Patterns of Trauma Induced by Motorboat and Ferry Propellers as Illustrated by Three Known Cases from Rhode Island*

Abstract: Understanding patterns of trauma is important to determining cause and manner of death. A thorough evaluation of taphonomy, trauma, and bone fracture mechanisms is necessary to reconstruct the circumstances of the death. This study examines the skeletal trauma caused by boat propeller strikes in terms of wound characteristics and location based on three cases from Rhode Island. These case studies review the traumatic characteristics caused by propeller injuries and highlight the anatomic regions most likely to sustain skeletal trauma. With this information, investigators may be able to identify propeller trauma even in severely decomposed remains. The discussion of boat propeller trauma also raises issues regarding how forensic anthropologists and forensic pathologists classify trauma (specifically blunt force vs. sharp) and highlights semantic issues arising in trauma classification. The study also discusses why these propeller cases should be classified as blunt trauma rather than sharp or chop/hack trauma. Ultimately, the authors urge consistency and communication between pathologist and forensic anthropologists performing trauma analyses.     

The forensic entomologist in the context of the forensic pathologist's role.

An adequate death investigation requires the combined efforts and cooperation of experts in different disciplines: crime scene technicians, death investigators, forensic pathologists, anthropologists, entomologists, other medical and non-medical professionals. These front-line experts play a crucial role in every death investigation process. The forensic pathologist normally has the legal authority to take charge of the dead body at a death scene and his primary functions are the exterior and interior examination of the cadaver by analyzing the extent of antemortem injuries and the postmortem changes and the recovery of physical evidence. He is responsible for determining how, when and why of any death which is the result of violence, suspicious or unexplained circumstances or a death which is sudden or unattended, defending and explaining the reasons for making these diagnoses in a courtroom. The forensic entomologist can provide invaluable aid in death cases where human remains are colonized by insects and in the overall investigation. His principal role is to identify the arthropods associated with such cases and to analyze entomological data for interpreting insect evidence. He is responsible for determining the period of insect activity according to all the variables affecting insect invasion of remains and their development. The major goal of medico-criminal entomology is to contribute to the determination of the time, cause, manner and place of the investigated death (especially on badly decomposed corpses or skeletonized human remains) with the support of all the elements which can be inferred from the study of insects found on the cadaver or nearby. The application of techniques devised recently in forensic entomology can allow experts in the field to collect strong entomological evidence and provide useful information not only in a death investigation including movement or storage of the remains following death, time of dismemberment, postmortem artifacts on the body but also at the scene, and even more in child neglect, sexual molestation and identification of suspects. As the role of the forensic entomologist at the death scene, at the autopsy and in the laboratory is defined and well known, this paper focuses on the difficulties that could arise if forensic pathologists and entomologists are uncertain about the procedures that they have to follow, do not realize the value of objective findings or fail to evaluate them. Although every forensic case presents a slightly different set of circumstances and has to be tackled individually, the forensic pathologist should work with the forensic entomologist from the visual observations of the cadaver on the scene, through the collection of arthropods and temperature data at the death scene and at the autopsy, up to the final report with the interpretation of entomological and other biological evidence.     

The effects of the (fentanyl-fueled) drug overdose epidemic on medicolegal death investigation in the United States

The evolving opioid epidemic in the United States, fueled by illicit fentanyl, has greatly increased deaths from illicit drug use. These nonnatural deaths require formal death investigation. The National Association of Medical Examiners states in its Forensic Autopsy Performance Standards that autopsy remains a necessary component for proper investigation of suspected acute overdose deaths. If a death investigation office lacks adequate resources to investigate all deaths under its jurisdiction while meeting expected standards, then that office may be forced to consider altering its protocols for investigation by changing the types of deaths investigated or the extent of its investigations. Drug death investigations take longer to complete because novel illicit drugs and mixtures of drugs complicate toxicological analyses, prolonging a family's wait for completion of a death certificate and autopsy report. Public health agencies must also wait for results, but some agencies have developed mechanisms for rapid notification of preliminary results to allow timely deployment of public health resources. The increased deaths have strained the resources of medicolegal death investigation systems throughout the United States. Given the significant workforce shortage of forensic pathologists, newly trained forensic pathologists are too few to meet the demand. Nevertheless, forensic pathologists (and all pathologists) must make time to present their work and themselves to medical students and pathology trainees to encourage an understanding of the importance of quality medicolegal death investigation and autopsy pathology and to provide a model that can encourage interest in a career in forensic pathology.     

