The forensic investigation of Arotile’s case

Following the unfortunate death of Flight Officer Tolulope Arotile as a result of the alleged motor vehicular accident in which she was the pedestrian victim, my professional opinion was sought by various concerned persons. I am aware of the various conspiracy theories, thanks to the social media, as well as, the submissions made by the Nigerian Air Force (NAF) Spokesman, Air Cdr. Daramola. The way the sad incident was handled unfortunately allowed for the proponents of various conspiracy theories to have a field day. The thrust of this write up is primarily directed at providing information from a strictly professional angle, to the average man on the street as to how to properly investigate a fatal motor vehicular accident involving a pedestrian. After this the parties involved can ask themselves if they had done the right thing, and for the man on the street to come to an informed conclusion on what might have happened and what to believe.

The aim of a forensic investigation into deaths of this nature is to determine the under-listed.
What happened?
How it happened?
Why did it happen?
Who was the victim?
What lessons are there to be learnt, and
How do we prevent a recurrence?

Once we fail to properly address these questions, we cannot claim that such a case has been investigated. There are no short cuts. A detailed accident investigation (complemented by accident reconstruction) is expected of any decent society, and the medico-legal system is supposed to seamlessly take care of such processes. I want to say from the onset that such a death as in the present case is a reportable one that the Coroner should investigate. In other words, it does not require the consent of the family. That is apart from the fact that it was a national disaster that should attract the attention of the country. Where the family suggests out of ignorance that they do not want an autopsy, it is the duty of the establishment to explain why such an investigation is necessary and must be done. The government owes the citizenry a duty to know how anyone died; anything to the contrary will suggest that we still live in pre-historic period.

I sincerely believe that the NAF Spokesman talked out of ignorance, but unfortunately he did so with a lot of arrogance. I am not sure if at least an Anatomic Pathologist is within the NAF Medical Corps to offer some professional advice. Ideally this type of investigation should be handled by a Forensic Pathologist and this would have been the case if such an incident had occurred in any of the western countries. To say that death resulted from ‘blunt force trauma and bleeding’ means nothing. It does not answer medico-legal questions; it is not sine qua non for a ruling of accident as the manner of death. In other words, it does not rule death as an accident as opposed to suicide or homicide. The investigation of these cases, include the locus (scene) of the fatal event, motor vehicle, the victim, and finally the accident reconstruction. It is noteworthy that even where there is no fatality the forensic investigation of vehicular accidents should be professionally handled and attention paid to all the required details; the outcomes might be relevant to any civil suit resulting from the event.

Locus
The scene should be secured immediately by the first responders at the earliest opportunity. I recognise the fact that bystanders would have flocked such a scene for various reasons ranging from sightseeing to theft or attempts at medical intervention; the ambulance crew might also arrive at such a scene before the Traffic Police Team. All these individuals are likely going to ‘contaminate’ the scene but certain basic and essential things will not change. The NAF Spokesman said that they have forensic experts in their service, apart from the NAF Police who conducted a ‘thorough investigation’. It will be interesting to know what they did.
Having secured the scene, the locus should be photographically recorded. In most instances, bystanders, ambulance crew or firemen would have rushed to take the victim(s) to the medical centre, and probably shifted the vehicle or some other objects in the attempt to retrieve an entrapped victim. Despite these ‘distortions’ a lot of information can still be obtained by properly securing the locus. It is noteworthy that what is required is forensic photography and not just ordinary photography.

The recording of the scene requires the identification of a reference point, usually very close to the primary locus and from which all other measurements can be referenced. This must be a permanent spot that allows for other coordinates to be taken. From this spot the accident investigator (usually an appropriately trained police officer) notes the point of primary contact and then the point of rest of the vehicle/victim. It is noteworthy that a certified traffic accident investigator is well trained in geometry, algebra, mechanics (physics), engineering, and related subjects; it is not a proficiency that is acquired simply through spending a long time in the traffic division of the Nigeria Police. Unfortunately I am yet to encounter one so trained in the Nigeria Police over the last 16 years, and it will be interesting to know if such experts are in the NAF. The accident investigator will among other things prepare a sketch (to scale) of the locus and interview all available eyewitnesses. This latter act must be done quickly and should involve all first attendees to the scene including those who might have been involved in retrieving and rushing the victim(s) to the hospital. Delay in carrying out this vital exercise can result in progressive distortion of the ‘facts’.

