Pathologic features of fatal shark attacks

To examine the pattern of injuries in cases of fatal shark attack in South Australian waters, the authors examined the files of their institution for all cases of shark attack in which full autopsies had been performed over the past 25 years, from 1974 to 1998. Of the seven deaths attributed to shark attack during this period, full autopsies were performed in only two cases. In the remaining five cases, bodies either had not been found or were incomplete. Case 1 was a 27-year-old male surfer who had been attacked by a shark. At autopsy, the main areas of injury involved the right thigh, which displayed characteristic teeth marks, extensive soft tissue damage, and incision of the femoral artery. There were also incised wounds of the right wrist. Bony injury was minimal, and no shark teeth were recovered. Case 2 was a 26-year-old male diver who had been attacked by a shark. At autopsy, the main areas of injury involved the left thigh and lower leg, which displayed characteristic teeth marks, extensive soft tissue damage, and incised wounds of the femoral artery and vein. There was also soft tissue trauma to the left wrist, with transection of the radial artery and vein. Bony injury was minimal, and no shark teeth were recovered. In both cases, death resulted from exsanguination following a similar pattern of soft tissue and vascular damage to a leg and arm. This type of injury is in keeping with predator attack from underneath or behind, with the most severe injuries involving one leg. Less severe injuries to the arms may have occurred during the ensuing struggle. Reconstruction of the damaged limb in case 2 by sewing together skin, soft tissue, and muscle bundles not only revealed that no soft tissue was missing but also gave a clearer picture of the pattern of teeth marks, direction of the attack, and species of predator.     

Paraquat poisoning

A fatal case of paraquat poisoning is described. Postmortem concentration of paraquat in different tissues reveals that treatment in this case could not prevent lethal tissue accumulation. Although accumulation was more pronounced in renal tissue, lung toxicity caused death. The formation of enormous fecaliths and the appearance of hypercalcemia are reported. Both were most likely connected with Füllers earth therapy. In spite of the fact that the exact nature of the equilibrium between plasma levels and tissue accumulation of paraquat (static or dynamic) is not understood, aggressive treatment must be recommended, even after the distribution phase and despite likely "fatal" plasma levels.     

Comparison of pulmonary autopsy findings of the rats drowned at surface and 50 ft depth

INTRODUCTION: When a body is recovered from the water after a fatal SCUBA diving accident, it is useful to know if the diver was under pressure or not when he/she took his/her last breath, in order to determine the cause and manner of the death. If the victim was under pressure, the air remained in the lungs of the diver will be equal to the environmental pressure. If the body comes to the surface, the air in the lung will expand according to the Boyle's Gas Law and give mechanical damage to the surrounding tissues, due to decreases in environmental pressure. We designed an experimental study to see the difference in pulmonary autopsy findings of the rats that drowned under normobaric and hyperbaric conditions. METHOD: Forty five male, 250-300 g, Sprague Downey adult rats were divided into three groups. Two groups of rats were drowned under normobaric conditions (Groups DS Group DSS) and the third group at 50 ft pressure (Group DD). The pulmonary autopsy findings of the groups were compared. In the light microscopy, the number of the microscopic fields (x10) containing at least one emphysematous area with longitudinal dimension greater than 300 micro m were compared among the groups. RESULTS: The gross examination revealed a prominent swelling of the lungs in all rats in the Group DD, in comparison to that of the Groups DS and DSS. The number of the microscopic fields, which included at least one emphysematous area with longitudinal dimension greater than 300 micro m out of 150 fields from each of the groups DS, DSS and DD, were 88, 101 and 115 respectively. The difference between the group DS and DD was found to be statistically significant. CONCLUSION: We conclude that in investigating the fatal diving accidents, pulmonary autopsy findings give valuable information whether the death occurred at the surface or at the depth.     

Puncture wounds caused by glass mistaken for with stab wounds with a knife

Three cases are presented where fatal puncture wounds caused by broken glass were very similar to stab wounds inflicted by a knife with a single-edged blade. Thus, all three cases caused a murder investigation to be initiated. It could only be determined that these wounds had been caused by glass after a detailed forensic autopsy. In two of the three cases, the only evidence for this was the identification of glass fragments in the wounds. The importance of X-ray examinations is underlined because modern glass in common use is radiopaque. Glass fragments lodged in the wounds can reduce the loss of blood and thus, prolong the capacity to act despite severe injuries.     

