Fatal Injuries of Law Enforcement/Correctional Officers Attacked with Sharp‐Edged Weapons,

According to the National Law Enforcement Memorial Fund, there were 117 law enforcement fatalities in the United States in 2015. Assaults with sharp‐edged weapons have resulted in a total of over 400 fatalities in the United States. The goal of the current research was to examine sharp‐edged weapon assaults against law enforcement and correctional agents that resulted in a fatal outcome. A total of twelve autopsy reports were reviewed from across the United States. Four cases involved law enforcement officers, seven involved correctional officers, and one was an off‐duty border officer. The male‐to‐female ratio was 11:1. A total of 70.2% of the wounds analyzed were stab wounds (n = 85), and 29.8% of the wounds were slash wounds (n = 36). Based on this review, the neck, shoulder, and chest regions were the most vulnerable to single fatal stab/slash wounds. Multiple stab/slash wounds often resulted in exsanguination. The use of body armor was only noted in one case.     

Evaluation of atypical stab and incision wounds in a case of combined suicidal injuries

A fatal case of stabbing and cutting is reported which involved a 37-year-old male who suffered from depressive disorder and had already attempted suicide in the past. The postmortem examination revealed 12 lacerations of the scalp, 5 deep incised wounds on the flexor surface of the right forearm, 3 stab wounds of the back of the head, 12 stab wounds of the chest (with cutting of ribs but no injury of heart and lungs), 35 stab wounds of the abdomen and deep incised wounds of both sides of the neck with hesitation marks and incision of the left internal jugular vein. The significance of criteria to properly establish the manner of death like localization, axis and pattern of the wounds, hesitation marks, defense wounds, pulling aside the clothing to expose the target area, sustained capacity of physical activity and potential lethal effects of the single injuries as well as conclusions from the scene of death are discussed.     

Complex suicide: an unusual case with six methods applied

Complex suicides (CSs) are committed by using more than one method. They account for 1.5-5% of all suicides. We present a case of CSs of a 44-year-old man, found dead in the vicinity of his car, in a deserted frozen field. Police investigation excluded homicide, and no medical data confirmed mental illnesses. Autopsy revealed wrist cuts, neck cuts, acid burns in the GI tract, multiple stab wounds to the head by a screwdriver, and several uncertain signs of hypothermia. Toxicology analysis (gas chromatography-mass spectrometry) confirmed ingestion of insecticide. We concluded that stab wounds to the head were the cause of death, while external hemorrhage and hypothermia were contributing factors. This is the first case of CSs reviewed in the literature where six suicide methods were applied. This particular case is interesting because the victim used a screwdriver as a tool for inflicting stab wounds to the head, which is a rare suicidal method.     

Unusual circumstances in a fourfold complex suicide

Complex suicides are defined as suicides using more than one method, which may sometimes suggest homicide. We present the case of a 27-year-old man who killed himself by using four different methods. The man was known as a loner and sufferd from bipolar psychosis. An eyewitness saw him afire and falling out of a window on the 4th floor of a hotel. He was wearing a judo dress with the belt wound twice around his neck. He died in a hospital about two hours later. The autopsy showed signs of neck compression typical of (self)-strangulation, several stab and cut wounds in the thoracic and abdominal region from sharp force, extensive first- to third-degree burns caused by the effect of heat, contusions of internal organs, serial rib fractures and several bone fractures of the extremities as signs of blunt force. The CO-Hb value in the blood amounted to 7%; the other toxicological tests were negative. Death was found to be due to exsanguination from a deep stab wound in the abdomen and multiple trauma caused by the fall from a great height in the course of a suicide. Homicide could be excluded due to the circumstances of the case, which demonstrated again that both the medical findings and the investigation results of the police are indispensable for the differentiation between suicide and homicide.     