The accident investigator would be expected to document the type and state of the environment, noting the time of the day and level of visibility, dryness or wetness of the road, presence or absence of speed breakers, gutters, kerb, electricity or other utility poles, trees, and any object that could potentially have obstructed the view of the driver, etc.
Motor vehicleE/motorcycle

The investigator must document the type(s) of vehicle(s) involved in the collision, noting the make and model, special configurations, overall height, bumper height relative to the road surface, any protruding parts or cargo, and the relative distance of same to the ground. These information are useful to the forensic pathologist in the attempt to account for injuries seen on the victim in the autopsy room. A good accident investigator will naturally complement the forensic pathologist, and where the former is not available, the latter should visit the scene to properly educate himself. The investigator should note the presence or absence of tyre impressions, such as, yaw, acceleration and deceleration (skid) marks. These can assist in calculating the speed of the vehicle at the time of the impact; this information will of course determine the magnitude of skeletal (bone) or soft tissue damage that the forensic pathologist is likely to observe on the victim at autopsy.

The point of primary or secondary impacts on the vehicle must be noted; rarely these can be deliberately superimposed to conceal information. Damages to the vehicle(s) can result from collision with another vehicle, the pedestrian(s), other objects on the road sidewalk, kerb, ditch, electric pole, etc. The damage can be found on the bumper, hood, trunk, windshield, rear windshield, or the roof. The traffic lights could have been damaged and the car paint could have been transferred during impact to the pedestrian or other objects. The damage to the hood, windshield or roof could have been produced when a pedestrian is struck by the vehicle and flung upwards before landing on the car. The point of landing is dependent on the car speed, attempts by the driver to decelerate by applying the brakes, angle of the impact, swipes and a lot of other variables. At times the victim can land on the road if the speed of the vehicle is great enough to allow it to move well forward before the pedestrian descend under gravity. The damages to the exterior of the vehicle would need to be related to the various injuries on the victim.

Damage to the vehicle could be found underneath with transfer of oil and grease to the victim. The latter could also have his/her hair or clothing becoming entangled with the vehicle’s underneath. All these observations tell a story. It is not uncommon for the vehicle to run over the victim causing additional injuries; the victim could be rolled while underneath the vehicle and the tyre could in some cases roll on the same spot while on top of the victim. It is not uncommon for the victim to be dragged over a distance while underneath the vehicle. The forensic pathologist must attempt to relate the injuries found on the victim to the various parts of the vehicle that could have produced the injuries. Finally, damage to the vehicle could have resulted from roll overs (when the vehicle summersaults) with the attendant possible injuries sustained by the victim.The vehicle must be inspected for any inherent mechanical defects.

DRIVER
The Police are required to question the surviving driver and any other occupant of the vehicle while satisfying other legal requirements such as fitness to be interviewed or ensuring that such interview, or the making of any statement is done after the interviewee has been read his rights. Ideally the medical history and any relevant medications being used by the driver must be recorded by the Police.

The Police doctor is expected to assess the physical and mental state of the driver through accepted medical examination processes, having secured informed consent or obtaining appropriate authorisation depending on the prevailing statutory requirements.

Finally, biological fluids which is usually urine, is collected for toxicological studies; the possible presence or absence of alcohol or other drugs of abuse must be determined. In some situations, the driver would have been breathalysed while at the scene of the accident or while at the Police Station. Where indicated, the driver might require psychological evaluation as long as there are statutory provisions that permit this type of evaluation.

POSTMORTEM EXAMINATION OF THE VICTIM
As earlier stated, the death of a pedestrian following a vehicular accident is a reportable death that must be investigated. That is the least that any government owes her citizens. Such investigations make a postmortem examination mandatory and it requires no family consent. Giving the excuse that the family objected simply plays into the hands of conspiracy theorists. It is a big shame that in the case of Flt. Off. Arotile, the NAF decided to refer the matter to the Police for investigation after burying the body! I was greatly saddened as a forensic pathologist when I heard the announcement that no autopsy was performed. Many of my other professional colleagues, junior anatomic pathologists and trainees were equally alarmed; it was unbelievable that this would happen in Nigeria in this century.

