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.     

Dog saliva transmitted pathogens as etiology of fatal infections (on the topic of causal relationship)

The authors report on 4 deaths. 3 of the victims had been bitten by dogs shortly before death; in one case the victim had close contacts with a dog. In 3 of the cases death was caused by septicemia; microorganisms occurring in the saliva of dogs, but rarely causing infection could be determined in 2 of the cases. While in case 1 there was no bite injury so that transmission must have occurred by droplet infection (without trauma) or via a discrete skin lesion, case 2 showed a penetrating dog-bite injury; in both cases the spleen had been surgically removed some years before. In case 3 a causal relationship had to be assumed between a dog bite and death, although no pathogen could be identified in microbiological tests. In case 4 death was not attributable to the dog-bite injury suffered, but was due to an internal pathological cause.     

Tongue bite injuries--a diagnostic criterium for death in epileptic seizure?

Bite marks of the tongue are often associated with epileptic seizures, although information about the real frequency of bite marks of the tongue is hard to find. This is also true for their presence in deaths of epileptics or in deaths in general. The purpose of this investigation was to analyze the frequency of bite marks of the tongue in deaths of epileptics in comparison to a control group. Further points of interest were the spectrum of the causes of death recorded, toxicological data as well as the presence and localization of external head injuries. The study group consisted of 105 individuals with a known history of epilepsy, the control group of 107 individuals with sudden cardiac death. Autopsy reports were analyzed retrospectively. In the first group bite marks of the tongue were seen in 21% (in the subgroup "observed death during seizure" even in 64%) and were thus significantly more frequent than in the control group (2%). In 35 cases of the study material an unnatural manner of death was found (trauma, especially craniocerebral trauma, drowning, asphyxia, intoxication) and in 70 cases a natural death was assumed. However, in 41 of these the exact cause of death was not ascertainable. According to the SUDEP criteria (Ficker 2000, Nilsson 1999) 29 of these cases could be categorized as possible or probable SUDEP (sudden unexpected death in epilepsy) with 17 showing bite marks of the tongue. The fact that half of the remaining 12 cases showed bite marks of the tongue suggests at least for these cases that death occurred during the seizure. Head injuries were reported in 41% of the epilepsy group--in the subgroup "observed death during seizure" in 73%. Our investigation did not produce evidence for a higher frequency of bite marks of the tongue in cases in which resuscitation had been attempted. In our experience the presence of fresh bite marks of the tongue--according to histological findings--is a useful signs for the assignment of death to an epileptic seizure and especially for death during acute convulsion.     

An elliptical incised wound of the breast misinterpreted as a bite injury

Bite injuries upon homicide victims are most often initially identified by the forensic pathologist during the course of the autopsy examination. Following such recognition, the injury or photographs of the traumatized site are then referred to a forensic odontologist for his or her examination, further characterization, and subsequent comparison with any suspect's dentition. However, if the pathologist misidentifies an injury caused by another mechanism as a human bite, this mistake can potentially be perpetuated by the dental consultant, since relatively few dentists regularly examine traumatic injuries other than those arising from bites. To illustrate such an event, a case is presented involving an incised wound of the breast, which was originally identified as an avulsive bite wound. Detailed examination by two odontologic consultants confirmed the wound as having been caused by human teeth, and further, they related the "bite injury" to a specific individual. The bite injury interpretation represented the only scientific evidence implicating the suspect at a subsequent trial for capital murder. Later examination of the tissues and photographs by a forensic pathologist and another dental consultant revealed that the injury was not due to human dentition, but rather resulted from a sharp-edged instrument. These consultants conducted a unique experiment to reduplicate the injury and prove its causation. This information was presented to the jury during the suspect's trial and resulted in his acquittal on all charges.     

Vital animal predation of the genital region caused by a mongrel dog

A 79-year-old man, who was in a helpless situation due to cardiac decompensation, suffered dog bite injuries on the left thigh and in the genital region while still alive. Two extensive soft-tissue defects with contused and bruised wound edges were surrounded by multiple slit-like skin lesions. The outer genitals were almost completely missing. Because of surgical emergency treatment, molecular biological investigations were no longer possible. Therefore, the cause of the bite injuries had to be determined solely on the basis of the documented morphology of the wounds.     

