How is the manner of death determined? A forensic pathologist tells everything

Like the second half of Accident, suicide or murder’s Season 5 is getting closer, Oxygen.com sat down with an expert to find out what helps postmortem investigators determine a manner of death.

Renowned, board-certified forensic pathologist Priya Banerjee MD, founder of Rhode Island-based Anchor forensic pathology, mentioned uncertainty about classifying someone’s manner of death as an accident, suicide or murder is a ‘rare question’. But “it’s not something I’ve ever encountered,” Banerjee explained.

Such lines of inquiry serve as a focus for the well-trained and tenacious researchers within them Accident, suicide or murder, to return Oxygen on November 16 at 8 p.m and streaming Peacock.

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Do post-mortem examiners work with the police?

Dr. Banerjee, who works in multiple states, said there is “a lot of communication” involved between those conducting post-mortem examinations and those tasked with finding a possible perpetrator. As a former medical examiner in Rhode Island, she occasionally lent her expertise to crime scenes, but only in direct examinations of the physical body.

Otherwise, crime scene investigators provided what they had.

“A death is reported and a history is given (by authorities),” Banerjee said Oxygen.com. “What is known at the time, but that is also very provisional.”

Part of Dr.’s career Banerjee consisted of training general practitioners or junior doctors who wanted to become pathologists. She often told them, “Sometimes you have to trust your gut” when their findings about someone’s death did not match what was in the preliminary report. Still, it was always crucial to keep the researchers’ notes in mind.

“Because the story changes,” she said. “By the time the investigation goes on, X, Y, Z, it could be a completely different concept. Because the police had not done everything.”

Take, for example, the alleged slip-and-fall death of a wealthy New York philanthropist Leslie Neulanderonly one case listed Accident, suicide or murder. Her death in 2012 was initially believed to be an accident, until friend and retired medical researcher Dr. Mary Jumbelic investigated her friend’s death and found that Neulander’s injuries were more consistent with defensive wounds than a fall.

Financial turmoil, infidelity and a history of violence could all be factors in ruling the woman’s manner of death a homicide and, ultimately, convicting her husband of murder.

“Let’s say I come across something strange,” said Dr Banerjee Oxygen.com. “I consider it (as) suspicious.”

Evidence found on the body is sealed and signed by pathologists, turned over to law enforcement authorities and becomes part of the chain of custody.

How do medical examiners determine whether a death is suspicious?

Of course, there are simpler examples where the cause of death doesn’t require as much work, such as when someone has had a fatal heart attack. Experts like Dr. Banerjee have to work with what they have, especially in more complex situations. If suspicions arise, they conduct “extensive investigations,” often involving DNA, toxicology and other modern technology.

“If it’s vague, we always treat it as suspicious,” she insisted.

Keeping fingernails would also be common, but X-rays have been crucial in helping determine how someone died.

“X-rays are invaluable for us to see what is happening inside the body before we even open it,” says Banerjee. ‘It will always be visible if there are bullets, or a knife point or something. Maybe you can collect broken bones.”

But X-rays aren’t just good for finding details that support a violent cause of death; they could also detect diseases. For example, fluid in the lungs can indicate pneumonia, or an enlarged heart can indicate a variety of physical conditions.

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How the history of the deceased plays a role in determining the cause of death

Citing the recent death on October 16, 2024 of One Direction singer Liam Payne, 31, (whose conduct and cause of death had yet to be released at the time of this post Oxygen interview), said Dr. Banerjee that a person’s history would also help pathologists determine a manner of death.

“The injuries will be the same” regardless of the manner of death, she explained.

Payne fell from the balcony of a hotel in Buenos Aires, leading to his death, according to the Argentine Public Prosecution Service, according to an October 22, 2024 report from NBC News. Preliminary toxicology reports stated that the former teen idol had an abundance of recreational drugs in his system, although the manner of death had yet to be determined.

Crime scene investigators were able to access evidence that people like Dr. Banerjee, such as obtaining surveillance photos, interviewing witnesses or reviewing the deceased’s message history. But, she said, a person’s medical or psychiatric history could “paint a better picture,” Banerjee shared Oxygen.com.

“I am one of those people who hate my researchers because I ask for everything,” Banerjee joked.

A person’s history of substance abuse or illegal drugs found at the scene could indicate a drug-related death, although a toxicology report could confirm or deny suspicions. A previous diagnosis of a mental illness may indicate suicide.

Dr. Banerjee gave an example: “If suicide is a factor, I always want to know if they have a psychiatric history and if they have been diagnosed,” she said. ‘Let’s just say it’s a clear suicide. Hanging, no doubt about it. But I would still diagnose ‘clinical history of depression or anxiety’… I would say, ‘I didn’t make that up.’”

What happens if you cannot rule out an accident, suicide or murder?

Professionals charged with performing autopsies can choose from five options when it comes to the manner of death: accident, suicide, homicide, natural causes and undetermined.

Dr. Banerjee said if she could not place a person’s death in one of the first four, she would label it as ‘undetermined’. She clarified that the manner of death was a medical ruling – and not a legal ruling – in which case law enforcement could still continue their own investigation.

One example could be a man who died after his car crashed into a tree at 90 miles per hour, and therefore his manner of death is considered “accidental.” However, if police later discovered that the vehicle’s brake lines had been cut by his scorned ex-wife, the report could be amended and the death could be labeled a “homicide.”

“It could even become a cold case-like thing,” Banerjee said Oxygen.com. “The ‘Indefinite’ does not mean ‘I don’t know, I give up.’ It just means, ‘I can’t channel it any better, but you guys can still work on it,’ and if there’s new information, we can always revisit it.”

Some of the most recent cases are discussed Accident, suicide or murder in which the manner of death had changed included the on-campus death of a Florida student Jennifer Kairisthe 2002 car accident Deborah Hollermannand the poisoned victims of the Missouri respiratory therapist Jennifer Hall.

See more in brand new episodes of Accident, suicide or murderairs Saturdays at 8/7c Oxygen and stream the next day Peacock.