Singular case of shooting a football fan with a signal rocket

The authors present a very rare case of fatal injuries resulting from shooting a parachute signal rocket with a hand operated launcher of signal pistol kind by pseudo-football fans. A 16-year-old football fan sustained extensive thermal burn of his lower extremities and abdomen, lacerated wound of his left thigh with a deep signal rocket-shot canal which caused injuries in subcutaneous tissue, fascia and both medial and posterior muscles of the thigh as well as injured both femoral vein and artery with subsequent hemorrhagic, burn and traumatic shocks. In spite of specialistic surgical treatment, the victim was not rescued. Analysis of medical documentation and our autopsy results were supplemented with an expert's opinion on physicochemical examinations supported by photographic documentation.     

156例道路交通事故活体损伤分析

１５６例道路交通事故活体损伤分析陈新山（武汉同济医科大学法医病理学教研室；武汉４３００３０）ＡＮＡＬＹＳＩＳＯＦ１５６ＣＡＳＥＳＯＦＮＯＮ－ＦＡＴＡＬＩＮＪＵＲＹＩＮＲＯＡＤＴＲＡＦＦＩＣＡＣＣＩＤＥＮＴ￥ＣｈｅｎＸｉｎｓｈａｎ（Ｄｅｐａｒｔｍｅｎｔ...     

Fatal exsanguination following complete transection of femoral vessels due to angle grinder injury in an industrial accident

Angle grinders are one of the most dangerous and frequently used tools in industrial settings. Angle grinder injuries range from superficial cuts to deep penetrating injuries with underlying fracture-dislocation and vascular trauma. The injuries caused by angle grinders mostly involve the head, face, or upper limbs, while the lower limb is an unusual site. The high-speed rotating disc of the angle grinders does not respect anatomical boundaries or structures; therefore, the injuries caused may be disfiguring, permanently incapacitating, or even fatal. We report a fatal case of an angle grinder injury to the lower limb. The victim sustained a sharp cut over the left thigh while woodworking in an industrial setup. The rotating disc of an angle grinder had transected the skin, subcutaneous fat and muscles, and both the femoral vessels of the left side, which led to fatal exsanguination within 10 min of the incident.     

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.     

Suicidal shot in the mouth with a rubber shot shell

The purpose of weapons designed for self-defence and their ammunition is to allow effective defence without causing serious injury provided that the recommended minimum firing distance is observed. However, close-range and contact shots to vulnerable body regions may cause severe or even fatal injuries. The authors report on a suicide who fired a fatal shot in his mouth with a weapon for self-defence. The weapon used was a double-barrelled SAPL break-action gun, mod. GC 54, from which a Mini Gomm-Cogne, cal. 12/50 rubber shot shell was fired. The wound findings and ballistic characteristics of the weapon are presented and discussed.     

Suicide by band saw

Suicidal injuries caused by power tools have rarely been reported in the literature. The case of a 37-year-old white male schizophrenic patient who sustained a fatal self-inflicted neck injury from a band saw, while engaging in occupational therapy, is presented. Unusual features of this type of injury as noted at postmortem examination were the extent of the wound, the absence of hesitation injuries, and the presence of grease wipe, bone dust, and sawdust within the wound.     

Death by complete decapitation of motorcyclist wearing full face helmet: case report

We describe a case of complete decapitation following a motorcycle accident in which the victim was wearing a full face helmet. A young man lost control of his motorcycle and was thrown about 20 m, hitting his head against the barrier separating a tramline from the road. The resulting trauma caused his decapitation, the only fatal wound ascertained by the various forensic investigations. The authors present this rare case and compare it against the other two cases reported in the literature, providing some observations on the ways in which this injury can come about. The absence of abrasions or signs that the wound edges came into contact with a metal structure, the presence of signs of impact on the side of the helmet and the finding of a transversal fracture at the base of the skull point to the violent action of a side-to-side opposite force, due to the resistance provided by the lower edge of the protective helmet.     

Injuring potential of drinking glasses

At a party of a sports club, an argument started between two groups of young men, in the course of which one of the persons involved threw a beer glass hitting a young man of the other group, who collapsed with a profusely bleeding wound. Although resuscitation measures were initiated immediately, the victim died at the scene due to exsanguination from the completely severed left external carotid artery in combination with the aspiration of blood. Tests with drinking glasses thrown at a skull-neck model suggested that an undamaged beer glass thrown at the head of the victim could not cause the fatal injuries on the neck because of its splintering behaviour. In fact, it seemed that the beer glass had been damaged prior to throwing it and that its sharp edges perforated the skin on hitting the neck.     

Stud guns revisited: report of a suicide and literature review

Stud guns (powder-actuated fastening tools) are a commonly used construction tool. Accidental injuries and fatalities are no longer frequent, presumably because of current safety features and practices. A case of an intentional fatal wound (suicide) is described. A literature review of stud gun injuries is also presented.     

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.     

