Common principles of person identification in disasters with a great number of victims

The authors give a detailed definition of the notion "identification of the dead body". They formulate and validate an algorithm of expert actions in identification of the dead and missing persons in disasters. Sound choice of specialists at different stages of identification is essential.     

Suicide bomber using a pipe bomb

Suicidal deaths caused by pipe bombs are rare. An 18-year-old man was found dead in a forest by hikers. In immediate proximity to the body, a crater was located obviously induced by a detonation. The postmortem examination revealed severe damage of the head, upper-body and both arms and hands along with the extensive presence of soot and dirt. Particularly noticeable were numerous "entry wounds" and the presence of five bullet like pieces of metal in the body. The young man had a history of drug abuse and psychiatric problems. On the basis of autopsy findings, the conclusions of the police investigation and psychopathological considerations regarding the victim's case-history, discussion centers upon the differentiation between suicide by self-explosion, homicide by explosion or death as a consequence of numerous bullet wounds followed by an attempt to burn the body. Also considered is the possibility of paranoid psychosis induced by cannabis use as a cause of suicide.     

Analysis of carbohydrate-deficient transferrin (CDT) in vitreous humour as a forensic tool for detection of alcohol misuse

Analysis of carbohydrate-deficient transferrin concentration in vitreous humour (VH-CDT) has recently been demonstrated to be useful for diagnosis of pre-mortal alcohol misuse, but more knowledge considering possible methodological problems is warranted. In a forensic sample we examined the stability of VH-CDT during laboratory handling as well as the possible affection of time-dependent changes of total transferrin concentrations in vitreous humour (VH-Transferrin) in the dead body on VH-CDT as indicator of alcohol misuse. By use of a commercial assay designed for serum analysis (CDTect) it was possible to measure VH-CDT with high precision, and detectable amounts were found in 20 of 21 alcoholics and in two of seven controls. The compound was demonstrated to be stable in vitreous humour during laboratory handling, since the results of the first analysis were well reproducible after 4 months storage of the specimens (rs=0.86, P=0.0002). Transferrin concentrations in vitreous humour (VH-Transferrin) correlated to the estimated time since the individual last time had been alive before the forensic examination (rs=0.57, P<0.005). However, in this small sample the discriminating property of VH-CDT as indicator of alcohol misuse was not decisively affected, whether or not the variables "VH-Transferrin" and "estimated time since the individual last time had been alive" were considered in a multivariate logistic regression analysis (minor change in the beta-coefficient from 0.57 to 0.52, P=0.086). We conclude that CDT is stable in vitreous humour during proper laboratory handling and that detection of VH-CDT is primarily a marker of alcohol misuse before death. However, the results of this study do not exclude that time-dependent changes of VH-Transferrin, possibly affecting VH-CDT, may occur in the dead body. VH-CDT analysis should thus, at present, be restricted to cases with rather short post-mortal time interval.     

Unusual carbon monoxide poisoning

Despite of indicative death scenes or characteristic findings of the external examination, about 40% of the accidental fatal intoxications due to carbon monoxide are not recognized before the performance of the autopsy. Six cases are reported which illustrate possible reasons for the delayed establishment of the diagnosis: unusual circumstances of the intoxication or sources of carbon monoxide, only subtle degree or lack of external signs of the intoxication or a competing cause of death at autopsy.--Cases 1 and 2: 53, respectively 54-year-old couple, found dead in a caravan, extreme putrefaction of the bodies, spectrophotometric detection of the fatal carboxyhaemoglobin level in oedema fluid of the scalp.--Case 3: 23-year-old lorry driver, found dead in the tightly closed cab of his lorry, operation of a source of electricity with "environmentally friendly" fuel, carboxyhaemoglobin level 83%.--Case 4: 19-year-old man, found dead in the flat of friends, removal of the CO-source before alerting the police forces, lack of the bright pink coloration of livor mortis, haemopericardium due to atrial rupture at postmortem examination, carboxyhaemoglobin level 65%.--Case 5: 27-year-old man, found dead in his flat, advanced decomposition of the body, residues of a charcoal fire in a metal bucket in the sink, carboxyhaemoglobin level 80%.--Case 6: 42-year-old woman, lying dead in the garage beside her car, engine switched-off, ignition key next to the body on the floor under the car, carboxyhaemoglobin level 46%.     

