Fall from heights is one of the major challenges posed by the Pathologist in concluding the Cause and Manner of Death.

All deaths due to fall may not necessarily be due to Trauma, Natural Causes should also be taken into Account besides other aspects like the Diseases process and Influence of Drugs (Alcohol) which should be carefully analyzed.

In deaths due to Trauma the Manner of death should be carefully analyzed by studying the circumstances surrounding the death.

The Deaths Investigation in falls:

1. Scene in falls
2. High level fall
3. Falls from a height (over 10-12 feet)
4. Experimentation.

Fall from high places usually come within the accidental or suicidal category; only vary occasionally they are proven homicidal in nature. One must remember the possibility that a dead body may be thrown down from the edge of a building and may sustain postmortem injuries.

Whenever a body is found near a high rise building or other place where a fall could have occurred, careful reconstruction of the scene is conjunction with postmortem findings is essential in order to ascertain whether:

1. Fatal injuries are caused by a fall from height
2. Fatal injuries were caused by some other means at ground level e.g. scene beating or vehicular accident.
3. The immediate environment of the body is where the injuries were sustained.
4. There are other signs/injuries on the body which indicate circumstances other than a fall.

Scene assessment:

The following items need to be considered

1. The place from where personal fell
2. The place from where the body was found
3. The route taken by body to reach the ground

Low level falls (under 10-12 feet)

1. Falls from higher level, descending to the point of final impact i.e. stair fall
2. Falling from one's own height.

1. The presence of injuries to the body, if there are no injuries, then one should consider the possibility that the person died of natural causes and collapsed at the bottom of the stairs.
2. If there are injuries, whether they are consistent with falling, or being propelled down stairs, bearing in mind the type of stairs, width, the number of flights involved, structure of stairs and wells etc.
3. Possible evidence of a fight at, say, the top landing with the person receiving the most severe injuries there before falling.

All these possibilities should be considered along with post-mortem findings and circumstances.