Analysis of human remains recovered from a shark

Trauma caused by marine scavengers and predators, especially sharks, is not well known. This paper describes the effect of shark attack on human remains. They were found in the stomach of a tiger shark caught by fishermen near Hollywood Beach, Florida. The remains belonged to a white male in his late twenties or early thirties with a stature of 175 cm. The damages to the skeleton and the association of these damages with the behaviours of tiger sharks is also analyzed. The trauma affecting long bones are circular punctures around the epiphyseal ends. Other changes include unique crescent shape grooves horizontal to the shaft of the bone. Although all of the bones are affected, none of them is fractured or crushed, suggesting that the body parts are first dismembered and then swallowed and digested.     

Peculiar circular and C-shaped injuries on a body from the sea

A case where a body with unusual circular injuries was found in the sea is presented. The victim was a 60-year-old woman who had been depressed and had attempted suicide before. She was missing for 6 days before the corpse was found. The body had several almost perfectly circular injuries and C-shaped incision injuries with almost circular flaps of skin. We concluded that the cause of the peculiar circular injuries might be bite marks of Isistius spp. (I. brasiliensis and/or I. plutodus), commonly known as cookie-cutter shark because of its very unusual feeding style.     

Diving-related fatalities caused by underwater explosions: a report of two cases.

The authors report two cases of diving-related water blast with fatal outcome resulting from nearby underwater explosions. Water blast with fatal outcome almost exclusively occurs in wars at sea. Underwater explosions are extremely rare in diving because of the limited exposure. Forensic findings in both cases reported included expected injuries to gas-filled organs such as the middle ear, lungs, and intestine; some rarely described injuries such as rupture of the liver, spleen, and kidneys; and also some lesions that were not found in a search of the literature: rupture of the heart and contusion of the hypophysis. Injuries caused by fatal underwater explosions should be carefully evaluated in forensic medicine to provide data that may support a criminal investigation.     

Distribution of lidocaine and disopyramide in human blood and tissue, a case report of death caused by spinal anesthesia

An 11-year-old girl was anesthetized with hyper-baric solution of lidocaine as spinal anesthesia for an appendectomy in a surgical clinic. Respiratory arrest which occurred soon after the injection, was not discovered for a period of time. Since spontaneous respiration recovered within 2 h of intensive resuscitation, the patient was transferred to a community hospital for intensive care. Ten hours after the spinal anesthesia, she died of cardiac failure. The concentration of lidocaine in the brain was 5-10 times more than that in other tissues. The relationship between the possibility of malpractice of spinal anesthesia and tissue distribution of the drug was discussed. In addition to lidocaine, a toxic amount of disopyramide, an antiarrhythmic drug, was detected in the body. The distribution of disopyramide was also estimated, and the pharmacokinetics of disopyramide in plasma and tissues were studied experimentally in rats.     

Fatal dog maulings associated with infant swings

We present three cases of fatal dog maulings of infants placed in mobile infant swings, a phenomenon not previously described in the literature. In each case, the victim was left in a mobile swing, unsupervised by an adult, and the attacking dog was a family pet. Case 1 involved an 18-day-old male infant attacked by a pit bull; Case 2 involved a 3-month-old male infant attacked by a Chow Chow and/or a Dachshund, and Case 3 involved an 18-day-old female infant attacked by a Labrador-pit bull mix. These cases not only underscore the importance of not leaving young children unattended in the presence of pet dogs, but also raise the possibility that mobile swings may trigger a predatory response in dogs and thus may represent an additional risk factor for dog attack.     

Shark‐Inflicted Trauma: A Case Study of Unidentified Remains Recovered from the Gulf of Mexico*

Abstract: Here, we present a case of an unidentified male whose remains, except for the right arm, were recovered from the Gulf of Mexico 10 years prior to osteological analysis by forensic anthropologists. After the poorly preserved soft tissue was removed and the bones cleaned, forensic analysis revealed an unusual series of hard tissue trauma later attributed by a shark expert as shark scavenging and/or predation. Identified were five unique hard tissue trauma patterns that are bite mark artifacts produced by sharks: punctures without fractures, punctures with associated fractures, striations with bone shaving, overlapping striations, and incised bone gouges. The cooperation among experts provided a comprehensive death case analysis and a better understanding of shark‐inflicted trauma on human skeletal remains.     