Analysis of blunt trauma injuries: vertical deceleration versus horizontal deceleration injuries

There are several similarities found in blunt trauma injuries to humans sustained as a result of vertical deceleration (falling) and those sustained as a result of deceleration in a horizontal plane (automobile accidents). However, examination of the patterns of traumatic skeletal injuries can distinguish those injuries associated with falling from heights from those associated with automobile accidents. While there is considerable variation within each type of blunt trauma injury dependent on the angle at which one falls or is struck, there are several characteristic skeletal features associated with each type of trauma. In this study we review both the current literature and human skeletal remains from the University of New Mexico's Documented Collection known to have been subjected to blunt trauma. This collection is used to characterize and differentiate the pattern of skeletal injuries to various parts of the body for each type of trauma. These assessments are applied to investigate the traumatic skeletal lesions observed in a forensic case where the manner of death is unknown. Analyses suggest two possible scenarios that would explain the death of the individual investigated, with death most likely related to a vehicular-pedestrian accident.     

The application of CT for 3D visualization of concealed bodies

In forensic radiology, computed tomography (CT) is often used as a medical imaging technique to identify the cause and manner of death of deceased victims of a possible crime. In this study, medical imaging is used to examine concealed bodies and packaging materials. Medical imaging techniques, mainly CT scan, were used to scan packaged or concealed bodies inside containers to identify clues and evidence indicating whether a crime might have been committed. Also, scene integrity and scene safety along with a systematic search for relevant evidentiary items value were considered.Eighteen concealed bodies that had been assessed using medical imaging techniques between 2010 and 2018 at the request of the Dutch National Police were selected. The file records of each case contained imaging data, a photographic record of the unpacking procedure, a list of all items and traces found in the package, and the forensic pathology report. The images were assessed with respect to the different aspects of the case and through a systematic approach.The packages included adult males, adult females, newborn infants, and animals. All human cases were related to criminal offences. In nine adult cases, evidence of a possible violent death could be determined using CT imaging. The cause of death in newborn infants, however, could not be determined. In cases of dismemberment, the completeness of the body could be determined by CT imaging, and the cutting surfaces of bones could be matched on CT images. Regarding scene safety and integrity, in this study all relevant macroscopic items were detected on the CT images.The CT-scans were supplemented with fiduciary markers to better map CT data with the real objects. This information in combination with 2D and 3D images provided the forensic investigator with information on how to unwrap the package layer by layer and help determine different types of packaging materials. Different textiles could not always be identified. The orientation of the body within the packages was provided in all cases, and advice could be given on the optimal approach to access the contents. The overall detection rate of items was 78%.This is one of the first studies to illustrate the contribution of medical imaging, specifically CT scan, to the analysis of concealed bodies and packaging materials prior to unpacking. This demonstrates its contribution to a systematic approach of the investigation by ensuring the safety and health of the investigator while documenting and maintaining the integrity of the crime scene. Imaging also provides information that can be helpful to determine whether a crime might have been committed and reducing the risk of damaging a concealed body. Medical imaging also provides the forensic investigator with information to draw up a workplan prior to unpacking, minimising loss of evidence and determining whether different forensic specialists (e.g., digital or DNA) are needed. It is therefore strongly recommended to use medical imaging, especially CT scanning, before opening a package containing a concealed body.     

Forensic anthropology in the 1990s.

Forensic anthropology has undergone considerable change over the past 10 years. Today it is utilized by most law enforcement, coroner, and medical examiner systems. The techniques for determination of age at death, sex, race, and stature from skeletal remains have been modified and greatly expanded. The role of the forensic anthropologist within a medicolegal context is much broader than in previous years. In addition to establishing individual identity, forensic anthropologists are now consulted for trauma analysis, facial reconstruction, photographic superimposition, determination of time interval since death, and crime-scene recovery. Not all physical anthropologists are forensic anthropologists. Qualified individuals are certified, through rigorous examination, by the American Board of Forensic Anthropology. A list of board-certified forensic anthropologists may be obtained through the American Academy of Forensic Sciences.     