Unusual death of a farmer.

A farmer was found dead, in a pool of blood on his farm. Evidence indicated that the farmer had dragged himself or been dragged from the stable to the point where his body was found. With the exception of abrasions in the face, there were no other signs of injury. An autopsy revealed a depressed fracture of the skull and showed a venous air embolism to be the cause of death. The medicolegal interpretation of the findings left no doubt that the farmer was killed by a cow.     

Duration of the fire and degree of charring of a burned cadaver]

A 37-year-old woman was found dead severely charred in the bedroom of her house. The autopsy revealed as cause of death a strangulation of the neck. On the basis of the decomposition of the body the experts were asked for a statement on the duration of burning. There seems to be only little medicolegal experience on the duration of burning to a defined state of decomposition. Based on observations during cremations published in the literature and experimental burnings a burning time of approximately 20 minutes (after temperatures of more than 700 degrees C had been reached) is supposed to be sufficient to produce the present state of the body.     

Human body buoyancy: a study of 98 men

The specific gravity and buoyancy of 98 men were calculated at various lung volumes. The data indicated that all subjects would be capable of floating in either freshwater or seawater at total lung capacity. At functional residual capacity, the value approximating the lung volume of a recently dead body, 69% of the subjects would float in seawater, whereas only 7% would float in freshwater. Results of this study indicate that while drowned bodies are more likely to sink than bodies dead of other causes, no conclusion regarding the cause of death can be made on the basis of whether bodies float or sink.     

Unnatural death investigation in India. A plea for the introduction of a medical examiner system of inquest

The inquest upon a dead body is the basis of the scientific crime investigation and administration of criminal justice. The pivotal issue in any inquest is the initial visualization of the body and its surroundings at the scene of incident by a team of investigators and experts. This must be carried out meticulously, since the subsequent course of the case, and its success or failure in the court of justice, essentially depends upon its proper execution. Unfortunately, such an important step as the inquest is generally the most neglected part of any crime investigation process as it exists in India today. It is quite often left entirely to the inspired guesswork and seasoned experience of the lowest ranking police officers and more often than not to a Head Constable of a police station or substation. Nevertheless, while the coroner's system has proved to be utterly unsuitable for Indian conditions, we have failed to find an alternative solution to the growing challenge of scientific crime investigation in India, by involving the forensic pathologist in inquests held upon dead bodies, by including him in the first crime investigation. A strong case is made for adoption of the medical examiner's system of inquest, wherein the forensic pathologist plays the pivotal role and leads the "unnatural death investigation team."     

Death on a sauna stove

A 67-year-old woman noticed a strange smell from the cellar of her house. When she followed the smell, she found her 64-year-old husband with the face and upper part of his body lying on the stove of the private sauna. He was dead when the emergency doctor arrived. The autopsy revealed upper gastrointestinal bleeding from mucosal lesions in the esophagus with an agonal fall on the sauna stove as the cause of death. In addition, there were signs of chronic alcohol and drug abuse.     

Unusual intravascular hemolysis in a case of fatal hypothermia.

A 55-year-old man was discovered dead inside a deep freezer maintained at -40 degrees C. After consuming a large quantity of alcohol, the man had become trapped in the freezer approximately 11 h before his body was found. The body was still frozen at the time of autopsy, but subcutaneous dendriform vessel repletion phenomenon was observed on the upper and lower extremities. Although this intravascular hemolysis resembled that which develops during putrefaction, in this case it was thought to be due to pooling and freezing of blood in subcutaneous vessels. Contributory factors included alcohol ingestion, vasodilation following vasoconstriction, vasomotor paralysis, and red cell sludging. Hemolysis followed freezing of the blood. When such phenomena are observed in a corpse, exposure to extreme cold should be suspected.     

