Detection of medical examiner cases from review of cremation requests

Title 9, Chapter 19, Article 3 of the Arizona Administrative Code requires all bodies that are to be cremated must have the death certificate reviewed by a county medical examiner. In Tucson, AZ, and surrounding Pima County, all cremation requests are submitted to the Forensic Science Center, where the death certificates are reviewed by one of 5 board-certified forensic pathologists. In 2002, there were 5557 cremation requests, and in 2003 there were 5662 cremation requests. Of these requests, 670 (12.1%) and 447 (7.9%) death certificates were flagged for further investigation in 2002 and 2003, respectively. Eventually, 47 cases (0.8% of total, 7.0% of flagged cases) were accepted as medical examiner cases in 2002, and 43 cases (0.8% of total, 9.6% of flagged cases) were accepted as medical examiner cases in 2003. In 2002, the majority of cases were handled as a records review; however, 4 cases were brought in for autopsy and 1 was certified after an external examination only. In 2003, all cases were certified via a records review. The manner of death in all but 3 of these deaths was certified as accident, with complications of remote trauma being the most common proximate cause of death. The 3 most common injuries were complications of fractured pelvis or femur (15 in 2002, 22 in 2003), head injury due to fall (18 in 2002, 8 in 2003), and complications of remote motor vehicle accident (3 in 2002, 6 in 2003). The other 3 deaths included 2 homicides, 1 in each year, and 1 suicide in 2003.     

INCREASING THE PROPORTION OF DOMESTIC VIOLENCE ARRESTS THAT ARE PROSECUTED: A NATURAL EXPERIMENT IN MILWAUKEE*

Research Summary: Mandatory and pro‐arrest policies in domestic violence incidents have increased strains on prosecutorial and court resources. They have also brought to prosecutors many cases in which victims never wanted batterers charged and prosecuted. Prosecutors are faced with the dilemma of (a) screening out difficult cases up front and expending resources on fewer but more winnable case or (b) prosecuting a larger number of cases as adequately as resources will allow. We studied a natural experiment that resulted when the Milwaukee prosecutor liberalized his screening policy to double the number of domestic violence case filings. After the new screening policy was implemented, time to disposition doubled, convictions decreased, the prevalence of pretrial crime increased, and victim satisfaction declined. Policy Implications: The results do not support the idea that domestic violence cases can be readily prosecuted without regard for victim desires. To commit to such a policy would require a substantial commitment of additional staff, resources to collect additional types of evidence, and a willingness to try a substantially larger number of cases.     

Delay reduction in the federal courts: Rule 50(b) and the Federal Speedy Trial Act of 1974

During the 1970s, 94 federal district courts implemented two major policy initiatives, Rule 50(b) of theFederal Rules of Criminal Procedure and the Federal Speedy Trial Act, that were designed in Washington to combat delay in the processing of federal criminal cases. Both of these initiatives established a national priority of delay reduction in criminal cases, encouraged local district court planning for delay reduction; established reporting procedures for monitoring local compliance, and provided for the determination of quantitative goals for the time to disposition of criminal cases. Neither initiative mandated specific activities for delay reduction; this determination was left to the discretion of local federal district courts. This research examines the effectiveness of Rule 50(b) and the Speedy Trial Act by constructing a 150-month time series of three measures of case processing time. A multiple-intervention time-series model found that both of these initiatives contributed to the dramatic reduction in the time to disposition in federal criminal cases. These effects persisted after controls for changes in case characteristics and judicial resources were introduced.Points of view expressed in this research are those of the author and do not necessarily represent the official position of the U.S. Department of Justice.     

