Accidental Hanging Deaths in Children in Konya,Turkey Between 1998 and 2007*

Abstract: In general, hanging cases are the result of suicide, and accidental and homicidal hanging cases are rarely seen. This study retrospectively investigated 4571 death examinations and autopsies that were performed at The Konya Branch of the Forensic Medicine Council (Turkey) between 1998 and 2007; hanging was involved in 201 (6.5%) of the cases. There were a total of 13 accidental hanging cases, where 12 of these involved children. In seven of the cases, the accidental hanging involved a scarf that wraps around swing‐like cradles and is intended to prevent infants from falling down. It was concluded that accidental hanging deaths can be reduced by replacing swing‐like cradles with cribs that are designed for children, removing ropes in and around the house, and preventing children from reaching and/or playing with rope‐like objects.     

吸入二氯甲烷和氯仿中毒后溺水死亡案例的法医毒物学分析

国外曾有一些二氯甲烷在工业事故中引起死亡及氯仿用于自杀、谋杀和作为成痛剂吸食而致死的案例检验报道[1-6]，国内尚未见报道。本文采用顶空气相色谱分析方法测定了二氯甲烷和氯仿在3名死亡人员及1只死鱼鹰体内的分布情况，并习国外有关文献资料进行了比较讨论，确定了3人因吸入二氯甲烷和氯仿而引起中毒昏迷，但昏迷后落水溺死是其最终致死原因。案情摘要1991年1月22日上午，某乡数只捕鱼小船，途经某化工总厂正在排放废水、废气的排放口时，船上渔民及数只渔鹰接连落水，致使3人和6只渔鹰死亡。1人经抢救脱脸，据脱险者讲：他与其他3人…     

Cause and manner of death among users of anabolic androgenic steroids

Medicolegally investigated deaths among 34 male users of anabolic androgenic steroids (AAS) are described. Nine persons were victims of homicide, 11 had committed suicide, 12 deaths were judged as accidental and 2 as indeterminate. In two cases of accidental poisoning, the levels of pharmaceuticals and illicit drugs were considered too low to be the sole cause of death and AAS was considered part of the lethal polypharmacia. Chronic cardiac changes were observed in 12 cases. In two cases of accidental poisonous deaths, these changes were regarded as contributory cause of death. Homicides, suicides, and poisonings determined accidental or indeterminate in manner were related to impulsive, disinhibited behavior characterized by violent rages, mood swings, and/or uncontrolled drug intake. The observations in the present study indicate an increased risk of violent death from impulsive, aggressive behavior, or depressive symptoms associated with use of AAS. There are also data to support earlier reports of possible lethal cardiovascular complications from use of AAS. Furthermore, a contributing role of AAS in lethal polypharmacia is suggested. Finally, the observations indicate that use of AAS may be the gateway of approach to abuse of other psychotropic drugs.     

Dementing diseases among elderly persons who suffered fatal accidents: a forensic autopsy study

The demographics and forensic autopsy findings of 125 elderly persons were analyzed to identify the risk factors of fatal accidents among elderly and to develop preventive measures to minimize such events. Cliniconeuropathologic dementing diseases were diagnosed in 13 of the 69 accidental death but only 1 of the 56 nonaccidental death cases, indicating that dementing diseases are associated with accidental deaths of elderly in forensic autopsy populations and suggesting that interventions for preventing fatal accidents should focus on elderly persons with dementia. Blood alcohol was only detected in persons without dementia, indicating that dementing diseases and drunkenness are not coexisting factors for fatal accidents among elderly. Living alone might increase the risk of mortalities associated with accidental injuries because of the absence of a caregiver at the scene and delayed medical help. The majority of fatal accidents occurred outdoors, emphasizing the need for interventions to reduce environmental hazards such as those related to traffic, open water, and cold weather. Increased public awareness of accident risks and preventive interventions will reduce accidental deaths among community-dwelling elderly people.     