Insects found on a human cadaver in central Italy including the blowfly Calliphora loewi (Diptera, Calliphoridae), a new species of forensic interest

In the case of unidentified bodies the estimation of the period since death or of the season of death plays an important role to focus the attention on a reduced number of people among the ones reported missing. Forensic entomology can be one of the most important methods for these estimations, as occurred in this case. Flies are typically the first insects to colonize a dead body. The case reported here concerns the colonisation by insects of a male body in advanced decay found during the winter in Central Italy. This case is of particular interest as few data are available on the entomological evidence in the cold season. In particular, in this case we recovered Calliphora loewi (Calliphoridae), a species never collected before on dead bodies in Southern Europe. Larvae of the black soldier fly Hermetia illucens (Stratiomyidae), pupae and larvae belonging to genus Hydrothea (Muscidae), and Necrobia rufipes (Cleridae) specimens were also collected. The estimated PMI enabled identification of the cadaver, confirmed by DNA analysis.     

Delayed sudden death in an infant following an accidental fall: a case report with review of the literature

Several controversies exist regarding ultimately lethal head injuries in small children. Death from short falls, timing of head injury, lucid intervals, presence of diffuse axonal injury (DAI), and subdural hematoma (SDH) as marker of DAI are the most recent controversial topics of debate in this evolving field of study. In this area of debate, we present a case of delayed death from a witnessed fall backwards off a bed in a 9-month-old black male child who struck his head on a concrete floor and was independently witnessed as "healthy" postfall for 72 hours until he was discovered dead in bed. Grandmother, babysitter, and mother all independently corroborated under police investigation that the child "acted and behaved normally" after the fall until death. Autopsy showed a linear nondisplaced parietal skull fracture, diastasis of adjacent occipital suture, subgaleal hemorrhage with evidence of aging, small posterior clotting SDH, marked cerebral edema, and a small tear of the midsuperior body of the corpus callosum consistent with focal axonal injury (FAI). No DAI was seen, and there were no retinal hemorrhages. All other causes of death were excluded upon thorough police and medical examiner investigation. Although this seems to be a rare phenomenon, a delayed, seemingly symptom-free interval can occur between a clinically apparent mild head injury and accidental death in a young child.     

Principles in construction of mathematical model for neonatal corpse cooling studies

The process of cooling of the body of a dead human was studied with consideration for the anatomical characteristics of adult and newborn human corpses. The body was simulated as a homogeneous elongated rotation ellipsoid and mathematical model was developed as function of relationship between body temperature and time. After appropriate characteristics in the mathematical model were established, cooling processes and effects of various factors on this process were analyzed for the final ellipsoid. The model suggests the possibility of amendments for environmental temperature and body parameters.     

Collembola of the grave: a cold case history involving arthropods 28 years after death

This report describes a cold case in which a cadaver of a 28-year-old female was exhumed in February 2005 from a cemetery in Battle Creek, Michigan. She had sustained a gunshot wound to the head and was found dead in her home on November 15, 1977. The body of the victim was subsequently embalmed and then buried at a depth of 1.8 m in an unsealed casket that was placed inside an unsealed cement vault. The exhumation yielded thousands of live specimens of a single species of the order Collembola or spring tails, Sinella (Coecobrya) tenebricosa (Entomobryidae). This species is considered to be a "tramp" species, cosmopolitan in the United States and Canada. Due to the ideal environmental conditions at the site, the population of this species underwent growth and development inside the casket for a number of years. Collected with the Collembola were large numbers of Acarina (mites) of the Family Glycyphagidae, and fly puparia, Conicera tibialis Schmitz (Order: Diptera, Family: Phoridae), also known as coffin flies. These invertebrates are sometimes mentioned by forensic investigators as occurring on corpses in graves, but aspects of their life history are rarely described. The species of Collembola that was found surviving and reproducing on this corpse in a casket exhumed after 28 years was the oldest reported grave site occurrence for any collembolan species based on a survey of the literature back to 1898.     

A diagnostic program for estimating the time of death using microcalculators MK-61 and B3-34

The programme design is based on the process of changes in dead body temperature. Specific features of the process of changes in temperature values of a dead body are characterized by a parameter which involves process sample obtained by temperature measurements in diagnostical area of a cadaver at the accident scene during 1 hour. Programme provides for estimation of postmortem interval within the first 60 h after death occurrence. Diagnostical deviations don't exceed +/- 3% as compared to the real time of death.     

