Automatic implantable cardioverter defibrillator rhythm strip data as used in interpretation of a motor vehicle accident

The automatic implantable cardioverter defibrillator (AICD) is an electronic device that monitors the rhythm of the heart and, upon detecting a life-threatening arrhythmia, shocks the heart in an attempt to restore a normal rhythm. The AICD will electronically store the information of the event. Later, the AICD can be "interrogated" and the information electronically retrieved, with a printout of the rhythm strip obtained. The interrogation is fairly simple and involves a magnetic device placed over the AICD, which in turn is connected to a portable computer, which, with specialized software, can deliver the information in a usable form. Not only can information about the most recent shock be obtained, but also information about previous shocks can be retrieved. This case presentation highlights how such preterminal information retrieved from an AICD helped to interpret the circumstances leading to a death--in this case, a fatal motor vehicle accident. Additionally, driving restrictions that may be placed on individuals with AICDs are discussed.     

Assessing the consequences of corporate discretion on regulatory compliance: the case of motor vehicle safety in Canada

What are the consequences of discretion when government shares the responsibility for regulatory compliance with the industry subject to regulation? Do differing underlying goals affect implementation? This article examines the implementation of Canada's Motor Vehicle Safety Act for fiscal years 1974–75 to 1981–82. Since the law creates opportunities for the exercise of discretion and those responsible for implementation (government versus industry) do not share the same underlying goals, one can expect that who implements the act will be of considerable importance. The data suggest that when incentives for compliance differ, discretion creates the opportunity for substantially different outcomes. Notable differences exist in the characteristics of recalls that manufacturers initiated and those that Transport Canada influenced.     

Correlation of trauma and cause of death to accident reconstruction: a case of a flight accident report.

This paper reports on the disaster that occurred after a flight was hijacked at Baiyuen International Airport in Guangzhou, China, on Tuesday, 2 Oct. 1990. The authors show the results of analyses for the causes of death and trauma and compare the disaster with several previous flight accidents that have occurred in China. The authors show, with the analysis on this accident, the possibility and reliability of reconstructing a disaster by medicolegal investigation.     

睾丸损伤的法医学鉴定

本文结合5例睾丸损伤检验鉴定，论述了睾丸损伤对阴茎勃起功能及生殖能力的影响，并对睾丸损伤法医学鉴定的若干问题进行了讨论。     

Hyperpigmentation in the long bones of the lower limbs as a basis for vehicle identification and traffic accident reconstruction

Following the earlier studies on the identification of injuries in unbroken cranial bones, the described method was adapted for the examination of the long bones in fatal casualties of traffic accidents.Two types of bumper injuries might occur: the bumper was found to cause fracturing of limbs [1], and femoral muscle contusions and microtraumas within compact and spongiose parts in the femoral with subsequent maculate hyperpigmentation [2].The authors show that the correlation of above mentioned traces of the trauma, facilitates the reconstruction of the accident and also the identification of the vehicle.     

"Overkill" in a case of neonaticide

A 14-year-old girl was found unconscious in a pool of blood by her mother in the family bathroom. A gynecological emergency operation revealed a state after spontaneous delivery. A few days later the corpse of a newborn, smeared with blood, was found by the father of the girl in a laundry basket in the bathroom. The autopsy revealed signs of blunt force against the cranium as well as multiple lesions caused by sharp force in the area of the neck and the thorax. The newborn died of hemorrhagic shock due to severance of the left subclavian artery. The pattern of injuries is presented. In addition, the girl's statement with respect to the course of events is discussed. Finally, this rare manner of committing neonaticide is compared with former reports in the literature.     

Postmortem blood and vitreous humor ethanol concentrations in a victim of a fatal motor vehicle crash

A 20-year-old male was found on the passenger side of a small car after a collision with a semi-trailer truck. Postmortem blood, collected from the chest cavity, and vitreous humor samples were collected following harvesting of the heart and bones. Gas chromatographic analysis revealed a blood ethanol concentration of 0.32 g/dL and a vitreous humor ethanol concentration of 0.09 g/dL. The stomach was intact and full of fluid and food, but its contents were not collected. Possible explanations for the large difference between the two results include diffusion of ethanol from the stomach into the chest cavity, contamination of the blood sample prior to collection, and ingestion of a large quantity of ethanol shortly before death. This case demonstrates the importance of proper quality assurance procedures in collecting postmortem specimens and of collecting a vitreous humor sample for ethanol analysis in postmortem toxicology cases.     

"Like a bird in a cage": Vietnamese women survivors talk about domestic violence

In recent years, a growing literature has emerged that explores the role of culture in domestic violence for ethnic minority populations, including immigrants and refugees. This article presents qualitative data collected from Vietnamese refugee women through a research project in partnership with the Refugee Women's Alliance in Seattle, Washington. Through the women's stories, their own self-awareness of domestic violence as Vietnamese women residing in the United States is available for reflection and review. Issues of acculturation, changing gender roles, examples of strength, and cultural persistence constitute the thematic structure within which these women articulate their needs for creating and sustaining a life free of abuse for themselves and their children.     

Children in motor vehicle collisions: analysis of injury by restraint use and seat location

This study was a retrospective chart review of hospital records and autopsy reports of 499 children nine years old or younger involved in motor vehicle collisions from 1994 to 1998. The objective was to evaluate the frequency and severity of injuries as a function of age, restraint use, and seat position. We found that 33% of the children were unrestrained and 20% were improperly restrained. Unrestrained children had the highest mean Maximum Abbreviated Injury Scores (MAIS) and Injury Severity Scores (ISS), accounted for 70% of the fatalities, and had the highest incidence of head injuries. Although most of the head injuries were superficial, 80% of the fatalities were the result of a head injury. Improperly restrained children had the highest frequency of abdominal injuries. Regardless of restraint use, the back seat was associated with fewer head injuries and lower mean MAIS and ISS scores compared to the front seat. Also, properly restrained children in the front seat had lower mean MAIS and ISS scores than unrestrained children in the back seat, suggesting that restraint use is more beneficial than seat position.     

The search for "Yvonne": a case example of the delineation of a grave using near-surface geophysical methods

Shallow electromagnetic (EM) and ground-penetrating radar (GPR) surveys were conducted in an area north of Auckland, New Zealand to assist the search for human remains. The body had been buried for almost 12 years in a plantation forest that was irregularly disrupted and modified by tree harvesting and the partial removal of stumps. EM identified anomalous areas of potential interest, because a target need only be nearby to generate an EM response. GPR was then used to map subsurface layering, layering disruption, and buried objects, immediately adjacent to an EM anomaly. Because of the nature of the site, numerous geophysical anomalies were present. GPR was particularly sensitive to site disturbance resulting from the forestry operations. An isolated EM anomaly on the fringes of an expanded survey area was coincident with the location of the body. Whether for criminal investigations or for archaeological work, a combination of geophysical techniques is recommended.