Statistical Discrimination of Footwear: A Method for the Comparison of Accidentals on Shoe Outsoles Inspired by Facial Recognition Techniques

Abstract:  In the field of forensic footwear examination, it is a widely held belief that patterns of accidental marks found on footwear and footwear impressions possess a high degree of "uniqueness." This belief, however, has not been thoroughly studied in a numerical way using controlled experiments. As a result, this form of valuable physical evidence has been the subject of admissibility challenges. In this study, we apply statistical techniques used in facial pattern recognition, to a minimal set of information gleaned from accidental patterns. That is, in order to maximize the amount of potential similarity between patterns, we only use the coordinate locations of accidental marks (on the top portion of a footwear impression) to characterize the entire pattern. This allows us to numerically gauge how similar two patterns are to one another in a worst-case scenario, i.e., in the absence of a tremendous amount of information normally available to the footwear examiner such as accidental mark size and shape. The patterns were recorded from the top portion of the shoe soles (i.e., not the heel) of five shoe pairs. All shoes were the same make and model and all were worn by the same person for a period of 30 days. We found that in 20–30 dimensional principal component (PC) space (99.5% variance retained), patterns from the same shoe, even at different points in time, tended to cluster closer to each other than patterns from different shoes. Correct shoe identification rates using maximum likelihood linear classification analysis and the hold-one-out procedure ranged from 81% to 100%. Although low in variance, three-dimensional PC plots were made and generally corroborated the findings in the much higher dimensional PC-space. This study is intended to be a starting point for future research to build statistical models on the formation and evolution of accidental patterns.     

Cocaine- and methamphetamine-related deaths in San Diego County (1987): homicides and accidental overdoses

Cocaine- and methamphetamine-related homicides and fatal accidental overdoses in San Diego County were studied retrospectively for the 1987 calendar year. Cocaine was involved in 66 cases (39 homicides, 27 accidental overdoses), methamphetamine in 32 cases (23 homicides, 9 accidental overdoses), and a combination of cocaine and methamphetamine in 10 cases (4 homicides, 6 accidental overdoses). The composite for cocaine-related deaths was a 30-year-old black man in whom was also found at least 1 other drug, usually ethanol or morphine. The composite for methamphetamine-related deaths was a 32-year-old Caucasian man who used methamphetamine with at least 1 other drug (usually ethanol). For cases involving both cocaine and methamphetamine, the composite was a 36-year-old Caucasian man in whom was also found at least 1 other drug, usually ethanol, codeine, or morphine. Mean tissue concentrations of cocaine and benzoylecgonine were significantly higher in accidental overdoses than in homicides except for cocaine concentrations in liver, which did not differ significantly between the two groups. For methamphetamine-related deaths there was no significant difference between mean tissue concentrations in accidental overdoses and in homicides. Cocaine or methamphetamine or both were involved in approximately one third of homicides in San Diego County in 1987, and when fatal accidental overdoses were included, cocaine was involved in twice as many cases as methamphetamine.     

Accidental sharp force injury fatalities.

The authors review all accidental sharp force injury deaths investigated at the Southwestern Institute of Forensic Sciences from 1990 to 1999. Twenty-two cases of accidental sharp force injury were identified, accounting for 0.29% of all accidental deaths (9,562) during the 10-year study period. Included in this series are 5 incised wounds, 11 stab wounds, 4 chop wounds, and 2 deaths caused by dog attacks. About half of the cases involved some type of motorized machinery. The victims' ages ranged from 2 years to 71 years, with most deaths occurring in older teenagers and younger adults. Male subjects (17) were involved much more frequently than female subjects (5). In 50% of the cases, ethanol or other drug use was a possible underlying contributing factor in the accident. The cases are briefly reviewed, and the importance of detailed investigation in manner-of-death certification is emphasized.     