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.     

A multifaceted,multijurisdictional, multiagency,and multidisciplinary approach to investigating unidentified and missing persons cases in Australia

Currently, there are approximately 750 unidentified human remains and 2500 long-term missing persons in Australia. The Australian Federal Police National DNA Program for Unidentified and Missing Persons (Program) is using a multifaceted, multijurisdictional, multiagency, and multidisciplinary approach in a dedicated effort to identify these unknown deceased persons, scientifically link them to known missing persons, and provide answers to their families. The nationally coordinated Program provides its police, forensic, and coronial stakeholders with a suite of contemporary forensic technologies, databases, and experts to forensically examine the skeletonised remains and recover post-mortem data for comparison to the available ante-mortem data for each missing person. Through a number of physical and virtual public outreach activities, families with missing relatives have been encouraged to provide vital ante-mortem forensic information, records, and samples to aid the identification process. To date, this unique Program has assisted to resolve a number of unidentified and missing persons cases from both historical and contemporary contexts, using a combination of genetic and non-genetic techniques, and local and national databases. The centralisation of Program capabilities, expertise, and resources to conduct this type of unique and challenging casework is proving to be the most effective and efficient way to generate investigative leads, identify human remains, and resolve long-term missing persons cases in Australia.     

Skeletal Indicators of Shark Feeding on Human Remains: Evidence from Florida Forensic Anthropology Cases

This research examines a series of six Florida forensic anthropology cases that exhibit taphonomic evidence of marine deposition and shark‐feeding activities. In each case, we analyzed patterns of trauma/damage on the skeletal remains (e.g., sharp‐force bone gouges and punctures) and possible mechanisms by which they were inflicted during shark predation/scavenging. In some cases, shark teeth were embedded in the remains; in the absence of this evidence, we measured interdental distance from defects in the bone to estimate shark body length, as well as to draw inferences about the potential species responsible. We discuss similarities and differences among the cases and make comparisons to literature documenting diagnostic shark‐inflicted damage to human remains from nearby regions. We find that the majority of cases potentially involve bull or tiger sharks scavenging the remains of previously deceased, adult male individuals. This scavenging results in a distinctive taphonomic signature including incised gouges in cortical bone.     

Medicolegal anthropology in France.

Medicolegal anthropology has a very long history in France. Basic studies on human skeletal remains started as early as the 18th century. The 19th century produced many medical theses and research papers on age, sex, as well as stature estimation. The research proliferated in the first 60 years of the 20th century, much of which is still in use in France and abroad. The later half of the 20th century, however, was dormant in research on human skeletal biology at a time when forensic anthropology was becoming an active field worldwide. In the last decade, medicolegal anthropology took a different perspective, independent of its traditional roots. Research and practice have both been in the professional domain of forensic physicians unlike the situation in many other countries. Population based studies requiring large databases or skeletal collections have diminished considerably. Thus, most research has been on factors of individualization such as trauma, time since death, crime scene investigation, and facial reconstruction. It is suggested that there is a need for cooperation between the forensic physician and anthropologist to further research. This also encourages anthropologists to carry out research and practice that can fulfill the needs of the medicolegal system of the country.     

The application of amino acid racemization in the acid soluble fraction of enamel to the estimation of the age of human teeth

Estimation of age-at-death for skeletonised forensic remains is one of the most significant problems in forensic anthropology. The majority of existing morphological and histological techniques are highly inaccurate, and show a bias towards underestimating the age of older individuals. One technique which has been successful in forensic age estimation is amino acid racemization in dentine. However, this method cannot be used on remains where the post-mortem interval is greater than 20 years. An alternative approach is to measure amino acid racemization in dental enamel, which is believed to be more resistant to change post-mortem. The extent of amino acid racemization in the acid soluble fraction of the enamel proteins was determined for modern known age teeth. A strong correlation was observed between the age of the tooth and the extent of racemization. No systematic bias in the direction of age estimation errors was detected. For the majority of teeth analyzed, the presence of dental caries did not affect the results obtained. In a minority of cases, carious teeth showed a higher level of racemization than would be expected given the age of the individual. These results indicate that amino acid racemization in enamel has the potential to be used in age estimation of skeletal remains.     