Where indicated and perhaps ideally, the forensic pathologist needs to be armed with the past medical history of the victim, including medications being currently used. This is mandatory where the victim survived for some time in hospital; the hospital notes must be carefully perused by the pathologist.

Postmortem examination is normally commenced by conducting a radiological (X-ray) examination. The body is examined for skeletal (bone) injuries, possible determination of the angle of impact, and assessment for the presence or absence of any foreign object such a missile (bullet). This simple examination will enable the establishment to debunk any unfounded conspiracy theory that the victim was shot, killed and then thrown underneath a vehicle.

The next thing is to identify the body of the deceased including documenting basic external features that will further aid identification. The next course of examination is fully photographed, and where available videography is added.

The clothes are gently examined for any rent, presence or absence of trace evidence like glass, car paint, grease or tyre marks. The location and orientation of these materials must be noted. The clothes are then carefully removed, dried and sent to the forensic laboratory for examination.

The body is fully examined externally to determine the type, location and concentration of injuries. Where a victim has been struck by the vehicle’s bumper this must be identified and attention paid to its level above the sole of the feet. The forensic pathologist should be able to determine the position of the victim at the time of the impact, whether the vehicle was accelerating or decelerating at the time of the impact, and whether the victim was stationary, walking or running at the time of the impact. The part of the body that was first struck by the vehicle and other secondary impacts due to being flung onto the road surface, kerb, walkway or roadside objects; these must be documented. Injuries caused by the side mirror, and protrusions from inside the vehicle such as cargo must be determined where present. Other injuries attributable to roll overs and being dragged underneath the vehicle must be identified. Where the victim was underneath the rolling tyre of the vehicle, a splayed injury is often seen on the body in addition to tyre, oil and grease marks. It is not uncommon for the driver to have fled the scene with the car, but where the latter is subsequently recovered, the victim’s DNA material might still be recovered from underneath the vehicle.

Examination of the internal organs might reveal various injuries in addition to any internal bleeds. The location and degree of the injuries might help to determine the point of impact; attention must be paid to injuries due to secondary impacts while also being mindful of brain injuries seen on the side opposite to the point of impact to the skull. It is noteworthy that both blunt and sharp force injuries can be seen but these might not necessarily be due to a motor vehicular accident. The onus is on the forensic pathologist to correctly interpret these injuries and determine the possible causation.

It is important for the pathologist to collect samples of biological fluids such as blood, urine, fluid of the eye, bile, and other samples like stomach content, from the victim for toxicological examination. A pedestrian under the influence of drugs or alcohol might have walked into the path of a moving vehicle. It is also possible that due to the effect of intoxicants, the pedestrian might have been slow in reacting and avoiding an approaching vehicle due to the slowed reaction time. Absence of these drugs eliminates a possible defence of contributory negligence on the part of the victim; of course the Courts are equally mindful of the principle of ‘eggshell skull’ where the assailant has to take his victim as he finds him.

During autopsy, the pathologist is required to take tissue samples for processing in the laboratory, after which he now examines the slides under the microscope to assess the injuries due to the vehicular accident. This stage of the examination is also important as it helps to further confirm whether or not the body is showing any vital reaction. The latter is absent if the victim had died prior to being thrown on the road or under a moving vehicle.

It is at the conclusion of the postmortem examination that a cause of death can be determined and ultimately, the manner of death. Armed with information from the locus, the vehicle and full postmortem examination, the forensic pathologist in the commentary portion of his report, will try to reconstruct the accident that happened, and how the victim came about sustaining the alleged injuries that resulted in death. The commentary will also attempt to answer the medico-legal questions bordering on the cause and manner of death.

Provided above, is information about the least that is expected in the medico-legal investigation of fatal road traffic accident involving a pedestrian. The question now is whether or not these were done in the case of Flt. Off. Tolulope Arotile? If not, why did we fail to do the right thing? Why did the establishment provide ammunition to conspiracy theorists? Are we incapable of doing the right thing as a nation?
Is Nigeria really cursed? Can we witness a better Nigeria in our lifetime?
Prof. Obafunwa is anatomic/forensic pathologist, department of pathology and forensic medicine, Lagos State University College of Medicine.