Secondary combined suicide viewed by the wife]

A 47-year-old man was found dead at the bottom of a wall outward the door of the cellar of his house. Preliminary physical examination at the scene of the death revealed a laceration of the scalp, an incised wound in front of the neck and several stab wounds in the left chest penetrating through the clothing. Questioned by the police his wife told that her husband who suffered from severe depression had inflicted the incised and the stab wounds himself, had made an unsuccessful attempt at self-strangulation and had finally jumped down from the wall beside the stairs declining to the cellar of their house. As the circumstances of the scenario were suspicious and as the pattern of injuries arose doubts concerning self-infliction homicide was taken into consideration as well. Autopsy showed additional hesitation marks adjacent to the left end of the incised wound in front of the neck. The stab wounds of the chest were restricted to the region of the heart and displayed only minimal penetration of the chest-wall, findings characteristic of self-infliction. As a consequence the manner of death could be determined as prolonged suicide, and exact reconstruction was possible with the help of the wife's testimony.     

Decapitation and Dismemberment of the Corpse: A Matricide Case*

Abstract: Dismemberment of a corpse has always been viewed by society to be a more hideous crime than the homicide itself. In this study, we present a case of a 57‐year‐old woman who was decapitated and her right arm and both hands were dismembered. It was determined that the victim was murdered and dismembered by her 33‐year‐old daughter, who had been receiving treatment for schizophrenia for 15 years. On the victim’s head and back there were 71 incised and stab wounds in total. They were superficial, except the five stab wounds which were connected to the right chest cavity and which incapacitated the victim. Although there is not a regulation for the act of dismembering the corpse in the Turkish Penal Code, since this type of case is rare, the crime scene and the autopsy findings were evaluated together with other pertinent data available in the literature.     

Frequency of bone/cartilage lesions in stab and incised wounds fatalities

A retrospective study was carried out on 58 fatalities due to stab or incised wounds. The frequency of bone or cartilage lesions was analysed according to the number of wounds, the circumstances of death and the anatomical site. Our findings showed that bone/cartilage lesions were present in about 53% of the cases. Cartilage lesions were more frequent than bone lesions. The mean number of wounds in the group with bone/cartilage lesions was statistically higher than the mean number of wounds in the group without lesions (P=0.0068). The main cause of death was thoracic injury in the groups with and without bone/cartilage lesions. In case of skeletal remains, only bone or cartilage lesions allow to diagnose stab or incised wounds. The discovery of these lesions, often of small size, justifies a complete and careful examination of skeletal remains with the help of stereomicroscopy.     

An unusual homicide case with subsequent suicide

In the medicolegal literature reports on homicides followed by suicide, especially in elderly people, are rare. In the present case, the victim, a 79-year-old woman, showed a rather unusual injury pattern: 3 gunshots to the head (with only 2 entrance wounds and 3 intracranial projectiles) and 2 stabs from a knife. The tools used for inflicting the stab wounds (a hunting knife and a double-edged dagger) were left in the victim's body after the offense. The 89-year-old husband hanged himself with an aerial cable after killing his wife. The police investigations and the autopsy findings suggested a combined homicide-suicide. The motive for the offense could be a so-called delusion of poverty associated with symptoms of depression.     

Postmortem dog bites after sexually motivated homicide with multiple stab wounds--differential diagnostic aspects

The body of a 20-year-old woman that had undergone significant putrefaction was found lying on the bed of her apartment in a supine position. The legs were straddled and apart from a T-shirt, she was naked. The inner side of the right thigh showed a circumscribed 20 cm x 40 cm defect exposing the underlying muscles. The wound margin was ragged and superficial scratch-type abrasions were found in the vicinity of the injury margin. The investigating police officers classified the injuries to be caused postmortem by a crossbreed dog that was inside the apartment. No other signs of external force were found on the body at the death scene and due to the previous history of the deceased, a drug death was assumed. Autopsy revealed 13 vital stab wounds in the neck and aspiration of blood in the lungs as well as signs of manual strangulation. The observed coincidence of injuries due to postmortem animal depredation and stab wounds, although in different localization, can be regarded as a rare entity in the light of the literature. The morphological appearance of traumatic injuries due to other causes can be modified by the simultaneous presence of postmortem injuries caused by animals and difficulties can arise concerning the differential diagnosis especially under poor conditions (e.g. advanced putrefaction) at the death scene.     