Forensic issues in cases of Diogenes syndrome

Diogenes syndrome is a syndrome described in the clinical literature in elderly individuals characterized by social isolation and extreme squalor. A number of typical features are found in the forensic evaluation of these deaths as the cases usually initiate medicolegal investigations due to the circumstances and the lack of recorded medical histories. Examinations of the death scenes are often difficult as victim's houses are in a state of disrepair, with filth and clutter, and pet dogs may resent the intrusion of strangers. Bodies are often filthy, with parasitic infestations, and are often putrefied due to the social isolation of the deceased and the delay in the finding of the corpse. Bodies may be traumatized from postmortem animal depredation by rodents or pets (eg, cats, dogs), and injuries such as bruises and lacerations may be present from falls associated with terminal illnesses or alcoholism. Blood or putrefactive fluids may be spread throughout the house by pets. Treatable medical conditions are often present in advanced stages, and features of hypothermia may be found. Attending police may suspect robbery due to disarray of the house and homicide due to apparent "bleeding" around the body from purging of putrefactive fluids, injuries from falls, or postmortem animal activity and "blood stains" throughout the house from antemortem injuries and/or fluid spread by animals. Finally, the identification of the deceased may be compromised by decay and/or postmortem animal activity. Thus, in addition to having typical clinical manifestations, such individuals appear to form a distinct subset of forensic cases having characteristic death scene and autopsy features and presenting particular difficulties in postmortem evaluations.     

Sudden death due to cerebral leukemic hemorrhage occurring after acupuncture treatment for gingival bleeding

A 45-year-old woman who experienced stomalgia and gingival bleeding for several days died unexpectedly after acupuncture treatment. At autopsy, trivial injuries on the liver and the stomach and mild hemoperitoneum due to improper acupuncture were found. Also,acute lymphoblastic leukemia and hyperleukocytosis were diagnosed by postmortem examinations. Intracranial hemorrhage due to undiagnosed acute lymphoblastic leukemia was identified as the cause of death.Moreover, the relationship between therapeutic misadventure and death was also determined. We suggest that undiagnosed leukemia should be considered as a differential diagnosis when sudden death occurs owing to intracranial hemorrhage. If therapeutic misadventure was involved,it is also of great importance to assess the relationship between that and death in forensic expertise.     

Comparison between computed tomography (CT) and autopsy findings in cases of abdominal injury and disease

We report 10 autopsy cases involving fatal pathological changes in abdominal organs, for which findings of computed tomography (CT) on admission or after death were compared with autopsy findings. Two of the cases were death due to natural causes and eight were death due to traffic accidents. From the findings at autopsy, the causes of death were considered to be rupture of an aortic aneurysm in one case, gastrointestinal bleeding due to gastric cancer in one case, retroperitoneal bleeding in two cases, laceration of the liver in three cases, and traumatic rupture of the small intestine in three cases. CT findings revealed ascites or retroperitoneal bleeding in eight cases. However, in the cases of small-intestinal rupture, CT findings on admission revealed no free air. Therefore, ascites on CT should be regarded as a useful indicator of blunt abdominal trauma. Hepatic portal venous gas, known to be a post-mortem change, was significantly evident on post-mortem CT in cases of traumatic liver or intestinal injury, and was also seen in cases where the period between the accident and CT examination was long.     

Bite mark or bottle top?

An alleged assault was reported by a 42-year-old female, with initial medical examination revealing an apparent bite mark on the right buttock. Odontological examination, including visual assessment, full history and photographs showed that the injury did not meet the class characteristics of a human bite. Subsequent digital overlay production showed that the injury pattern was consistent with a corrugated bottle top. This case highlights the need for careful assessment of injuries alleged to be caused by human teeth.     

Artifacts Caused by Leaf-Cutting Ants of the Genus Atta (Hymenoptera: Formicidae): Postmortem Bite Injuries and the Tearing of Clothes

Ants are one of the first insects to find an exposed cadaver and can be present during all stages of decomposition. Although these organisms are not commonly used in postmortem interval estimates, they are to be taken into account on criminal investigations involving human corpses, since they can leave bite marks that can be mistaken for antemortem or perimortem injuries, which could be misleading when ascertaining the occurrence of abuse or physical altercation during a crime. A few studies report the action of ants on human cadavers and even though leaf-cutting ants of the genus Atta are frequently encountered in succession studies that use animal carcasses, there are no records of these fungus-growing species on human corpses. Atta is a genus restricted to the New World, ranging from northern Argentina to southern United States and acts as one of the most conspicuous neotropical herbivores. In this study, we report three cases of violent death that illustrate the impact of ants, especially those of the genus Atta, in a forensic setting. We compare the patterns displayed by postmortem bite injuries caused by leaf-cutter ants and other common species with less robust mandibles. We also present the capability of Atta ants to create artifacts by cutting victim’s clothes in a crime scene, contributing to the knowledge of ant-mediated confounding factors in crime scene investigation.     

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.     

Fatal injuries caused by glass fragments. Case reports and autopsy findings

The authors report three cases of fatal domestic accidents by falling through glass doors. Multiple cuts and stabwounds in one of these cases primarily suggested a crime of violence. In contrast the bodies of the two other perished persons showed only unsignificant injuries. Causes of death were aerous embolism (1 case) and mechanical bleeding to death (2 cases). The common morphological signs of these glass injuries are exemplified and preventive measures are discussed.     

