Ambulatory monitoring devices and the forensic autopsy

Ambulatory monitoring devices (AMDs) such as Holter (ECG) and apnea (respiratory) monitors with built-in date- and time-correlated memories are occasionally encountered in the forensic autopsy. Diagnostic data are usually readily obtained by returning the device to the hospital department or rental company. This data can be easily correlated with autopsy findings to arrive at surprisingly precise conclusions in some cases. We present two illustrative cases: an elderly man wearing a Holter monitor who shot himself in the mouth with a shotgun, and a 15-month-old oxygen-dependent prematurely born boy with bronchopulmonary dysplasia whose apnea monitor had been turned off 5 days before he died of bronchopneumonia. We discuss other kinds of AMDs that may be encountered in the forensic autopsy and suggest that information from these monitors perhaps should become part of the forensic autopsy report.