Breaking point? An analysis of fatal stab wounds to the torso in Ireland between 2011 and 2018, examining the extent of rib fractures

This study examines the pattern of rib injuries occurring in cases of fatal torso stab wounds in Ireland between 2011 and 2018. It has been suggested by previous studies that rib fractures are not commonly sustained in stab wounds to the torso. We wanted to ascertain whether this was the case, as our data suggested that rib fractures were frequent, and where a rib is fractured there is a higher chance of organ injury and death, making this an important area of study. One hundred and forty seven cases of fatal stab wounds from an eight-year period were retrospectively reviewed. Fatal stab wounds to other body areas, were excluded; leaving a total of 104 cases with stab wounds to the torso. We found that 69.2% of cases had rib injuries, a figure significantly higher than previously reported. Our data suggests that stab wounds to the torso often fracture ribs, putting the underlying organs at increased risk of injury and perhaps contributing to fatality. The amount of force needed to cause a rib fracture can be difficult to quantify and indeed from the high percentage of rib fractures sustained in our data it appears that the ribs may be fractured regardless of the amount of force used; this is borne out by the finding that self-inflicted injuries also caused rib fractures. Our study shows that other factors, such as anatomical positioning and wound depth may have a greater bearing than force in terms of whether a rib fracture is sustained.     

Suicidal incised wound of a fistula for hemodialysis access in an elderly woman: case report

A very rare case of suicide by stab wound of a fistula for hemodialysis access in an elderly woman is reported. The incidence of suicide attempts in people undergoing hemodialysis is well known. Nevertheless, suicide means do not usually include stab wounds of the arteriovenous access. Various pattern differences between homicidal and suicidal stab wounds, characteristics of suicide in the elderly, and approaches to the investigation of such cases are briefly discussed.     

A possibility for identification of the knife's edge in stab wounds (author's transl)

It is known from forensic-medical practice that the wound track of stab wounds reflects the form and dimensions of the knife's edge, when there are no supplementary cuts. If the wound channel passes through compact organs (liver, kidney, spleen, etc) it can be exposed for direct observation by removing one of its sides which allows observation of the approximate form and dimensions of the knife's edge. It enables eliminatione of those weapons which do not fit. A case of homicide is described with 9 stab wounds, one of which penetrating the liver, where the above described method was successfully used. A case of an adult man's murder is described with 9 puncture wounds, one of which penetrating the liver, where the above described method was successfully used. A case of an adult man's murder is described with 9 puncture wounds, one of which penetrating the liver, where the above described method has been successfully applied.     

Homicide in Cape Town, South Africa

All autopsies performed on homicide victims at the Salt River police mortuary, Cape Town, in the first 6 months of 1986 were reviewed. Most of the homicides that had occurred in Cape Town were as a result of stab wounds to the chest. Smaller, but significant, numbers of homicides were as a result of stab wounds to the head and neck, blunt injury to the head, or gunshot wounds. Homicidal burning also has occurred in civil unrest situations. Infanticide was rarely encountered. Alcohol was detected in the homicide victims in 62.9% of cases; 8.4% had a blood alcohol concentration higher than 0.30 g/100 ml. Our figures confirm that Cape Town has one of the highest homicide rates in the world (56.9/100,000 per annum for 1986). Homicides in Cape Town are characterized by assaults with sharp instruments, usually knives, although "pangas," or cane knives, are also commonly used.     