Forensic Case Reports Presenting Immersion Pulmonary Edema as a Differential Diagnosis in Fatal Diving Accidents

Immersion Pulmonary Edema (IPE) reduces the transport of gases over the respiratory membrane due to edema in the interstitium and respiratory zones. IPE has previously been described in both swimmers and divers, with a few known fatal cases. We have reviewed 42 SCUBA and snorkeling‐related drowning deaths, and through a thorough analysis of each case, including both diving physiology and forensic pathology, we present IPE as a differential diagnosis to drowning in four cases. Our findings propose that; absence of watery content in the stomach and conducting airways, and liquid filled lungs without hyperexpansion, may be compatible with IPE. We suggest that IPE should be considered in cases where witness testimony reveals; no obvious signs of aspiration and rapid respiratory deterioration despite continuous breathing through an appropriate air source. The diagnosis should be based on the overall impression, including both the autopsy findings and the circumstances regarding the accident.     

Postmortem changes of human bodies on the bathyal sea floor--two cases of aircraft accidents above the open sea

Forensic taphonomy in the marine context recently received growing attention. However, only limited information is available about the fate of human bodies at greater sea depth. Following two fatal aircraft accidents (west of Namibia, south of Sicily) human remains were recovered from a depth of 540-580 m (both cases) after 3 months (Namibia)/34 days (Sicily). In the Namibia case fully skeletonized bones were lifted. In the Sicily case a complete, dressed body was found exhibiting a partially skeletonized skull, starting adipocere formation and pink teeth. The rate and mode of decomposition of human bodies in the deep sea varies considerably and is mainly influenced by the local faunal composition. Of special relevance for the understanding of both cases was the oceanographic observation that the highly efficient necrophageous lyssianassids are abundant off Namibia but are rare in the Mediterranean, emphasizing the importance of collaboration of forensic and marine scientists in such case work.     

Fatal cardiac arrhythmia after repeated exposure to 1,1-difluoroethane (DFE)

A 42-year-old man was found dead after repeated exposure to 1,1-difluoroethane (DFE, Freon 152a), a propellant found in CRC Duster, a product intended for the removal of dust and lint. Toxicologic analysis detected DFE in femoral blood 136.3 mg/L, brain 117.5 mg/kg, liver 87.6 mg/kg, lung 60.3 mg/kg, adipose 235.7 mg/kg, and vitreous fluid 25.1 mg/L. The cause of death was determined to be a fatal cardiac arrhythmia due to intoxication with 1,1-difluoroethane. After comparison to previously published cases involving DFE, we suggest that analysis of adipose tissue for DFE and similar compounds, along with blood and other tissues, may be useful in distinguishing between acute versus chronic exposure. Adipose may also be a valuable alternate specimen for detection in cases where loss or elimination from blood is likely to have occurred.     

Suicide by the use of a chain saw

The paper describes a case of suicide by the use of a chain saw. Visceral and tissue damage caused by vibrations are documented in occupational medicine, but fatal damage is not often seen at autopsy. This paper gives an account of the damage to viscera and tissues that has been noted when strong vibrations of low frequency have been directed to the body for a very short time with fatal result after a few minutes survival time.     

Suicide by sodium tetraoxoselenate(VI) poisoning

Selenium is one of the most toxic elements necessary for the life of mammals. Only a narrow range separates therapeutic (connected with a protective effect) and toxic doses. Selenium incorporated into animal or human tissues in larger amounts can exceed normal human levels and may be toxic (only elemental selenium and selenium sulphide are poorly absorbed). Acute poisonings with selenium or its compounds, especially fatal ones, occur extremely rarely in humans. Levels of selenium in four fatal cases are reviewed, and the levels in a fatal poisoning with sodium tetraoxoselenate(VI) are evaluated. Postmortem tissue selenium contents in the latter case were the following: brain, 1.45 and 1.60 microg/g; stomach, 6.12 and 6.37 microg/g; small intestine, 4.37 and 4.13 microg/g; large intestine, 4.53 and 4.43 microg/g; liver, 4.20 and 4.35 microg/g; kidney, 3.35 and 3.60 microg/g; lung, 1.80 and 1.60 microg/g; blood, 1.43 and 1.41 microg/ml measured by the use of ETA-AAS and fluorimetric methods, respectively.     