Nursing home deaths which fall under the jurisdiction of the coroner: an 11-year retrospective study

Twenty percent of deaths in the United States occur in nursing homes, yet less than 1% come to autopsy. The current study analyzed causes and manners of death in all nursing homes between 1993 and 2003, investigated by the coroner of Allegheny County, PA, which has the second highest elderly population in the United States. Two hundred eight decedents were identified, aged 19 to 91 years, 58% women and 42% men, 88% Caucasian and 22% African-American. Fifty-eight percent were accidental and 38.5% were natural manners of death, with 2 homicides, 2 suicides, and 3 undetermined cases. The manner of death was significantly different between Caucasians and African-Americans, with 92.6% of accidental deaths occurring in Caucasians and 6.6% in African-Americans (P < 0.1). Most common natural deaths were arteriosclerotic cardiovascular disease, nonarteriosclerotic cardiovascular disease, pneumonia, pulmonary thromboembolism, chronic obstructive pulmonary disease (COPD), seizure disorder, and atraumatic intracranial hemorrhage. Blunt force trauma was the single most commonly identified traumatic accidental death. Accidental deaths were more common in Caucasians than African-Americans. Homicides and suicides were rare events (<2%). Blunt force trauma is a major autopsy finding in accidental nursing home deaths, and a root-cause analysis may be helpful in developing policies and procedures to decrease the incidence of blunt force trauma.     

Accidental methylene chloride fatality

A case of accidental methylene chloride poisoning by inhalation is presented. The methylene chloride concentration in post-mortem blood was 29.8 mg% as determined by a headspace gas-chromatography technique. The accidental death was attributed to improper ventilation of vapors.     

Cardiopulmonary resuscitation-related injuries and homicidal blunt abdominal trauma in children

Defendants accused of inflicting fatal abdominal injuries to children occasionally raise the defense that the injuries were caused by cardiopulmonary resuscitation (CPR). The purpose of this study is to answer the question: Does closed chest CPR result in fatal blunt abdominal injuries that can be mistaken for homicidal assault? To that end, a retrospective study was conducted of all homicidal blunt abdominal injuries in children 10 years and younger from the Dade, Broward, and Palm Beach Medical Examiner's Offices from 1981 through 1997. These were compared to cases of children who died of natural causes during the same time period in Broward County who had CPR (control group 1) and to children who died of nonvehicular accidental blunt abdominal trauma (control group 2). Children with life-threatening head injuries were excluded. Medical examiner records, autopsy reports, documenting photographs, and clinical records were reviewed. The data analyzed included subject demographics, whether CPR was performed and by whom, and autopsy findings. Thirty-three child homicides with fatal abdominal injuries were reviewed. Twenty-four (73%) of the homicides received CPR. There was no difference in the nature and severity of injuries between the 24 children who received CPR and the 9 who did not. Three hundred and twenty-four cases of pediatric natural deaths were reviewed, all of which had CPR. No traumatic abdominal injuries were found in any of the children who died of natural causes. Only four children who died of natural causes had evidence of extraabdominal trauma related to CPR. No cases of nonvehicular accidental blunt abdominal trauma were identified during the 17-year period, although there were nonvehicular accidental fatalities due to extraabdominal injuries. The likelihood of CPR-related primary abdominal trauma in child homicides is very low.     

Importance and Approach to Manner of Death Opinions in Opioid-Related Deaths

The majority of opioid-related deaths are accidental. However, the number of opioid-related suicidal deaths is likely under recognized. Presented here is a case of suicide by heroin overdose. The manner of death would have likely been deemed accidental if not for critical information shared by the decedent’s family during follow-up telephone interviews between the forensic pathologist and the decedent’s family, which included text messages that were sent by the decedent just before his death that were not known at the time of the initial medicolegal death scene investigation. This case highlights that when a forensic pathologist establishes an engaged relationship with the decedent’s family, the information elucidated can prove to be invaluable in reaching an informed opinion about the manner of death. For overdose cases, identifying an accurate manner of death allows the design of public health efforts that adequately address the health risks in the community. For aid in the determination of the manner of death for overdose cases, we propose a five-step checklist that may assist forensic pathologists and medicolegal death investigators when approaching similar cases.     

