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How is the manner of death determined? A coroner tells all
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How is the manner of death determined? A coroner tells all

As the second half of Accident, suicide or murder”s Season 5 is approaching, Oxygen.com we sat down with an expert to find out what helps post-mortem examiners determine a manner of death.

Dr. Priya Banerjee, renowned board certified forensic pathologist, founder of the Rhode Island company. Anchor Forensic Pathology, stated that uncertainty about classifying a person’s manner of death as an accident, suicide or homicide is a “rare question”. But “it’s not something we haven’t encountered,” Banerjee explained.

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

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Do post-mortem examiners work with the police?

Dr. Banerjee, who practices in several states, said “there’s a lot of communication” between those who conduct post-mortem examinations and those tasked with finding a possible culprit. As a former Rhode Island medical examiner, she occasionally offered her expertise at crime scenes, but only when directly investigating the physical body.

Otherwise, crime scene investigators provided what they had.

“A death is reported and there is a history given (by the authorities),” Banerjee said Oxygen.com. “Whatever is known at the time, but it’s also very preliminary.”

Part of the career of Dr. Banerjee consisted of training resident or junior doctors aspiring to become pathologists. She often told them, “Sometimes you end up trusting your gut” if their findings about a person’s death didn’t match what was in the preliminary report. However, keeping the investigators’ notes in their minds was always crucial.

“Because the story changes,” she said. “Until the investigation continues, X, Y, Z, it may be a totally different deal. Because the police hadn’t done all their things either.”

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

Financial turmoil, infidelity and a history of violence would all be factors when changing the woman’s manner of death to homicide and ultimately her husband’s conviction of murder.

“Let’s just say I find something strange,” said Dr. Banerjee Oxygen.com. “I’m treating him (as) a suspect.”

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

Medical instruments on a table with a doctor's hand holding a sampleMedical instruments on a table with a doctor's hand holding a sample

Medical instruments on a table with a doctor’s hand holding a sample

How do medical examiners determine if a death is suspicious?

Of course, there are simpler examples where the cause of death does not require as much work, such as when a person has suffered a fatal heart attack. Experts like Dr. Banerjee has to work with what they have, especially in more complex situations. When suspicions arise, they conduct “extensive evaluations,” often including DNA, toxicology and other means of modern technology.

“If it’s nebulous, we always treat it as suspect,” she claimed.

Fingernail preservation would also be common, but X-rays were vital in helping to determine how someone died.

“X-rays are such an invaluable tool to see what’s going on in the body before you open it up,” Banerjee said. “It will always show if there are bullets or the tip of a knife or something. He might collect broken bones.”

But X-rays aren’t just good for finding details that support a violent means of death; they could also detect disease. Fluid in the lungs, for example, could indicate pneumonia, or an enlarged heart could indicate a multitude of physical conditions.

RELATED: From Submerged Scooters and Runaway Hay Bales to Eating Bugs, These Are 5 of the Weirdest Accidental Deaths

How the decedent’s history influences the determination of cause of death

Citing the recent death on October 16, 2024 of One Direction singer Liam Payne, 31, (whose manner and cause of death had not yet been disclosed at the time of this Oxygen interview), Dr. Banerjee said 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 a hotel balcony in Buenos Aires, which Argentina’s National Prosecutor’s Office said resulted in his death, according to an October 22, 2024 report from NBC News. Preliminary toxicology reports stated that the former teen idol had a multitude of recreational drugs in his system, although a manner of death has yet to be determined.

Officials investigating the crime scene could access evidence that people like Dr. Banerjee could not, such as obtaining surveillance photos, interviewing witnesses or reviewing the deceased’s message history. But, she said, a person’s medical or psychiatric history might “make for a better picture,” Banerjee said. Oxygen.com.

“I’m one of those (people) my interrogators hate because I ask for everything,” Banerjee joked.

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

Dr. Banerjee gave an example: “If suicide comes into play, I always want to know if they have a psychiatric history and if it’s diagnosed,” she said. “Let’s just say it’s a clear suicide. Hungry, no doubt. But I’d still put “clinical history of depression or anxiety” as a diagnosis… I’d say “I didn’t make that up”.

Crime scene tape.Crime scene tape.

Crime scene tape.

What if you can’t control the accident, suicide or murder?

Autopsy professionals have five options to choose from when it comes to the manner of death: Accident, Suicide, Homicide, Natural Causes, and Undetermined.

Dr. Banerjee said that when she could not “fit” a person’s death to fit into any of the top four, she labeled it “Undetermined”. She clarified that the manner of death was a medical determination — not a legal determination — in which case law enforcement could continue their own investigation.

An example might include a man who died after his car hit a tree at 90 mph 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 changed and the death ruled a “homicide.”

“It can even become a cold case type of thing,” Banerjee said Oxygen.com. “‘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 presented in Accident, suicide or murder in which the manner of death was changed included the on-campus death of a Florida student Jennifer Kairisthe 2002 car accident of Deborah Hollermannand the poisoned victims of the respiratory therapist in Missouri Jennifer Hall.

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