Use of the dead body in healthcare and medical training: mapping and balancing the legal rights and values

By exploring the central legal principles and issues regarding usage of the dead body in healthcare and especially in medical training, this article aims at drawing some general conclusions on the legal status of the dead body and the protection of the deceased's integrity, dignity and autonomy. The article demonstrates that the use of the cadaveric body for scientific and educational purposes involves a redrawing of the traditional boundaries between the decent and the indecent, making these acts acceptable that would otherwise be regarded as assaults on the sanctity of bodily boundaries. This is made possible by the fact that the underlying principle of dignity is not perceived to be of an absolute nature when applicable to deceased persons.     

Autopsy Identification of Viable Mycobacterium Tuberculosis in the Lungs of a Markedly Decomposed Body

Various infectious diseases, including COVID-19, MERS, and tuberculosis, are global public health issues. Tuberculosis, which is caused by Mycobacterium tuberculosis (MTB), is highly contagious and can be transmitted through inhalation of the bacteria. However, it has been assumed that the infectiousness of bacteria and viruses in dead bodies weakens as the time from death increases. In particular, there is little awareness of infection control measures concerning decomposed bodies or even the need for such measures. The deceased, in whom we discovered MTB 3 months following her death, was a woman in her 80s who died at home. We performed judicial autopsy, because police suspected homicide when her husband hanged himself. Obtained organs were used for microscopic examination by hematoxylin–eosin staining and Ziehl–Neelsen staining. In addition, real-time PCR and mycobacterial culture testing using Ogawa's medium were performed for the detection of MTB. We found that the MTB in the decomposed body remained viable and potentially infectious. To identify the bacterial strain further, we performed DNA-DNA hybridization and identified the strain as MTB complex. Potentially infectious live MTB survived in the dead body far longer than had been previously reported. Pathologists should consider microbial culture tests for all autopsied cases in which the decedent's medical history or macro-examination suggests possible infection, even when a long duration of time has passed since death. Pathologists and specialists who perform autopsies should recognize that all dead bodies are potentially infectious, including those in which long periods have elapsed since death.     

死亡的变形记--对传统的继承和颠覆

卡夫卡的<变形记>中主人公格里高尔经历了两次死亡:在梦醒时分,他的人形肉体已经消亡,灵魂在他人的观照下寄存于甲虫体中;继而在被忘记、被抛弃的状态下彻底死亡.死亡是主人公被迫、也是主动的选择.卡夫卡在小说中表现出自我在不断与社会、与他人和解的企图中加剧对生的恐惧.格里高尔消灭自己的意愿和行动被理解为具有耶稣救赎精神,然而他的精神并未得到认同,甚至连他的尸体都未得到起码的尊重.上帝死了,英雄死了,人也死了.卡夫卡在这一层面上表现出的现代人的孤独、绝望和恐惧以及异化的状态,恐怕是无人企及的.     

Pseudo-Stab Wounds: Putrefactive Dehiscence of Remote Surgical Incisions Masquerading as Stab Wounds

Abstract:  Artifacts due to decomposition can be mistaken for antemortem injury leading to an incorrect suspicion of foul play. We describe an instance of postmortem wound dehiscence that mimicked antemortem stab wounds. A man with a history of colon cancer and substance abuse was found dead. There were advanced putrefactive changes and multiple defects of the anterior torso that resembled stab wounds. Subsequent investigation revealed that 11 months earlier, he had a laparoscopic-assisted colon resection that involved surgical incisions corresponding in location and size to the above defects. Putrefactive gases may cause bloating of the body. This distension may cause recent and remote healed incisions to dehisce. Correlation of these "defects" at autopsy with the antemortem clinical history is crucial in determining their etiology.     

自行车道路交通事故损伤特征研究与应用

目的 研究自行车交通事故人体损份情况,以此推断自行车交通事故中当事人的交通方式。方法 对北京地区1997～2002年958例机动车与自行车相撞的交通事故伤亡者的损伤进行统计分析。结果 自行车骑行者与机动车发生交通事故可于会阴部、双下肢形成特征性损伤。结论 可以运用法医学鉴定方法推断自行车交通事故伤亡者的交通方式。