Category Archives: Forensic pathology

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

Academic Forensic Pathology – Original Articles – September 2015

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The perfect murder: how a suicide became a homicide

Benefits of utilising full-body Lodox Digital Radiography in Forensic Pathology

Tracking the opioid drug overdose epidemic in King County, Washington, using an improved methodology for certifying heroin related deaths

CASE OF THE MONTH: Exploding targets in recreational use

Academic Forensic Pathology – Review article – September 2015

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What good are partial autopsies?

Academic Forensic Pathology – Invited Reviews – September 2015

The following are a list of ‘invited reviews’ from September 2015 Academic Forensic Pathology.  Click on the any link to request the article:

Mind your manners: 20 years later

The right to due process in challenging a determination of cause and manner of death: giving the family the ability to contest a cause and manner decision by a ME in Maryland.

Manner of death for in-custody fatalities

Death with dignity laws and the Medical Examiner

Medical therapy-related deaths and the Medical Examiner

The Coronial System and determining manner of death in Australia – an overview

Medicolegal death investigation in India: an overview

Forensic Pathology in Israel

Death investigation and certification in Italy

Suicide by hypothermia: a report of two cases and 23 year retrospective review

Traumatic injuries after mechanical cardiopulmonary resuscitation (LUCAS™2): a forensic autopsy study

International Journal of Legal Medicine September 2015, Volume 129, Issue 5, pp 1035-1042

The aim of our study was to compare traumatic injuries observed after cardiopulmonary resuscitation (CPR) by means of standard (manual) or assisted (mechanical) chest compression by Lund University Cardiopulmonary Assist System, 2nd generation (LUCAS™2) device.

A retrospective study was conducted including cases from 2011 to 2013, analysing consecutive autopsy reports in two groups of patients who underwent medicolegal autopsy after unsuccessful CPR. We focused on traumatic injuries from dermal to internal trauma, collecting data according to a standardised protocol.

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Fatal sepsis by Klebsiella pneumoniae in a patient with systemic lupus erythematosus: the importance of postmortem microbiological examination for the ex post diagnosis of infection

International Journal of Legal Medicine September 2015, Volume 129, Issue 5, pp 1097-1101

The utility of postmortem microbiology has continuously been a topic of controversy. The present study describes a case of fatal sepsis in a patient with systemic lupus erythematosus. Postmortem culture and genotyping analyses allowed us to identify Klebsiella pneumoniae as the cause of sepsis, revealing the inadequateness of antimicrobial therapy.

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A method for reclassifying cause of death in cases categorized as “event of undetermined intent”

Population Health Metrics 2015, 13:23;  doi:10.1186/s12963-015-0048-y


We present a method for reclassifying external causes of death categorized as “event of undetermined intent” (EUIs) into non-transport accidents, suicides, or homicides. In nations like Russia and the UK the absolute number of EUIs is large, the EUI death rate is high, or EUIs comprise a non-trivial proportion of all deaths due to external causes. Overuse of this category may result in (1) substantially underestimating the mortality rate of deaths due to specific external causes and (2) threats to the validity of studies of the patterns and causes of external deaths and of evaluations of the impact of interventions meant to reduce them.


We employ available characteristics about the deceased and the event to estimate the most likely cause of death using multinomial logistic regression. We use the set of known non-transport accidents, suicides, and homicides to calculate an mlogit-based linear score and an estimated classification probability (ECP). This ECP is applied to EUIs, with varying levels of minimal classification probability. We also present an optional second step that employs a population-level adjustment to reclassify deaths that remain undetermined (the proportion of which varies based on the minimal classification probability). We illustrate our method by applying it to Russia. Between 2000 and 2011, 521,000 Russian deaths (15 % percent of all deaths from external causes) were categorized as EUIs. We used data from anonymized micro-data on the ~3 million deaths from external causes. Our reclassification model used 10 decedent and event characteristics from the computerized death records.


Results show that during this period about 14 % of non-transport accidents, 13 % of suicides, and 33 % of homicides were officially categorized as EUIs. Our findings also suggest that 2011 levels of non-transport accidents and suicides would have been about 24 % higher and of homicide about 82 % higher than that reported by official vital statistics data.


Overuse of the external cause of death classification “event of undetermined intent” may indicate questionable quality of mortality data on external causes of death. This can have wide-ranging implications for families, medical professionals, the justice system, researchers, and policymakers. With our classification probability set as equal to or higher than 0.75, we were able to reclassify about two-thirds of EUI deaths in our sample. Our optional additional step allowed us to redistribute the remaining unclassified EUIs. Our method can be applied to data from any nation or sub-national population in which the EUI category is employed.

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Suicide by blunt head trauma – two cases with striking similarities

Forensic Science International Available online 12 August 2015;  doi:10.1016/j.forsciint.2015.08.002

There have been several forensic pathological studies on the distinction between falls from height and homicidal blows in blunt head trauma, but few studies have focused on suicidal blows. Self-inflicted blunt head trauma is usually a part of a complex suicide with more than one suicidal method applied. Actually, no reports on suicide indicate blunt head trauma to be the singular cause of death in recent publications. Cases with self-inflicted blunt trauma are often challenging for those involved in the investigation because they are confronted with findings that are also found in homicides. A refined guideline to differentiate suicidal blows from homicidal blows in blunt head trauma allows for a more accurate representation of the events surrounding death.

This paper presents two cases of suicide by self-inflicted blunt head trauma in which blunt head trauma from repeatedly hitting the decedent’s head with a hammer was considered to be the only cause of death.

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