Usually straight wound Coup - Both ends are sharp - Primary coup - The brain strikes the skull on the side of the Manner of Infliction: impact. Contre coup - Secondary impact SUICIDAL HOMICIDAL ACCIDENTAL - Contrecoup impact posterior area of skull. Found on parts Both accessible Usually multiple; Coup-contre-Coup Injury of the body and found mostly on - Damage may occur directly under the site accessible to the non-accessible VA. of impact (COUP), or it may occur on the hand like neck, parts; defense side opposite the impact (CONTRECOUP). elbow, groin, wounds present; Locus minoris resistencia knee, wrist; clothings always Extensive injury hesitation involved. wounds/cuts are present. Type of Wounds (Medical Classification): I. Closed Wound II. Open Wound ➔ Chopped/Hacked wound - quite severe injury A. Superficial A. Abrasion produced by a heavy, cutting instrument like axe, - Petechial B. Incised wound - Contusion C. Stab wound big bolo, saber. - Hematoma D. Punctured wound B. Deep E. Lacerated wound 2) Punctured wound - sharp-pointed 1. Musculoskeletal 3) Stab wound - Sharp-edged-pointed - Sprain Change of atmospheric pressure (BAROTRAUMA) - Dislocation Tearing force (LACERATED WOUNDS) - Fracture Heat or Cold (BURNS, SCALD, FROSTBITES) - Strain - Subluxatio Chemical explosion (GUNSHOT or SHRAPNEL) n Infection 2. Internal hemorrhage As to the Manner of Infliction 3. Cerebral concussion Hit Thrust 1) Closed Wound Stab No breach in the continuity of the skin or mucous Gunpowder explosion membrane. Sliding - Petechiae, contusion, hematoma Rubbing - Sprain, dislocation, fracture, strain Abrasion - Internal hemorrhage As to the Depth of the Wound a. Petechiae - circumscribed extravasation of blood in the subcutaneous tissue or underneath the mucous Superficial membrane. Deep b. Contusion - effusion of blood into tissues - Penetrating underneath the skin on account of the rupture of When they enter the cavity of body blood vessels as a result of the application of blunt or viscus. force or violence. - Perforating When the weapon enters the body Age of Contusion: on one side and comes from the The contusion is red, sometimes purple other side. soon after its complete development.  - Laceration of other parts of the body DAYS CHANGE IN COLOR Cerebral concussion - jarring/stunning of the brain 4–5 days Green as a result of injury to the head. 7–10 days Yellow and gradually 2) Open Wound disappears on the 14th With break in the continuity of the skin or mucous and 15th day. membrane. Up to 4 weeks Total disappearance of color. 1. Abrasions - removal of the superficial epithelial layer of the skin caused by a rub or friction against a hard rough surface. Contusion vs. Postmortem Hypostasis Forms of Abrasion: CONTUSION PMH a. Linear - single line, straight or curved line Below the epidermis In the epidermis b. Multi-linear - several line marks, parallel c. Confluent - almost indistinguishable linear marks May be present both ways present in the dependent and dependent part only d. Multiple - varying sizes and shapes independent part Abrasion – Medico-Legal Importance Often elevated Not elevated 1. May indicate struggle or assault (face, neck, Incision shows blood Incision shows blood is still forearm, hands). outside the vessels (vital in the vessels (no vital tissue reaction) tissue reaction) 2. May indicate intentional or accidental (bony parts of the body). Color variegated Color uniform 3. Nature of abrasion may infer degree of pressure. Nature of rubbing object and direction of movement. c. Hematoma - extravasation of blood in a newly formed cavity underneath the skin. Antemortem vs. Postmortem Abrasion Contusion vs. Hematoma ANTEMORTEM POSTMORTEM CONTUSION HEMATOMA Reddish brown Yellowish Effused blood in the Effused blood in a newly Location – any aresa Location – bony interstices underneath the formed cavity underneath prominence skin the skin Vital Reaction – YES Vital Reaction – NONE With or without elevation Always with elevation No blood obtained on Presence of blood on - Scratch aspiration aspiration - Graze - Impression mark Closed Wound – DEEP - Friction mark - Incised Musculoskeletal