Robberies with guns: Neighborhood factors and the nature of crime

Over the past two decades, both research and policy related to crime have increasingly focused on community characteristics. Neighborhood level studies of crime have provided important insights into the factors related to variation in the quantity of crime across place, and have suggested policies for controlling crime. At the same time, however, little attention has been given to the potential impact of neighborhood characteristics on the nature, or quality, of crime. Examinations of variation in the nature of violent crime across communities has only recently begun to be empirically examined (see for example, Baumer, Horney, Felson, & Lauritsen, 2003; Kubrin, 2003; Kubrin & Wadsworth, 2003; Kubrin & Weitzer, 2003; Miles-Doan, 1998; Wadsworth & Kubrin, 2004), and these studies were limited in the number and type of neighborhood variables examined. The current study extended this developing literature on neighborhood variation in the nature of violence through its examination of several neighborhood factors theorized to be associated with qualitatively different forms of violence. Specifically, this study examined neighborhood variables associated with a structurally induced subculture of violence in relation to robberies with and without guns. The analysis was based on noncommercial robberies that occurred in twenty-nine neighborhoods in one city. Findings suggested that faith in the police was a more important neighborhood factor affecting the nature of robbery than disadvantage, the percent young African-American males, or oppositional values.     

涉案财产处置程序的完善——以审前程序为视角的分析

近年来,中国司法同时步入扫黑除恶和企业产权保护的元年,针对审前程序中涉案财物处置乱象问题,有必要厘清与规范涉案财物处置相关的制度与程序,强化民营企业产权司法保护。应当正确界定涉案财产的概念与范围,合理把握涉案财物的处置方式和处置标准,在区分程序性处置和实体性处置的基础上,从职能、权力和程序三个方面强化审前涉案财产处置的控制体系。为了应对实践中存在的处置任意化、程序偏行政化、移送和保管混乱等问题,应以取证规范化为基础强化涉案财物的审查认定,丰富涉案财物的保全措施体系,对审前处置程序进行正当化改造,建立和完善涉案财产集中管理制度。     

Forensic Pathological Examination on 73 Medical Malpractice Cases of PediatricsCSCD

Objective: To analyse 73 medical malpractice cases of pediatrics for discussing the importance of forensic pathology in solving the issues such as medical malpractice of pediatrics. Methods: From January 2002 to August 2016, 73 medical malpractice cases of pediatrics with age of death between 28 days old and 10 years old were collected from Institute of Judical Expertise of Nanjing Medical University. The relationship between causes of death and related medical institutions was retrospectively analysed. Results: In 73 cases, the male to female ratio was 1.70:1, and ages of 28 days old to 1 year old were common (26 cases, 35.62%), followed by ages between 1 year old and 3 years old (21 cases, 28.77%). In 71 cases which had been determined the cause of death by postmortem examination, the main cause of death was disease, especially respiratory diseases (33 cases, 46.48%), followed by cardiovascular diseases (12 cases, 16.90%). In 75 medical institutes which involved with these medical malpractices, most were tertiary medical institutes (32, 42.67%), followed by the sub-secondary (excluding the secondary)medical institutions (23, 30.67%). The clinical diagnosis of 38 cases (52.05%) completely or mostly corresponded with the pathological findings. There were 35 cases (47.95%) undefined or misdiagnosed cases. Conclusion: Autopsy and forensic pathological examination contribute to determine causes of death, which not only provide scientific evidence for medical malpractice of pediatrics, but also enrich and develop clinical medical knowledge, and thus improve diagnosis and treatment level in a certain extent. © 2018 by the Editorial Department of Journal of Forensic Medicine.     

Sudden unexpected death in epilepsy: neuropathologic findings

Sudden unexpected death in epilepsy refers to sudden death of an individual with a clinical history of epilepsy, in whom a postmortem examination fails to uncover a gross anatomic, toxicologic, or environmental cause of death. Evidence of terminal seizure activity may not be present. One to two percent of natural deaths certified by the medicolegal death investigator are attributed to epilepsy. Detailed microscopic examination of the brain has increasingly afforded the identification of structural changes representative of epileptogenic foci. The authors present 70 cases of death attributed to sudden unexpected death in epilepsy. These cases were classified as follows: individuals who lacked a gross brain lesion, those who had a brain lesion demonstrable at autopsy, and those who lacked neuropathologic evaluation because of decomposition or because only an external examination was done. All of the subjects had a clinical history of seizures. The authors confirm that various microscopic findings, including neuronal clusters, increased perivascular oligodendroglia, gliosis, cystic gliotic lesions, decreased myelin, cerebellar Bergmann's gliosis, and folial atrophy, are present in a higher percentage of the brains of sudden unexpected death in epilepsy subjects than in the brains of age- and sex-matched control subjects.     