Self-injury or attempted murder--analysis of an unusual case

An unusual case of self-injury involving several, partly deep penetrating stab wounds is described. A young emotionally disturbed consulting-room assistant accused her husband of having inflicted the injuries upon her in the course of an argument over custody of the children. An analysis of the injury pattern showed clear indications of self-injury and willfully transferred blood from punctures in the woman's fingertips to the clothes of the accused. The case demonstrates that in cases involving members of a medical profession and individuals with psychiatric disorders, the possibility of highly unusual types of self-injury should not be excluded. It further emphasizes the importance of a physical examination performed by a medico-legal specialist.     

A Fatal Leopard Attack

Abstract: A rare case of a big cat fatal attack is presented. A male leopard that had escaped from its unlocked cage attacked a 26‐year‐old male zoo worker. The man sustained penetrating injuries to the neck with consequent external bleeding. The man died while being transported to the hospital as a result of the injuries sustained. The wounds discovered on the victim’s body corresponded with the known methods of leopard attacks and with findings on the carcasses of animals killed by leopards in the wild. The conclusion of the medicolegal investigation was that the underlying cause of death was a bite wound to the neck which lacerated the left internal jugular vein, the two main branches of the left external carotid artery, and the cervical spine. The cause of death was massive external bleeding. Special attention is paid to the general pattern of injuries sustained from big cat attacks.     

Abdominal Stab Wounds with Tension Pneumopericardium Confirmed by Autopsy and Postmortem Computed Tomography

We present the first report of pneumopericardium observed by autopsy and on postmortem computed tomography (PMCT) images. The subject was a woman who died of self‐inflicted stab wounds to the abdomen. The PMCT scan revealed air in the pericardial sac, a “flattened heart” sign, and retroperitoneal hemorrhage. Medicolegal autopsy revealed two abdominal stab wounds near the xiphoid process that had cut the apical pericardium and adjacent diaphragm and liver. Examination of the open thorax confirmed that the pericardial sac was distended with air. The wound extended to the abdominal aorta, causing retroperitoneal hemorrhage. PMCT images showed that the pneumopericardial volume was 133 mL. We believe that cardiac tamponade occurred resulting from the tension pneumopericardium; however, the effects were mitigated by hypovolemia secondary to the retroperitoneal hemorrhage as well as obstructive shock. Therefore, the cause of death appears to have been low‐pressure cardiac tamponade.     

Clocapramine-related fatality. Postmortem drug levels in multiple psychoactive drug poisoning

A suicide caused by ingestion of multiple psychoactive drugs is reported. A 42-year-old man with a history of psychosis was found dead in a blood pool in his room. The forensic autopsy revealed two stab wounds on his chest. However, these wounds could not explain the cause of death. Eighty-six tablets were found in his stomach. Four psychoactive drugs; clocapramine (CC), chlorpromazine (CP), promethazine (PM) and clotiazepam (CT) were detected in blood and tissues. The concentrations of CC, CP, PM and CT in the femoral vein (FV) blood were 0.39, 0.61, 1.23 and 0.09 microg/ml, respectively. The cause and manner of death were attributed to suicidal multiple psychoactive drug poisoning.Postmortem drug redistribution showed great site-dependent variations with the lowest level in the FV blood. Remarkable variations were observed in CC, CP and PM, but not in CT compared to other three drugs. The variations were dependent on the volume of distribution (Vd) of the drugs. Our human case has demonstrated drugs with higher Vd values showed higher degree of postmortem redistribution of the drug and vice versa.     

A transnasal intracranial stab wound by a plastic-covered umbrella tip

A 48-year-old man died from a transnasal intracranial stab wound caused by an umbrella. The track of the stab passed from the right nostril, through the sphenoid sinus, the left side of the sella turcica and anterior clinoid process, and finally reached the surface of the brain. The stab wound crossed the left internal carotid artery, causing an exsanguination and aspiration of blood into the airway, resulting in death. It is extremely rare that an umbrella tip used during a struggle would stab the nostril of the victim. Transnasal intracranial stab wounds can be overlooked and require sensitive handling.