A case of fatal rotenone poisoning in a child

A case of a fatal rotenone poisoning in a three-and-a-half-year-old girl is described. The case report and autopsy findings are mentioned. For the extraction of rotenone out of biological samples, a solvent partitioning and silica gel open column chromatographic cleanup procedure has been used. The determination of rotenone was performed by high pressure liquid chromatography.     

Biomechanism of intracranial and spinal trauma of child born in occipitoanterior presentation as used in forensic examination

The new conception of mechanism and sequence of damages typical for labor trauma is presented: injury of ligaments of atlas and axis and anterior atlanto-occipital membrane, ruptures of synchondrosises of cranial bones because of vertebral column pressing on occipital bone; tears of dura mater of brain upon basilar impression in the area of focal spot; subarachnoid hemorrhage and intracerebral bleeding in case of cerebral compression by bone borders where they overly override; ruptures of ligaments of cervico-occipital and intervertebral joints in case of excess flexion and overextension of head. Authors show that damage of sutures, bones of calvarium and partition parts of dura materialize later than injury of synchondrosises of base and they are absent if sinchondrosises are not damaged. Also iatrogenic damages of fetal in labor and the mechanism of their formation are described.     

Nonfracture-associated fatal fat embolism in a case of child abuse

Fatal fat embolism is usually thought of as a sequel to long-bone fracture, although cases secondary to soft tissue injury and atraumatic conditions have been infrequently reported. In this case of a two-year-old child-abuse victim who sustained multiple blunt traumatic injuries without skeletal fractures, pulmonary and systemic (brain and kidney) fat emboli were identified. At autopsy, all thoracic and abdominal viscera were intact; cranial contents exhibited only diffuse symmetrical petechial hemorrhages of the white matter. Because of the severe and widespread nature of soft tissue hemorrhage, and the absence of a grossly discernible cause of death, fat embolism was suspected. Using a combination of frozen section with oil red O staining and formalin-fixed osmium stained tissues, the immediate cause of death was determined to be diffuse fat embolism. Review of the literature reveals a pathophysiologic basis for fat embolism in the absence of fracture, both as a consequence of an acute increase in local pressure at the site of trauma and an alteration of the emulsification of blood lipids during shock. In light of these findings, we present this case to remind the forensic science community to consider fat embolism as the cause of death in cases of blunt-force injury without fracture.     

An unusual fatal case of accidental asphyxia in a child.

The death of a three-year-old child by asphyctic mechanism is described. The child was accidentally suspended by the neck from a half-opened car window. This report details the form in which the accident occurred. The influence of the type of window and the autopsy findings.     

Fatal blunt trauma of the larynx in a child

We report an autopsy case of an 11-year-old girl who suffered mechanical asphyxia from falling off the metal bars in the playground. This autopsy case is interesting because of the atypical trauma and lesions. To our knowledge there has been no similiar published case reports in the forensic literature. The young age of the victim, the setting and the pattern of the injuries are rare in a fall at playground by a child.     

Laceration of the stomach by blunt trauma in a child: a case of child abuse

A case of perforation of the stomach following blunt abdominal trauma is described in a two-year-old boy. The abdominal trauma was the result of a blow to the abdomen by the stepfather. The child had ingested a large meal in the hour preceding the injury. The child died from peritonitis and shock 12 h following the injury. The literature on gastric perforation by blunt trauma is reviewed. Injuries to the stomach from nonpenetrating trauma are quite rare and are most often related to vehicular accidents. Gastric injury in a child presenting with a history of a minor home or play injury should arouse suspicion of more significant and perhaps intentional trauma.     

Causality of an accident in subsequent fatal pulmonary embolism a few hours after trauma

An 87-year-old woman, who was largely immobilized in a wheelchair, suffered rib fractures and an unstable fracture of the pelvic ring in a fall. Approximately 2 1/2 hours later she developed marked clinical symptoms of pulmonary thromboembolism and died 5 hours after the accident. The question to be discussed with regard to the causality was the unusually short interval of only 2 1/2 to 5 hours between the accident and the clinical signs of embolism leading to her death. Current literature gives only rough outlines stating that thromboembolism can occur as early as the first day after the trauma. An alternative theory explaining the pulmonary thromboembolism may be the breaking off of a pre-existing thrombus due to manipulation during transport or diagnostic measures in connection with the unstable fracture of the pelvic ring.     

Late-form hemorrhagic disease of the newborn: a fatal case report with illustration of investigations that may assist in avoiding the mistaken diagnosis of child abuse

Hemorrhagic disease of the newborn (HDN) is usually a self-limiting hemorrhagic disorder of childhood that occurs as a result of vitamin K deficiency. It may be defined as early or late form depending on the time of onset related to birth. HDN is recognized as one of several bleeding disorders that can mimic the findings of nonaccidental head injury and may lead to a mistaken diagnosis of child abuse. We present a single fatal case of late-onset HDN with illustration of hematologic assays that can be performed to assist the pathologist in making the correct diagnosis of HDN.     

Preconception tort liability: recognizing a strict liability cause of action for DES grandchildren.

Over the past decade more than 1,000 "DES daughters" have filed lawsuits against the manufacturers of DES, alleging that their in utero exposure to the drug caused various reproductive tract abnormalities, including cancer. Plaintiffs now allege that their grandmothers' use of DES during pregnancy caused genetic damage leading to cancer in third generations. This Note addresses the validity of preconception tort liability in the context of third-generation DES cases. Plaintiffs in preconception tort liability cases have sought recovery under both negligence and strict liability causes of action. Courts should recognize the validity of preconception tort liability and allow a strict liability cause of action in third-generation cases.