Fatal firearm accidents in Sweden

According to Swedish law, it is prohibited to possess and use firearms without a special permission (license), which is given only after a detailed personal investigation. This restrictive legislation accounts for the fact that deaths due to firearms in Sweden are rare in an international comparison. The number of accidental firearm fatalities in Sweden is 0.074/100,000 living persons. We have previously published a series of accidental firearm fatalities during hunting, and now we present an investigation on the non-hunting fatalities. The mean age of the victims was 27 years, and males predominated. Handguns, military rifles, and shotguns caused most of the accidents. The first published case of fatal thoracic airgun wound is also included. Slightly more than half of the accidents were caused by another person and were inflicted at close range. Unsafe handling of the guns, especially "playing" with the gun or during military training caused most of the accidents. It is doubtful that one could further decrease the low number of fatal firearm accidents in Sweden by even more restrictive legislation. Instead, it is concluded that the most important factor to stress is the safer handling of weapons.     

Accidental railway-related fatalities. The Metro Dade County experience, 1980-1984

A study of accidental railway-related fatalities was performed using the case files of the Office of the Medical Examiner of Metropolitan Dade County in Miami, Florida, during the years 1980-1984. The nine cases that were collected are presented here in some detail. A discussion ensues concerning the most common type of accidental railway-related fatalities, why they occur, and what future work remains in order to avoid such fatalities. Evidently, fatalities more frequently result from victims' disregard for safety--either by crossing the tracks despite warning, or by utilizing railroad trestles as a fishing pier--than from mass disaster. Future work involving forensic engineers, forensic pathologists, and lawyers along with community activists should include both public education and a design of less accessible trestles to avoid such tragedies. In conclusion, it is hoped that this article will serve as a catalyst for further research on this subject.     

A Case of Accidental Fatal Aluminum Phosphide Poisoning Involving Humans and Dogs

Aluminum phosphide is one of the commonest poisons encountered in agricultural areas, and manner of death in the victims is often suicidal and rarely homicidal or accidental. This paper presents an unusual case, where two humans (owner and housemaid) and eight dogs were found dead in the morning hours inside a room of a house, used as shelter for stray dogs. There was allegation by the son of the owner that his father had been killed. Crime scene visit by forensic pathologists helped to collect vital evidence. Autopsies of both the human victims and the dogs were conducted. Toxicological analysis of viscera, vomitus, leftover food, and chemical container at the crime scene tested positive for aluminum phosphide. The cause of death in both humans and dogs was aluminum phosphide poisoning. Investigation by police and the forensic approach to the case helped in ascertaining the manner of death, which was accidental.     

Sustained Combustion of Bodies: Some Observations*

Abstract: Previous tests have explored the fire effects and fuel characteristics of animal carcasses in intense fires of relatively short duration. Here, test fires were conducted involving intact human cadavers and torsos that included nonaccelerated, long‐duration fires involving the bedding and clothing (in the manner of typical accidental deaths). The objective was to observe the fire conditions (size, radiant heat flux, and duration), where a human body represented the major fuel package in a nonaccelerated fire. The pattern of damage to the body was documented and compared with that resulting from a furnished room fire. Two intact, unembalmed human cadavers were exposed to fires of simulated accidental origin. The bedding was ignited by an open flame, and the fires were allowed to burn unaided to self‐extinguishment. It was found that normal human bodies can support a modest‐sized fire for some 6–7 h under these conditions. The presence of a substrate material that can act as a wick for the combustion of the rendered body fat results in extensive destruction of the torso where the greatest amount of subcutaneous fat resides, with less damage to the head and limbs. A third (partial) cadaver was exposed to a recreation of a typical accidental fire in a furnished room that progressed to full room involvement. This fire of some 15 min of total duration inflected only surface‐layer damage to the torso of the victim.     

