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# Postmortem artefacts: what is not an injury

- Finding

An artefact is a change that appears after death or from medical care and can look like an injury or a disease.

Updated Nov 5, 2026

## Key points

- The vital reaction (haemorrhagic infiltration, inflammation, repair) separates an injury in life from an artefact.
- Resuscitation: rib or sternal fractures, defibrillator marks, puncture sites, mouth and neck injuries from intubation.
- Decomposition: blood-stained purge from mouth and nose, facial swelling and dark colour mimic violence or asphyxia.
- Fauna: insects and animals cause defects with clean edges and no bleeding.
- Heat: pugilistic posture, heat fractures and skin splits do not indicate struggle or blows.

## What it is

An artefact is a change in a dead body that imitates disease or an injury inflicted in life, but was produced by resuscitation, handling of the body or natural processes after death. The most important are lividity and internal hypostasis (mimicking bruises, pneumonia or infarction), decomposition changes (swelling, discolouration, blood-stained purge), skin slippage, drying of lips and skin, insect and animal activity, resuscitation injuries and heat changes in burned bodies. The key to telling them apart is the vital reaction: an injury inflicted in life shows infiltrating blood, inflammation or repair, and an artefact does not. Misreading an artefact can lead to alleging a homicide that never happened, or to missing a real one.

## How to tell it apart

- Lividity vs bruise: dependent area and no infiltration on incision in lividity.
- Hypostasis of the larynx or oesophagus vs strangulation haemorrhage: hypostasis follows body position and lies in dependent areas.
- Drying vs an abrasion inflicted in life: drying shows no vital reaction under the microscope.
- Heat split vs incised wound: the split follows tension lines, with no infiltration at the edges.
- Insect defects can hide or mimic bullet holes: a full autopsy is required.

## How to recognise it

- Skin defects with irregular edges and no infiltrating blood at the margins (fauna, dragging, handling).
- Brown, hard areas on lips, scrotum or skin scraped after death (drying), with no vital reaction.
- Round or rectangular chest marks from defibrillator pads and puncture marks at venous access sites.
- Aligned anterior rib fractures, typical of chest compressions.
- In burned bodies: linear skin splits, flexed limbs and fractures with heat-type margins.

## How it forms

- Gravity, decomposition and drying change the colour, shape and volume of tissues after death.
- Medical procedures act on a living or newly dead body and can leave marks that resemble injuries.
- Heat coagulates and contracts muscle and skin, which split and shorten.
- Insects and animals consume soft tissue, especially around orifices and existing wounds.

## Next step: what to do and document

- Record in the medical record, and report to the judicial police, every resuscitation manoeuvre and procedure performed, with its location.
- Do not remove tubes, catheters or electrodes from a body going to medico-legal autopsy; describe their position.
- Describe doubtful marks without calling them injuries, and leave the distinction to the autopsy (incision and histology).
- Take histology samples from doubtful lesions to look for a vital reaction.
- Record how the body was handled and transported (falls, straps, bags) in case it explains marks.

## Common mistakes

- Attributing resuscitation rib fractures to blows.
- Mistaking decomposition purge for haemorrhage from violence.
- Reading the pugilistic posture of a burned body as a defensive position.
- Describing a fauna defect as a wound without looking for a vital reaction.

## Test yourself

Think of the answer, then tap the question to see it.

## Which finding distinguishes an injury inflicted in life from a postmortem artefact?

The vital reaction: haemorrhagic infiltration, inflammation or signs of repair at the edges, which an artefact lacks.

## What injuries are expected from cardiopulmonary resuscitation?

Anterior rib or sternal fractures, defibrillator pad marks, venous puncture sites and mouth or neck injuries from intubation.

## Does the pugilistic posture of a burned body show that the victim fought back?

No. It is due to heat coagulating and contracting the muscles, and it happens even if the person was already dead.

## Which internal hypostasis can mimic a myocardial infarction?

Hypostasis of the posterior wall of the heart in a supine body; pulmonary hypostasis can mimic pneumonia.

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## Connections

## Related 4

- [Vital reaction: was the wound made in life?](https://durgical.com/en/forensic-medicine/vital-reaction-was-the-wound-made-in-life/)
- [Livor mortis (hypostasis)](https://durgical.com/en/forensic-medicine/livor-mortis/)
- [Decomposition: autolysis and putrefaction](https://durgical.com/en/forensic-medicine/decomposition-autolysis-and-putrefaction/)
- [Rigor mortis and cadaveric spasm](https://durgical.com/en/forensic-medicine/rigor-mortis-and-cadaveric-spasm/)

## Related conditions 2

- [Burns (thermal, chemical, electrical; inhalation injury)](https://durgical.com/en/conditions/burns/)
- [Cardiac arrest (VF, pulseless VT, asystole, PEA)](https://durgical.com/en/conditions/cardiac-arrest/)

[← All of forensic medicine](https://durgical.com/en/forensic-medicine/)

Educational content on forensic and legal medicine; not legal advice and no substitute for the technical guides of Colombia's National Institute of Legal Medicine and Forensic Sciences. Laws change: each page links the official text and says when it was last checked. For a real case, follow the guide in force and ask the competent authority.

Sources: [The Minnesota Protocol on the Investigation of Potentially Unlawful Death (2016), glossary: artefact and decomposition](https://www.ohchr.org/sites/default/files/Documents/Publications/MinnesotaProtocol.pdf) (Office of the United Nations High Commissioner for Human Rights, 2017); [Livor Mortis and Forensic Dermatology: A Review of Death-Related Gravity-Dependent Lividity and Postmortem Hypostasis (Cohen PR, Moss RJ, Prahlow JA)](https://doi.org/10.7759/cureus.90760) (Cureus, 2025); [Accelerated rigor mortis: A case letter (Mesri M, Behzadnia MJ, Dorooshi G)](https://doi.org/10.4103/jrms.JRMS_599_17) (Journal of Research in Medical Sciences, 2017).

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License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/forensic-medicine/postmortem-artefacts-what-is-not-an-injury/