Forensic Epidemiologic and Biomechanical Analysis of a Pelvic Cavity Blowout Injury Associated with Ejection from a Personal Watercraft (Jet‐Ski)

Jet‐propelled personal watercraft (PWC) or jet‐skis have become increasingly popular. The means of propulsion of PWC, which is a jet of water forced out of small nozzle at the rear of the craft, combined with a high risk of falling off of the seat and into close proximity with the water jet stream, raise the potential for a unique type of injury mechanism. The most serious injuries associated with PWC falls are those that occur when the perineum passes in close proximity to the jet nozzle and the high‐pressure water stream enters the vaginal or rectal orifice. We describe the forensic investigation into a case of an anovaginal “blowout” injury in a passenger who was ejected from the rear seat position of a PWC and subsequently suffered life‐threatening injuries to the pelvic organs. The investigation included a biomechanical analysis of the injury mechanism, a summary of prior published reports of internal pelvic injuries resulting from PWC falls as well as other water sports and activities, and a comparison of the severity of the injuries resulting from differing mechanisms using the New Injury Severity Score (NISS). The mean (±standard deviation [SD]) NISS values for reported PWC injuries [not including the NISS of 38 in this case study] were 11.2 (±9.5), while the mean value for reported water‐skiing falls was half that of the PWC group at 5.6 (±5.2). It was concluded that the analyzed injuries were unique to a PWC ejection versus other previously described non‐PWC‐associated water sport injuries. It is recommended that PWC manufacturers help consumers understand the potential risks to passengers with highly visible warnings and reduce injury risk with revised seat design, and/or passenger seat “deadman” switches.     

玻璃刺创形态学特点的初步研究

目的研究玻璃刺创的形态学特点。方法分别用3个厚度为0．31cm带尖状突起的啤酒瓶残端及3块厚度为0．29cm有尖的普通窗玻璃碎片按设定的不同方向刺击带皮猪肉组织,重复此过程3次,形成198例创口,观察、编号、拍照、测量各创口。结果198例创口的整体形态可分为5种类型,即“工”型、“”型、“”型、“上”型与“一”型,各型在不同刺击方向的分布上存在差异,其中前4种为主要类型,共约占总数的93％,其共同点为在损伤的中部出现了一段与损伤整体走向垂直的创口,啤酒瓶残端所致垂直创口的长度为0．31±0．Olcm（x±s）,窗玻璃碎片所致垂直创口的长度为0．29±0．Olcm（x±s）。结论损伤中部有与损伤整体走向垂直的短创口是玻璃刺创中易出现的一种形态学特点,垂直创的长度与致伤玻璃的厚度具有一致性。     

Bloodstain pattern analysis in a case of suicide with a compound bow and arrow

The incidence of human fatalities due to arrow injuries in the medical literature is rare. We report an incident involving a 46-year-old man who was found in his secured apartment with a fatal arrow wound of his chest and abdomen. The initial scene investigation suggested that the victim impaled himself with an arrow attached to a razor-sharp, 4-bladed broad-head hunting tip before collapsing on the floor. However, analysis of the bloodstain patterns suggested that the victim used the compound bow to propel the arrow.When investigating deaths due to bows and arrows, thorough scene investigation along with bloodstain pattern analysis is essential in determining the mechanism of injury and manner of death.     

Knee joint injuries as a reconstructive factors in car-to-pedestrian accidents.

Knee joint injuries were found in 214 out of 357 fatal pedestrian victims of traffic accidents (60%). The cross-sections of tibial and femoral epiphyses revealed bone bruises (due to compression and avulsion) and the percentage of victims with knee injuries increased to 80% (in the group of lateral impacts - 94%). The bone bruises in the central tibial and femoral condyles were observed only in victims hit in an upright position. There was a strong correlation between the side of impact on the extremities in medium sized pedestrians (from the front, back, lateral and medial side) caused by passenger cars and the mechanism of knee injuries (hyperextension, anterior dislocation of the proximal tibial epiphysis in relation to the femoral condyles, valgus and varus flexion). In the cases of very low impacts (e.g. in very tall victims hit by rapidly breaking wedge-shaped cars) or very high impact (e.g. in very short victims or truck hits) the "reversed" complexes of injuries were found (lever principle). These findings showed that knee joint injuries are useful for determining the car-pedestrian location on collision and the type of vehicle (in hit-and-run accidents).     

Fatal and near-fatal animal bite injuries

Fatal and near-fatal maulings of humans by pit bulls have recently become a topic of major public concern, resulting in the passage of laws in some jurisdictions that make the owner of a pit bull criminally liable for manslaughter if his or her pet causes a human death. The authors recently investigated two cases in which children were fatally injured by pet dogs. In the first case, a 17-day-old girl suffered fatal abdominal injuries when attacked by a pregnant Siberian husky. A 2-year-old girl expired from neck wounds inflicted by a pit bull or a rottweiler or both. Because no expert would testify as to which dog caused the fatal injury, the owner of the animals was not charged under a statute which specified criminality only if a pit bull caused the fatal injury. We also examined a 12-year-old boy who attempted to pet a circus tiger; the animal grabbed his arm with its claws and bit off the arm at the shoulder. The arm could not be reattached, but the child survived. These cases and the differentiation of animal bites from other injuries will be presented.     