Accidents,Agency and Asylum: Constructing the Refugee Subject

Refugee law demands that the asylum seeker demonstrate an extremely limited and distorted form of agency that is encapsulated within the legal definition of the refugee. Such a framework also denies the role of the accidental in the refugee experience. I argue that the problem lies at the heart of the legal form, as constructed under capitalism. The sans-papiers show us the potential for refugees themselves to reconstruct a subjectivity that transcends the distorted form of agency and the false dichotomy between the accidental and agency found in law, through their rejection of legal definitions and the re-emergence of themselves as political subjects.     

Death by overlaying and wedging: a 15-year retrospective study

Overlaying, the accidental death by smothering caused by a larger individual sleeping on top of an infant, is a cause of death that has been documented for centuries. The hazard of death has been reported to be greater in infants less than 5 months of age but may occur in children up to the age of 2 years. When an adult or older child rolls on top of an infant, mechanical asphyxia results. The face may be pressed into the mattress or into the body of the sleeping adult or older child. The infant's air may be expressed, and he or she is unable to cry due to pressure on the thorax and the inability to inhale. Some pathologists and investigators believe that the victims of overlaying have no pertinent physical findings at autopsy and that any injury is indicative of inflicted trauma. Others believe that one may see contusions and abrasions from overlaying in and of itself. Wedging is another form of accidental mechanical asphyxia that may have negative autopsy findings. The prevalence of bruising, contusions, or facial and ocular petechiae is not clear. The author reviewed all pediatric forensic cases referred for autopsy to the Forensic Section of the Medical University of South Carolina/Medical Examiners' Office over the past 15 years, from 1985 to 1999. Of these, all cases of overlaying, cases listed as undetermined sudden infant death syndrome versus overlaying, and wedging were included. The cases were analyzed as to victims' age, sex, race, location/bedding, bed-sharer, and whether the bed-sharer was known to have ingested drugs or alcohol before sleep. Postmortem physical findings were also reviewed, particularly for documentation of contusions, abrasions, or facial or ocular petechiae. By clarifying not only the victim, bed-sharer, and scenario but also the presence or absence of physical findings in cases of overlaying, wedging, and other accidental asphyxia, we can better categorize these cases.     

意外死亡尸检率下降原因分析

本文调查分析了公众对意外死亡是否同意进行尸检态度的影响因素。利用设计的“公众对意外死亡进行尸检认知情况调查问卷”对386名社会随机个体进行问卷调查。运用Logistic回归分析、最优尺度回归分析的统计学方法对回收的问卷进行分析。通过调查分析，发现公众对尸检相关知识了解程度的因素、对尸检结果的认可程度因素、文化程度因素、家庭经济状况因素，影响着公众对意外死亡后尸体解剖检验的态度。     

指纹三角周边区域细节特征分布相似现象研究

目的研究一定区域内指纹细节特征相似和偶合的可能性以及发生偶合的规律对于准确鉴定指纹有重要的意义。方法本文通过使用CAFIS系统进行检索，借助Image-Pro Plus图像处理软件对箕型纹和斗型纹纹线特征偶合的情况进行研究。结果发现在箕型纹和斗型纹三角区域纹线特征的偶合可能性明显高于其他区域，应引起指纹鉴定专家的重视。     

Unreasonable Women: Gender and the Law of Accidental Injury, 1870-1920

At the wheels of railroads and streetcars, the law of accidental personal injury, known as negligence, became a discrete body of law between 1870 and 1920. The defining component of negligence was "fault"–the notion that the individuals (injured and injurer) must have failed to act according to some minimal standard of caution. Theorists of the history of negligence have explained that the conduct of all was measured against what a "reasonable man" would have done under the circumstances. The author here challenges this fundamental assertion. Through trial records, lawyer's written arguments, and appellate opinions, she reconstructs the critical role of gender in shaping the law of accidental injury. As she argues, in 19th- and 20th-century America, injury was a gendered event. The fact that courts in these years held men and women to different standards of care undermines theorists' arguments that economic considerations drove the law of accidental injury. Moreover, the reification of gender nm in private law, in turn, vitally affected the experience of gender in turn-of-the-century America.