Fatal Injury Caused by a Ram (Ovis Aries) Attack

Animal‐inflicted injuries to humans are a major public health problem around the world resulting in great morbidity, money loss, and mortality. They are related to wild and domestic animals alike. Animals can cause injuries by various mechanisms—biting, stinging, crushing, goring, stomping, butting, kicking, pecking, etc. We present a case of a ram's attack with fatal consequences. A 4‐year‐old, 120 kg jezersko‐sol?ava breed ram with prior history of aggressive behavior inflicted multiple injuries to his 83‐year‐old owner, who died in the hospital a few hours later due to severe blunt force injuries sustained in the attack. The autopsy revealed the cause of death to be multiple injuries of the thorax and the head. Sheep, even though they are not considered aggressive or large farm animals such as cattle and horses, can inflict serious injuries with devastating results.     

An Unusual Case of Predation: Dog Pack or Cougar Attack?

Injuries produced by animals are capable of leaving severe patterns and in some cases may result in the death of the attacked individual. Law enforcement authorities may come to erroneous conclusions about the source of the bites based on their awareness of animals present and similarities of the injuries to the untrained eye, with dreadful consequences. Expertise of a carnivore biologist and an odontologist that indentifies the particularities of bite marks may be useful for identifying the attacking species. We present the investigation of a fatal dog pack attack involving a 43‐year‐old man in Bell Ville (Argentina) where the evidence provided by a forensic dentist and a biologist was categorical for establishing the animal species involved. Because of the unusual characteristics of the wounds and the initial hypothesis made by local authorities of a cougar attack, habits and specific patterns of both dog pack and cougar predation on humans are discussed.     

Fatal suicidal crossbow injury--the ability to act

We report a case of a 58-year-old man who committed suicide using a modern crossbow. The victim shot himself in the chest with a conical field-tip arrow from close proximity. We first presumed that this was a case of homicide committed with a firearm. We were, however, subsequently proved wrong. The reasons for the primary statement were as follows: the external morphology of the entrance wound being typical of a firearm discharged from long distance; the perforation found on the victim's clothing; the absence of the firearm at the place of death; the absence of the arrow in the wound. All of these reasons forced us initially to conclude that the case was one of homicide. In the reported case, the man, after having been shot with an arrow, was further able to act, even though the abdominal aorta and liver were seriously injured. While the arrow was in the wound, the injuries may not have led to massive bleeding because of incomplete tamponade of the defects by the arrow shaft. Pulling the arrow out of the victim's wound track initiated massive bleeding. Despite all these injuries, the man was capable of pulling the bow string again and reloading the crossbow with the arrow used in the first attempt. This case demonstrates that forensic investigations into crossbow injuries can be very difficult, especially when the bolt has been removed from the body.     

Site of injuries in falls on staircases]

52 autopsy cases in combination with falls on staircases examined in the Bonn Institute of Legal Medicine in 1992 to 2000 were evaluated with respect to the query whether the morphological criteria were valid for reconstruction of the fall, in what way facial injuries were involved and whether isolated trunk injuries caused the death. In 80 per cent of all cases the localization of impact on skull and trunk could be deliminated in regards to heaviness of injuries with fractures and involvement of inner organs. Facial injuries were noticed in 50 per cent and were--as well as arm and leg injuries--caused by strike in fall or after impact. In only two cases in consequence of falls on staircases trauma of the trunk led to death by bleeding.     

Not all bite marks are associated with abuse, sexual activities, or homicides: a case study of a self-inflicted bite mark

A case of self-inflicted bite mark during an episode of myocardial ischemia is presented. Using current bite mark identification techniques, the bite mark was shown to be self-inflicted. Self-biting may be an emotional response to pain or a type of counterirritation to alleviate pain. The recognition and documentation of this unusual case of a self-inflicted bite mark was due to the cooperation of the forensic pathologist and forensic odontologist.     

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.     

Sickle Cell Trait Mimicking Multiple Inflicted Injuries in a 5-Year-Old Boy

Abstract:  Sickle cell disease (SCD) and sickle cell trait (SCT) can be associated with sudden unexpected death in the pediatric population, usually due to pulmonary complications occurring within the acute chest syndrome (ACS). Musculoskeletal complications can occur and are classically limited to bone infarcts. The occurrence of bone pathology centered upon the epiphyseal growth plate in SCD/SCT is extremely rare, and multiple such injuries in a single patient have not been previously reported. Herein, we describe a case of sudden unexpected death in a 5-year-old child with undiagnosed SCT due to the ACS, with widespread epiphyseal and periosteal bone lesions mimicking multiple inflicted injuries at autopsy. This case highlights the importance of clinicopathological correlation and is the first to describe SCT pathology as a mimic of nonaccidental injury.