Injuries - Hacked 1) Sprain - partial of complete disruption in the - Stab continuity of a muscular or ligamentous support of a - Lacerated joint. - Punctured 2) Dislocation - displacement of the articular surface of bones entering into the formation of a joint. Special Types of Wounds: 3) Fracture - solution of continuity of bone resulting from violence or existing pathology. a) Patterned Wounds 4) Strain - over-stretching, instead of an actual tearing The wound assumes the shape of the offending or the rapture of a muscle or ligament, which may instrument. not be associated with the joint. Ex: belt buckles, tire marks, radiator grill Internal hemorrhage - rupture of blood vessel: b) Defense Wounds - Traumatic intracranial hemorrhage - Rupture of parenchymatous organs  Wounds sustained by the victim while parrying the a. Shall incapacitate the offended party for labor ten thrusts of the assailant in an attempt to defend (10) days or more or shall require medical himself. attendance for the same period… Always found on the extremities of the victim. Qualified if the injuries shall have been inflicted with c) Hesitation Cuts or Test Cuts manifest intent to insult or offend the injured Found commonly among suicide victims. person, or under circumstances adding ignominy to Usually found on the area where the mortal cut is the offense; located. or the victim is the offender’s parents, ascendants, guardians, curators or teachers; or a person of Self-inflicted Wounds (Motives): rank or in authority. To create or deliberately magnify an existing injury ART. 266 – SLIGHT PHYSICAL INJURIES AND or disease for pension or workmen’s compensation. MALTREATMENT To escape certain obligations or punishment. a. By inflicting physical injuries which shall To create a new identity or destroy existing one. incapacitate the offended party for labor from one to To gain attention or sympathy. nine days, or shall require medical attendance for Psychotic behavior the same period; b. by inflicting injuries which do not prevent the Psychotic Behaviors of Self-mutilation offended party from work nor require medical Legal classification of physical injuries attendance; c. by ill-treating another by deed without causing ART. 262 – MUTILATION injury Kinds: 1. Intentionally depriving a person totally or partially of ART. 252 – PHYSICAL INJURIES INFLICTED IN some of the essential organs for reproduction. TUMULTUOUS AFFRAY 2. Intentionally depriving a person of any part or parts When serious physical injuries are inflicted upon of the human body other than the organs for the participants thereof, and the person responsible reproduction. therefor cannot be identified, all those who appear to have used violence upon the offended party shall ART. 263 – SERIOUS PHYSICAL INJURIES by suffer the penalty next lower in degree than that for WOUNDING, BEATING or ASSAULTING another, if in the physical injuries so inflicted. consequence, the injured: a. Shall become insane, imbecile, impotent or blind; Causes of Physical Injuries: b. Shall have lost the use of speech, or the power to hear or to smell, or shall have lost an eye, a hand, a Physical violence foot, an arm or a leg or shall have lost the use of Heat/cold any such member, or shall have become Electrical energy incapacitated for work in which he was theretofore Chemical energy habitually engaged; Radiation by radioactive substances c. Shall have become deformed, or shall have lost any Change of atmospheric pressure (Barotrauma) other part of his body, or shall have lost the use Infection thereof, or shall have been ill or incapacitated for the performance of the work in which he was habitually engaged for a period of more than ninety (90) days; d. Shall have caused the illness or incapacity for labor of the injured person for more than thirty (30) days. ART. 264 – ADMINISTERING INJURIOUS SUBSTANCES OR BEVERAGES Any person who without intent to kill, shall inflict upon another: - Any serious physical injury; - by knowingly administering any injurious substance or beverage; - by taking advantage of the victim’s weakness of mind or credulity. ART. 265 – LESS SERIOUS PHYSICAL INJURIES