Utility of a Grief Services Program for Medical Examiners' Offices

Medical examiner/coroner's (ME/C) offices investigate sudden, violent, and unexpected deaths, leaving those close to the deceased suffering traumatic loss with little in terms of support and counseling. We investigated a grief services program (GSP) at the New Mexico Office of the Medical Investigator (OMI) to better understand the needs of bereaved individuals, identify the services provided, and propose our findings as a model for others. A total of 1085 contacts occurred over 1 year, with the majority occurring at OMI (60.5%), followed by telephone (23.1%). Support was primarily provided to those suffering a loss due to homicide (28.8%) and suicide (26.1%). The roles grief counselors play in the setting of a GSP and ME/C office are multiple. Given the frequent utilization of OMI's GSP and diverse reasons for visits, it is apparent there is a need for GSPs at ME/C offices, particularly given the traumatic nature of deaths investigated by ME/Cs.     

Nature and consequences of dismissals: Implications for public safety and crime prevention in criminal courts in America

The role of dismissal as a major case disposition in criminal courts in America has been largely neglected in empirical studies to date, despite long-lasting questions about its nature and important implications for justice goals. This paper is a first attempt to fill in this gap.

Purpose

Drawing on untested assumptions about a possible dismissal-reoffending connection, the paper proposes a public safety framework for examining the nature of dismissals and their consequences for the community. Under this perspective, dismissal is a function of defendants’ risk attributes and contributes to subsequent public safety threat.

Methods

To test these hypotheses, predictive and causal analyses were conducted on an 800-case sample of criminal defendants in one large urban American jurisdiction, Philadelphia, Pennsylvania. Cases were sampled at the first judicial stage and followed as a cohort for one year to record disposition and post-disposition outcomes.

Results

The findings indicate that defendants’ risk attributes contribute to the explanation of dismissal and that dismissal in itself adds to the probability of subsequent offending.

Conclusions

The findings raise questions about the justice system goals, particularly deterrence and have important policy implications for the processing and disposition of criminal cases in American jurisdictions.     

Anal findings in sexual abuse of children (a descriptive study)

The aim of this study was to assess anal physical findings in children whose abuse was admitted by the perpetrator. Fifty children were studied in whom medical assessment took place remote in time from anal abuse which was admitted by the perpetrator. Medical assessment included examination to detect the presence of anal physical signs. Most frequent signs were anal scars and tags (either single or multiple) present, respectively, in 84 and 32% of cases. In some cases scars extended to the perianal region. Other signs included reflex anal dilatation (RAD) and venous congestion (VC) found, separately or associated with other signs, in over 33% of the cases. In 6% of the cases there were no abnormal anal findings. The results confirm earlier reports that physical signs, including scars, tags, RAD, funneled anus and extensive venous congestion, are often present in abused children, singly or in combination, and that anal examination should be undertaken even months after a known or suspected sexual assault. In the legal setting these physical signs are seen in association with anal abuse and support the child's statement. They do not per se provide proof of abuse.     

Optimal enforcement of competition policy: the commitments procedure under uncertainty

The introduction of a commitments procedure in EU antitrust policy (Article 9 of Council Regulation 1/2003) has entitled the the European Commission to extensively settle cases of alleged anticompetitive conduct. In this paper, we use a formal model of law enforcement to identify the optimal procedure to remedy cases in a context of partial legal uncertainty (Katsoulacos and Ulph in Eur J Law Econ 41(2):255–282, 2016). We discuss in particular the merits of a policy of selective commitments where firms either take strong commitments or are investigated under the standard infringement procedure.     

