Category Archives: Forensic pathology

Journal articles relating to forensic pathology including coronial autopsies and Disaster victim identification.

When the hidden features become evident: The usefulness of PMCT in a strangulation-related death

Legal Medicine Available online 5 July 2014; DOI: 10.1016/j.legalmed.2014.06.009

Asphyxia related-death is a common incident in forensic practice, since they can be related to suicide, homicide and accident. The deep structures of the neck can be very difficult to reach using the traditional neck dissection when no certain information about potential injuries are obtained.

Furthermore in this kind of deaths no specific signs or injuries can be found at the external and internal examination of the body (such as the slight, if any, displacement of a body structure following a infraction and fissures, as well as injuries involving lamellae of the thyroid cartilage, cricoid cartilage, trachea). In recent years a great contribute to the field of postmortem diagnostics (e.g. gunshot wounds, sharp and blunt forces, etc.) has been given by the introduction of the post-mortem CT (PMCT); that is becoming a standard procedure performed before the traditional postmortem examination.

In cases of asphyxia related-death (with special regards to homicidal strangulation) the PMCT with 3D documentation can be very helpful in revealing injuries on the small structures of the neck, that can be also masked by soft tissues and surrounding bleedings and provides a useful guide for the pathologist to choose the right dissecting technique and avoid artifacts or iatrogenic injury to delicate structures, such as hyoid bone or thyroid cartilage.

The case of a homicide by ligature strangulation using two items (electric wire and cotton bed sheet) is presented, in which the PMCT was performed before the autopsy, showing helpful features concerning the mechanism of death.

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Report on the occurrence of synanthropic derived form of Chrysomya megacephala (Diptera: Calliphoridae) from Royapuram fishing harbour, Chennai, Tamil Nadu, India

Biodiversity Data Journal 2: e1111 (26 Jun 2014);  doi: 10.3897/BDJ.2.e1111

The occurrence of dipteran fly, Chrysomya megacephala (Fabricius, 1794) is reported for the first time from Royapuram fishing harbour (Chennai), Tamil Nadu, South East India. The fully grown third instar larvae of C. megacephala were collected from decaying fishes near Royapuram fishing harbour. This site is found to be the regular breeding site for C. megacephala. Larvae were reared under laboratory condition and freshly emerged adult flies from pupae were collected and identified by morphological features and molecular tools. Molecular identification through generation of DNA barcoding using mitochondrial COI gene of C. megacephala is appended.

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Forensic Science, Medicine, and Pathology July 2014

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A minimum data set approach to post-mortem computed tomography reporting for anthropological biological profiling
Anthropological examination of bones is routinely undertaken in medico-legal investigations to establish an individual’s biological profile, particularly their age. This often requires the removal of soft tissue from bone (de-fleshing), which, especially when dealing with the recently deceased, is a time consuming and invasive procedure. Recent advances in multi-detector computed tomography have made it practical to rapidly acquire high-resolution morphological skeletal information from images of “fleshed” remains. The aim of this study was to develop a short standard form, created from post-mortem computed tomography images, that contains the minimum image-set required to anthropologically assess an individual. The proposed standard forms were created for 31 juvenile forensic cases with known age-at-death, spanning the full age range of the developing human. Five observers independently used this form to estimate age-at-death. All observers estimated age in all cases, and all estimations were within the accepted ranges for traditional anthropological and odontological assessment. This study supports the implementation of this approach in forensic radiological practice.

Radiological analysis of hand and foot injuries after small aircraft crashes
Medico-legal investigation of fatal aviation accidents should contribute to the reconstruction of the accident in addition to providing the usual information about cause and manner of death. In cases with more than one fatality, the question of who was flying the plane at the time of the crash may need to be answered. In such cases the identification of “control injuries” plays an important role. This study aims to investigate whether specific patterns of skeletal hand and foot injuries could assist in the identification of the pilot. The analysis of radiological investigations of hands and feet of 27 fatalities from 18 accidents showed that foot injuries are more frequent than hand injuries in pilots and passengers, dislocations of feet were more frequent in passengers, and right-sided injuries were more frequent in pilots. Injuries of the distal parts of the hand were slightly more frequent in the pilot group. The limited numbers in the study do not allow definitive conclusions and further investigations are needed. However, the study yields interesting results and shows that radiological examination should be included in the medico-legal air crash investigation.



Further evidence for a lack of reliability in the histologic ageing of bruises – an autopsy study

Australian Journal of  Forensic Sciences 04 Jul 2014

Two adult males are reported whose deaths occurred 19 h and five days, respectively, after blunt craniocervical injury. In case 1, although interstitial haemorrhage was present in four samples of bruised paravertebral muscle, only one sample had an early acute inflammatory cell infiltrate. In case 2 microscopic examination of two bruises showed haemorrhage into muscle and adipose tissue, again with no significant inflammatory reaction and only occasional haemosiderin-containing macrophages. These cases demonstrate considerable variability in histological response to blunt trauma in human tissues and suggest that samples taken from areas of extravasated blood in a bruise may not manifest the type of vital reaction that occurs in areas where there has been direct tissue damage. As the presence and/or degree of inflammation may be influenced by the site of tissue sampling, interpretations of the age of a bruise based on histologic reaction should, therefore, be undertaken with caution.