A fatal diazinon poisoning

A case of fatal suicidal ingestion of diazinon insecticide is presented. Diazinon concentrations in post-mortem body fluids and tissues were determined using electron capture and flame ionization gas-liquid chromatography. The highest concentrations of diazinon were found in blood, stomach contents, bile and adipose tissue.     

Death due to neurogenic shock following gastric rupture in an anorexia nervosa patient

We report a case of fatal gastric rupture discovered after death, which developed due to a bulimic attack of a 19-year-old woman suffering from anorexia nervosa. An autopsy revealed an acute gastric dilatation and rupture without commonly observed ischemic damage of gastric wall structures. However, it may be difficult to determine the cause of death despite the marked findings. The death as a consequence of neurogenic shock accounts for all the results of gross examination and histologic analysis. This case is the first reported case of fatal gastric rupture of an anorectic patient discovered after death.     

Accidental sharp force fatalities--beware of architectural glass, not knives.

In a retrospective evaluation of 799 consecutive autopsies of victims of sharp force performed between 1967 and 1996 in Münster and Berlin, only 18 cases (2.3%) were classified as accidents. A typical pattern was present in 15 cases: inebriated adults (1.4-3.6g/l BAC) fell into an architectural glass surface in the form of a door or window (12 cases), an aquarium, a mirrored wardrobe or a telephone cell. Another man fell into a large drinking glass. Many victims in this group showed multiple scratches, abrasions and superficial incisions as well as one or more deep tear/cut/puncture injury. The wound margins can be clean-cut or irregular and abraded. Death was mostly caused by exsanguination except for one case of air embolism and one case of cerebral injury. The fatal injuries were produced by large and dagger-like slivers of glass, by sharp-edged fragments of glass remaining inside the frame or by a portion of glass which fell down and acted in a way similar to a guillotine. Ordinary types of flat glass were involved in all cases and it is not until the impact that sharp fragments or cutting edges are produced. So the motion of the person commonly provides the force necessary for a fatal injury. This was also true for the remaining two cases not involving architectural glass. A farmer suffered cerebral injury from a fall into the long prong of a pitch fork, and the wounding agent was a knife in only one case. A man who stated that he had fallen into the knife in his hand died from pneumonia after inadequate therapy following a single stab injury to the periphery of the left lung and liver. Accidents where the victim is killed by his own knife therefore appear to be extremely rare.     

Forfeiture Theory and Symmetrical Attackers

This article defends the following thesis: The Problem of Symmetrical Attackers does not falsify forfeiture theory. The theory asserts that except in the case where violence is necessary to avoid a catastrophe, only those who forfeit their rights are liable for defensive violence. The problem arises from the following sort of case, the Symmetrical Attacker Case, in which Al and Bob are doppelgangers. They both mistakenly but justifiably think that the other is about to attack them. They both respond with violence that is necessary and that they think is necessary to prevent the attack. The problem is that one person forfeits his right if and only if the second does not and that it appears to be impossible for both or neither to forfeit. The article argues that the forfeiture theory is not falsified by this problem because the problem is equally damaging to every plausible theory of permissible defensive violence.     

The usefulness of lung surfactant phospholipids (LSPs) in the diagnosis of drowning

The authors have studied the usefulness of some lung surfactant phospholipids (LSPs) isolated from lung tissues as markers of drowning. Two different groups of rabbits were sacrificed by drowning in fresh and salt water, and their phospholipid compositions were compared with those of a non-drowned control series. For the phospholipids studied in lung lavages (phosphatidyl choline, phosphatidyl ethanolamine, and phosphatidyl glycerol) the proportions differed between the control group and the drowned group, and between the fresh-water and salt-water drowned animals. According to these results, the lipids we have analyzed can be employed as markers in forensic autopsies, where it is necessary to differentiate between death by drowning and postmortem immersion and between fresh-water and salt-water drowning. In lung tissue, only phosphatidyl choline and phosphatidyl inositol showed significative differences. These results also confirm that LSPs are strongly affected in drowning.