离婚时处理按揭房屋的法律问题探析

婚姻期间购买的按揭房屋在夫妻离婚时如何处理是司法实践中的难点问题,《法释[2003]19号》第21条将按揭房认定为"尚未取得所有权"的房屋,要求人民法院在夫妻离婚时仅就按揭房屋的使用权予以判决。这一处理方式,既不符合物权法定分止争、物尽其用的立法宗旨,也不符合婚姻法确立的夫妻财产分割原则,更有违法律的公平正义。本文试图通过探讨按揭房屋的产权问题,特别是夫妻以一方名义购买的按揭房屋在离婚时的分割问题,突破现有的处理方式,以解决因处理按揭房屋衍生出的各种矛盾。     

Faster and as Satisfying: An Evaluation of Alaska's Early Resolution Triage Program

The Alaska Court Early Resolution Program (ERP) addresses many issues – self‐representation in divorce and custody cases, triaging to determine the appropriate resolution approach, the importance of early intervention and the desire to use a simplified process and a problem‐solving approach. This article reports on an evaluation of the Anchorage ERP. It found different outcomes for ERP cases that settled than comparable cases that proceeded on the regular trial process track with respect to the following outcomes:

• time to disposition,
• number of staff processing steps and associated completion time, and
• number of motions to modify filed within two years of the disposition.

     

Clinical urinalysis of drugs and alcohol in instances of suspected surreptitious administration ("spiked drinks").

Many suspected victims of surreptitious drug and/or alcohol administration may present to hospitals or healthcare centres and never come to the attention of forensic or law enforcement professionals. Therefore, it is necessary to include clinical toxicological findings in order to assess the growing perception that instances have become more widespread within society. Between July 2002 and June 2004, 180 requests were received for toxicological analysis of individuals presenting to their GP or hospital following self-reported or suspected surreptitious drug administration (e.g. "spiked drink"). There was a rise of 77% in the number of requests from 2002-2003 to 2003-2004 which peaked in December of each year (most likely due to the increased socialization of people during the festive season). Between 2002 and 2004, 34% of patients were male and 66% were female with an overall average age of 25 (range 11-73). Following urinary analysis using immunoassay and gas chromatography (mass spectrometry, flame-ionisation detection and nitrogen-phosphorus detection), 59% of cases were negative for drugs and alcohol in 2002-2003 and 51% in 2003-2004. Drugs or alcohol were detected in 32% of cases in 2002-2003 and in 45% in 2003-2004. Out of the 169 cases analysed, ethanol (alcohol) was the most commonly detected compound (24% of cases), followed by amphetamines (amphetamine, MDMA, MDA, MDEA--11% of cases), cannabinoids (9% of cases), benzodiazepines (temazepam, nordiazepam, oxazepam--9% of cases), cocaine (4% of cases), opiates (dihydrocodeine, codeine--2% of cases), chlorpheniramine (0.6% of cases), ephedrine 0.6% of cases), fluoxetine (0.6% of cases), tramadol (0.6% of cases) and zopiclone (0.6% of cases). No gamma-hydroxybutyrate (GHB), gamma-butyrolactone (GBL) or flunitrazepam was detected in the cases analysed.     

Verbal Aggression Among Male Alcoholic Patients and Their Wives in the Year Before and Two Years After Alcoholism Treatment

Our earlier reports on 88 male alcoholics and their wives showed that domestic violence decreased significantly in the first and second year following a behavioral marital therapy (BMT) alcoholism treatment program. The present study examined verbal aggression in this same sample. In the year before BMT, verbal aggression was significantly greater—being five to seven times more prevalent for clinically elevated aggression and substantially more frequent—for the alcoholic husbands and their wives than for a demographically matched, nonalcoholic comparison sample. In the two years after BMT, both alcoholic men and their wives showed significant and substantial reductions in verbal aggression as compared with the year before BMT. Despite these significant reductions from the year before BMT, verbal aggression in the two years after BMT remained significantly elevated relative to demographically similar nonalcoholic controls. As predicted, relapsed alcoholics and their wives showed more verbal aggression in the 2 years after BMT than both couples with a remitted alcoholic husband and demographically similar nonalcoholic controls, whereas remitted alcoholics and their wives had similar levels of verbal aggression to the nonalcoholic controls. Further, frequency of drinking was positively correlated with verbal aggression in the 2 years after BMT; verbal aggression was greater when the alcoholic husband drank more frequently.     