A single fatal penetrating chest wound from shattered wind-blown glass

The great majority of penetrating wounds of the thorax result from firearms and bladed weapons. Penetrating wounds of the heart and of the great vessels still have a high immediate mortality. While penetrating chest wounds occasionally result from fragments of glass; most severe and fatal wounds from glass result from one's falling into or through architectural (plate) glass, sustaining wounds of abdomen or extremities, or both. A single, fatal penetrating chest wound resulting from a wind-blown fragment of glass is distinctly uncommon. The unique case of this type reported herein is that of a 12-year-old youth who was struck in his home in the left anterior chest by a single, sharp, slender fragment of glass blown from a window which shattered in a thunderstorm. This resulted in a rapidly fatal penetrating wound involving thoracic viscera. The forensic pathologist must thoroughly investigate and document such accidental deaths, modifying his/her autopsy procedure as necessary for these purposes and to avoid accidental injury at the autopsy table.     

Cardiac Ventricular Laceration Due to Child Abuse: Abusive Ventricular Laceration

Traumatic cardiac ventricular ruptures in children are rare. Only a single case of left ventricular rupture due to child abuse has been reported. We report a child who sustained a fatal left ventricular apical rupture. It appeared to have resulted from hydrostatic forces resulting from abusive blunt thoracic injury. That he was being abused was previously missed when he was presented to the emergency department with facial pyoderma. It was not noted that he also had lip and oral mucosal injury, sites not affected by staph toxins. As a result, his underlying, abusive and secondarily infected, facial flow type scald burn was not appreciated. Within a week thereafter his fatal injury occurred, accompanied by extensive and obvious associated abusive injuries. Postmortem high‐detail whole body computed tomography scanning aided the autopsy. Although rare, ventricular rupture from abusive blunt thoracic injury can occur.     

Localization and quantification of histamine in injured skin as parameters for the timing of wounds.

Localization and estimation of the histamine (HA) content in skin wound edges in 86 Sprague-Dawley rats and three cases of human injuries were carried out by a microfluorimetric method specific for this amine which forms a complex with o-phthalaldehyde (OPT). Distribution and density of the mast cells in the same areas were observed at the same time by toluidine blue stain. In all skin specimens with antemortem wounds, both the epidermis and upper dermis exhibit extracellular yellowish fluorescence of the HA-OPT complex. The fluorescent zone spreads in the wound edges with the lapse of time in vital injuries. The HA content increases gradually up to 30 min and then the yellow histamine fluorescence in areas 0-200 microns from the wound edge decreases. None of these features can be observed in normal skin and postmortem-injured skin. Mast cell degranulation can be demonstrated in all antemortem-injured skin. No statistical relationship exists between the number of mast cells and the HA-OPT fluorescence in either ante- or postmortem-injured groups. This study indicates that skin HA microfluorimetry by the OPT method is of practical value for distinguishing ante- from the postmortem wounds and for timing antemortem wounds.     

Shooting Through Clothing in Firearm Suicides

Abstract: There is a longstanding empirical rule that people who commit suicide rarely shoot through their clothing, but rather put it aside to expose the nude skin. Signs of shots through clothing have always been considered suspicious, raising presumptions of the presence of an abettor. Our report, based on a retrospective study of fatal suicidal firearm injuries from the years 1980 to 2007, points out that suicide victims only rarely remove clothing from the site of the future entry wound. The report covered 43 cases with fatal gunshot wounds in the area of the thorax, with only four persons (9%) removing the clothing present in the area of the subsequent self‐inflicted wound. Defects present on the clothing of a victim cannot, therefore, be understood as an absolute criterion for disproving the possibility of suicide, and nor do they necessarily indicate an unfortunate accident or homicide. If, however, the suicide victim removes the clothing from the area of the future wound, then this is almost always an indication of suicide.     

Fatal Wounds by “Manja” to a Motorbike Rider in Motion

“Kite fights” are quite popular throughout Asia. Most kite variations, including the fighter kites of India, Pakistan, and Japan, are small, flat, roughly diamond‐shaped kites composed of paper, with a tapered bamboo spine and a balanced bow. They are flown with the help of a “Manja,” which is a thread made of cotton or nylon, and coated with fine glass powder using glue and other chemical adhesives to cut down opponent's kite string. The nylon “Manja” is particularly more dangerous, as it not only cuts down opponent's kite string but also causes bodily injuries to humans, which may be at times fatal. The pattern of injuries by Manja is underreported in literature. In the present case, the deceased had encountered fatal injuries by “Manja” while riding on his motorbike. This case discusses the pattern of injuries caused by Manja when the victims are in motion on their two‐wheelers.