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A keyhole gunshot wound to the head: an autopsy case

Australian Journal of Forensic Sciences Vol. 46, Issue 3, 2014

Considering the high incidence of deaths caused by firearms, forensic pathologists must possess a thorough understanding of the patterns of injuries caused by these weapons. Occasionally, distinguishing between entrance and exit gunshot wounds can be difficult. In our case, a 61-year-old man was killed by a 9 mm calibre gunshot wound to the head during a robbery. At the post-mortem examination the calvarium exhibited an atypical injury that showed both entrance and exit wound characteristics, compatible with a ‘keyhole’ defect of the skull. Keyhole fractures occur when a projectile strikes the cranium tangentially, owing to the vertical and horizontal forces usually generated by the fragmentation of the bullet. Atypically, in our case the bullet showed no fragmentation after the impact with the cranial bones and was still able to result in a keyhole defect. An accurate evaluation of the pattern of atypical lesions found in the post-mortem examination is necessary in order to evaluate the cause and the manner of death.

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New edition – Disposition of Toxic Drugs and Chemicals in Man (2014)

Disposition of Toxic Drugs and Chemicals in Man, 10th ed. (2014)  /  Randall C. Baselt

The purpose of this work is to present in a single convenient source the current essential information on the disposition of the chemicals and drugs most frequently encountered in episodes of human poisoning. The data included relate to the body fluid concentrations of substances in normal or therapeutic situations, concentrations in fluids and tissues in instances of toxicity and the known metabolic fate of these substances in man.

Cost is approximately $370 US including shipping.

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Diving fatality investigations: recent changes

Diving Hyperb Med. 2014 Jun;44(2):91-6.

Modifications to the investigation procedures in diving fatalities have been incorporated into the data acquisition by diving accident investigators. The most germane proposal for investigators assessing diving fatalities is to delay the drawing of conclusions until all relevant diving information is known. This includes: the accumulation and integration of the pathological data; the access to dive computer information; re-enactments of diving incidents; post-mortem CT scans and the interpretation of intravascular and tissue gas detected. These are all discussed, with reference to the established literature and recent publications.

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Suicide pact by drowning with bound wrists: a case of medico-legal importance

Medico-Legal Journal March 2014 vol. 82 no. 1 29-31;  doi: 10.1177/0025817213508676

Suicide pacts are uncommon and mainly committed by male–female pairs in a consortial relationship. The victims frequently choose methods such as hanging, poisoning, using a firearm, etc; however, a case of a suicide pact by drowning is rare in forensic literature. We report a case where a male and a female, both young adults, in a relationship of adopted “brother of convenience” were found drowned in a river. The victims were bound together at their wrists which helped with our conclusion this was a suicide pact. The medico-legal importance of wrist binding in drowning cases is also discussed in this article.

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Understanding death in custody: a case for a comprehensive definition

Journal of Bioethical Inquiry June 2014;   DOI: 10.1007/s11673-014-9545-0

Prisoners sometimes die in prison, either due to natural illness, violence, suicide, or a result of imprisonment. The purpose of this study is to understand deaths in custody using qualitative methodology and to argue for a comprehensive definition of death in custody that acknowledges deaths related to the prison environment. Interviews were conducted with 33 experts, who primarily work as lawyers or forensic doctors with national and/or international organisations. Responses were coded and analysed qualitatively. Defining deaths in custody according to the place of death was deemed problematic. Experts favoured a dynamic approach emphasising the link between the detention environment and occurrence of death rather than the actual place of death. Causes of deaths and different patterns of deaths were discussed, indicating that many of these deaths are preventable. Lack of an internationally recognised standard definition of death in custody is a major concern. Key aspects such as place, time, and causes of death as well as relation to the prison environment should be debated and incorporated into the definition. Systematic identification of violence within prison institutions is critical and efforts are needed to prevent unnecessary deaths in prison and to protect vulnerable prisoners.

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Study on the postmortem submersion interval and accumulated degree days for a multiple drowning accident

Forensic Science International Volume 238, May 2014, Pages e15–e19;  DOI: 10.1016/j.forsciint.2014.02.026

Recreational accidents in aquatic environments leading to death by drowning are quite frequent. Even if they do not usually require forensic investigation, they may provide useful information on the post mortem submersion interval (PMSI) and its relation with accumulated degree days (ADD). This is particularly useful to forensic science since most studies dealing with these matters rely mostly on animal carcasses as human analogues.

In this work we report on a multiple drowning accident resulting in 6 victims. ADD was calculated based on the PMSI and water temperature during this period. PMSI varied between ∼7.4 days and ∼11.4 days, and estimated body drift from the accident site ranged from 0.5 km to 8.0 km. Surface water temperature in the accident area showed little variation during the PMSI (14.5–16.0 °C). Estimated ADD varied between 115 °C and 174 °C, and between 104 °C and 191 °C when considering the cumulative lower (ADDmin) and upper (ADDmax) limits for ADD.

We compare the results with recently published data on two similar cases, and suggest a range for ADD that can be assumed as necessary before body floatability is regain after a drowning accident.

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