Dehydration-Induced alterations to sharp force trauma on Sus domesticus radii

Dehydration is a taphonomic process that affects nearly all skeletal remains, yet there is a dearth of evidence on this process within the forensic taphonomy literature. When considering the forensic implications of skeletal dehydration, a particular area of concern is sharp force trauma due to its global prominence in forensic cases. In an attempt to address these literature gaps and quantify the effects that dehydration has on skeletal elements, a controlled experiment subjected Sus domesticus (i.e., domestic pig) radii samples (n = 36) to laboratory-induced dehydration after they were inflicted with knife trauma. All samples were photographed pre- and post-dehydration; bone section and kerf mark length, width, and area were then measured from these photographs using ImageJ. Statistical analysis of pre- and post-dehydration samples showed that all measurements experienced significant (p ≤ 0.001) shrinkage, with bone sample area shrinking an average of 8.8 % and kerf mark area an average of 29.7 %. Alterations in length, width and area between the kerf marks and bone samples showed a weak, moderate, and strong correlation, respectively. These findings suggest that anthropological analysis may be affected by dehydration-induced shrinkage, highlighting the necessity of continued research into the effects of dehydration on skeletal trauma.     

Survival of Atherosclerotic Calcifications in Skeletonized Material: Forensic and Pathological Implications

Atherosclerosis is a chronic inflammatory disease creating calcifying plaques in the arterial walls. Because its paleopathological diagnosis remains little studied on skeletal remains, its impact on forensic and archeological data is completely underestimated. Here, 24 skeletal remains from the Milano Cemetery Skeletal Collection have been studied to evaluate the chance of atherosclerotic calcification survival, retrieval, and identification. Through direct comparison with a known autopsy collection and literature, the identification and categorization of several types of calcifications were performed. Clothing elements such as tights or socks played a definitive role in the preservation of the calcifications; hence they are more likely to be found in forensic cases than in archeological ones. Therefore, vascular calcifications are possible to collect and identify in skeletal remains if sufficient care is given to their recovery. Consequently and as markers of the disease, such identification can provide valuable pathological information for forensic and archeological cases.     

A multidisciplinary investigation of chronic animal abuse: Collaboration between veterinary forensics and forensic anthropology

An unknown juvenile female mixed breed dog was found non‐ambulatory on a dead‐end street in an urban setting adjacent to a public park. During initial veterinary examination, she was assessed to have untreatable injuries and was humanely euthanized. The forensic veterinarian requested consultation from a forensic anthropologist to assist with documenting antemortem skeletal trauma. Analyses of skeletal tissues indicated numerous injuries in various stages of healing diagnostic of non‐accidental injuries. Veterinary forensic cases may benefit from collaborative analysis of bony remains by forensic anthropologists.     

The reliability of forensic osteology--a case in point. Case study

The medico-legal investigation of skeletons is a trans-disciplinary effort by forensic scientists as well as physical anthropologists. The advent of DNA extraction and amplification from bones and teeth has led to the assumption that morphological assessment of skeletal remains might soon become obsolete. But despite the introduction and success of molecular biology, the analysis of skeletal biology will remain an integral part of the identification process. This is due to the fact, that the skeletal record allows relatively fast and accurate inferences about the identity of the victim. Moreover, a standard biological profile may be established to effectively narrow the police investigator's search parameters. The following study demonstrates how skeletal biology may collaborate in the forensic investigation and support DNA fingerprinting evidence.In this case, the information gained from standard morphological methods about the unknown person's sex, age and heritage immediately led the police to suspect, that the remains were that of a young man from Vietnam, who had been missing for 2.5 years. The investigation then quickly shifted to prove the victim's identity via DNA extraction and mtDNA sequence analysis and biostatistical calculations involving questions of kinship [4].     