Medicaid program; time limitation on record keeping requirements under the drug rebate program. Interim final rule with comment period

On August 29, 2003, we published a final rule with comment period in the Federal Register that finalized two specific provisions: it established new 3-year recordkeeping requirements for drug manufacturers under the Medicaid drug rebate program and set a 3-year time limitation during which manufacturers must report changes to average manufacturer price and best price for purposes of reporting data to us. In addition, it announced the pressing need for codification of fundamental recordkeeping requirements. On September 26, 2003, we issued a correction notice to change the effective date of the August 29, 2003 rule from October 1, 2003 to January 1, 2004. In this interim final rule with comment period, we are removing the 3-year recordkeeping requirements, replacing them with 10-year recordkeeping requirements on a temporary basis, and soliciting comments on the 10-year requirements. Manufacturers must retain records beyond the 10-year period if the records are the subject of an audit or a government investigation of which the manufacturer is aware. These provisions contain a sunset date with respect to the record retention requirements to ensure that we reexamine whether the retention rule remain necessary and effective. This interim final rule with comment period also responds to public comments on the August 29, 2003 final rule with comment period that pertain to the 3-year recordkeeping requirement at Sec. 447.534(h).     

A National Survey of Mental Health Services Available to Offenders with Mental Illness: Who Is Doing What?

The purpose of this study was to examine the national practices of psychotherapy services for male offenders with mental illness (OMI) in state correctional facilities. Participants consisted of 230 correctional mental health service providers from 165 state correctional facilities. Results indicated that mental health professionals provided a variety of services to OMI that can be conceptualized by six goals considered important in their work: mental illness recovery, emotions management, institutional functioning, re-entry, risk-need, and personal growth. Mental health professionals in this study generally viewed mental illness recovery, institutional functioning, and personal growth as significantly more important and spent more time focused on these goals than emotions management, re-entry, and risk-need. Mental health professionals tended to believe the services they provided were effective across four key treatment foci including mental illness, skill development, behavioral functioning, and criminogenic needs with more progress perceived in areas related to mental illness and skill development than their ability to effectively change behavioral functioning. Implications of these findings and directions for future research are discussed.     

人体器官买卖与捐献的法律分析

在性质上,人体器官是一种“准物”。自然人对其身体器官的处分需要受到一定的限制。自然人无权买卖人体器官,但却有权捐献自己的身体器官。     

Public (Interest) or Private (Gain)? The Curious Case of Network Rail's Status

This paper develops Whitehouse's 2003 examination of the creation of Network Rail, a case study of New Labour's attempt to operationalize the 'third way'. Significant changes have occurred since 2003 which make Network Rail's position as a private company with private sector debt appear increasingly anomalous. These changes include: the reclassification of the debt of another rail company from private to public, and the introduction of'imputed debt'into public sector debt measurement; new funding arrangements for Network Rail which make it heavily dependent on public support; and important rail regulatory policy changes. The paper analyses these changes, and revisits White-house's conclusions. In particular, this paper challenges Whitehouse's contention that Network Rail's creation led to the de facto renationalization of the railway infrastructure at a reduced public cost. The paper demonstrates that Network Rail is a very expensive mechanism for channelling public money to private companies, and argues that the Labour government's attempt to maintain the company's private sector status as part of its third way approach is ultimately untenable.     

TRACING CHARGE TRAJECTORIES: A STUDY OF THE INFLUENCE OF RACE IN CHARGE CHANGES AT CASE SCREENING,ARRAIGNMENT, AND DISPOSITION*

Although social scientists and legal scholars have made valuable headway in identifying and explaining the relationships between myriad demographic, social, and legal factors and case outcomes, a sizable gap in understanding remains with respect to how cases evolve across decision points and how charges change for different racial and ethnic groups at individual decision points and cumulatively. This gap is partially addressed in this study through the examination of charge decreases, increases, and no change at three essential decision points—case screening for prosecution, arraignment, and final disposition. The results show that, overall, screening and disposition were much more dynamic decision points than was arraignment and that one third of cases experienced a charge decrease at some point. Even though racial differences in charge reductions at case screening were not large, at arraignment and disposition, as well as cumulatively, Black and Latino defendants were less likely than White defendants to have charges decreased. Conversely, Asian defendants experienced even more favorable outcomes than White defendants as they were more likely to have charges reduced and less likely to experience an increase. These findings are framed in the context of focal concerns, cumulative disadvantage, and “charge reasonableness” arguments.