Cognitive bias in forensic anthropology: Visual assessment of skeletal remains is susceptible to confirmation bias

An experimental study was designed to examine cognitive biases within forensic anthropological non-metric methods in assessing sex, ancestry and age at death. To investigate examiner interpretation, forty-one non-novice participants were semi randomly divided into three groups. Prior to conducting the assessment of the skeletal remains, two of the groups were given different extraneous contextual information regarding the sex, ancestry and age at death of the individual. The third group acted as a control group with no extraneous contextual information. The experiment was designed to investigate if the interpretation and conclusions of the skeletal remains would differ amongst participants within the three groups, and to assess whether the examiners would confirm or disagree with the given extraneous context when establishing a biological profile. The results revealed a significant biasing effect within the three groups, demonstrating a strong confirmation bias in the assessment of sex, ancestry and age at death. In assessment of sex, 31% of the participants in the control group concluded that the skeleton remains were male. In contrast, in the group that received contextual information that the remains were male, 72% concluded that the remains were male, and in the participant group where the context was that the remains were of a female, 0% of the participants concluded that the remains were male. Comparable results showing bias were found in assessing ancestry and age at death. These data demonstrate that cognitive bias can impact forensic anthropological non-metric methods on skeletal remains and affects the interpretation and conclusions of the forensic scientists. This empirical study is a step in establishing an evidence base approach for dealing with cognitive issues in forensic anthropological assessments, so as to enhance this valuable forensic science discipline.     

Postmortem Skeletal Survey Practice in Pediatric Forensic Autopsies: A National Survey*

Abstract: Recommendations for the evaluation of an unexplained death in infancy include a postmortem skeletal survey (PMSS) to exclude skeletal trauma. Objectives of this study were to assess adherence to these recommendations in forensic autopsies in children equal to or less than 36 months of age, and what factors influence the use or nonuse of the PMSS. We surveyed pathologists who were members of the American Academy of Forensic Sciences. The survey included practice characteristics about where, when, and how PMSS were done. Nearly all respondents (99.6%) indicated they performed PMSS at least some of the time; however, almost a third did not use PMSS for all suspected Sudden Infant Death Syndrome (SIDS), abuse, unsafe sleep, or undetermined causes of death. Despite evidence that “babygrams” are inappropriate in a SIDS workup, 30% of pathologists use them preferentially. Despite SIDS being a diagnosis of exclusion that requires a PMSS, almost 10% of pathologists do not order a PMSS. Future research is necessary to reduce barriers to this important component of the pediatric forensic autopsy.     

Skeletal Trauma Resulting From Fatal Low (≤3 m) Free Falls: An Analysis of Fracture Patterns and Morphologies

The skeletal trauma resulting from fatal low (≤3 m) free falls is poorly researched and understood by forensic practitioners. The aim of this study was to identify the types of skeletal trauma resulting from low falls through investigating fracture patterns and morphologies. Skeletal trauma was analyzed using full‐body postmortem computed tomography scans of 145 individuals who died from a low free fall. Trauma was then contextualized to the variables that influence how a person falls using multiple logistic regression. Results showed fracture patterning primarily involved the axial skeleton and that there were a number of patterns significantly associated with the height fallen, pre‐existing health conditions, and age. Analysis of fracture morphologies showed 108 possible fracture types, six of which were significantly associated with the height fallen. Understanding the skeletal trauma characteristic of low free falls will further inform anthropological interpretations of trauma in cases where a fall may be considered the possible mechanism.     

Erythrocytes in cervical lymph nodes of the human as a sequela of stasis and/or lymph drainage. Questionable diagnostic significance in strangulation and mechanical injuries of the head

Information on the diagnostic significance of follicular hemorrhage and/or presence of red blood cells in the lymph node sinus was obtained by microscopic investigation of the superficial and deep human cervical lymph nodes. Fifty cases were selected on the basis of the following criteria: (1) cases without strangulation or mechanical head trauma; (2) cases in which death occurred by strangulation without additional mechanical head trauma; (3) cases without strangulation but with mechanical head trauma; (4) cases with strangulation and mechanical head trauma. The usual degree of stasis and hemorrhages and the dilation of the veins and/or capillaries are not sufficient to discriminate between cases with and cases without strangulation. Moreover, erythrocytes, erythrophages, and siderophages were encountered in the lymph node sinus of both cases with and cases without mechanical head trauma. Neither follicular hemorrhage nor the presence of red blood cells in the sinus is therefore diagnostically significant in forensic pathology.