客机失事的法医学鉴定——附一例报告

本文报告了1985年1月18日,中国民航 B-434(安-24)号客机在济南失事的法医学鉴定。机上乘员41人,死38人,伤3人。死难中以撞击伤(大部四肢骨折)和烧伤为主。死因主要是脏器的严重损坏、创伤性休克、大出血。部分死于烧伤。个人识别是空难法医学鉴定的主要内容,本例主要采用体貌鉴别和个人遗物鉴别(占90％),得到满意结果。本文讨论了客机失事的法医学处理问题,还就作者实践并结合国外经验提出我国飞机失事法医学鉴定程序的设想。     

美国马里兰州法医学制度

各国的法医学体制各有所长。随着我国开放政策的实施 ,体制改革的深入 ,借鉴国外的经验 ,吸取其优点 ,将有助于我国法医学体制改革 ,进一步提高法医学鉴定工作质量 ,尽快做到与国际接轨。关于英国、德国、日本及美国等的法医学体制已有数篇报道[1,2 ] 。本文作者介绍美国马里兰州法医局的法医学建制 ,并对照我国现行的法医学管理体制 ,对其特点进行分析。马里兰州法医局始建于 193 9年 ,是美国第一个以州为法医检验中心、实行法医检验人制度的法医局。马里兰州法医局负责全州 1市和 2 3县的法医检案工作 ,在行政上属马里兰州死后医学鉴定委…     

对医院开展法医学鉴定业务存在问题的探讨

全国人大常委会《关于司法鉴定管理问题的决定》颁布实施后，很多医院成立了司法鉴定所，面向社会开展法医学鉴定业务。由于众多因素的影响，目前法医学鉴定出现了较多问题。作者在此对医院及临床医师是否可以从事法医学鉴定，医学鉴定与法医学鉴定的区别等问题进行分析探讨，以便同行在工作中参考。     

法医学鉴定标准的现状与问题

司法鉴定标准化是一个世界性的司法话题,伴随我国司法改革的实施和政府对标准化工作的重视,我国将迎来建立法医学鉴定标准体系的黄金时代。然而当前我国法医学鉴定标准却存在标准少、质量参差不齐、更新缓慢、标准制定的科学性不足等问题,导致司法鉴定工作与实践脱轨,很多鉴定项目缺乏鉴定标准。为此,作者建议,正确认识法医学鉴定标准的法律地位和存在的错误,致力于法医学鉴定标准化。     

拳击伤后糖尿病视网膜脱离鉴定1例

在法医学鉴定中,与外伤有关的视网膜脱离的案例并不少见,但如何正确评定视网膜脱离与外伤的关系非常重要.作者报告一典型案例,并就此对与法医学鉴定相关的问题予以分析讨论.     

书讯

正科学出版社上海分社出版的《医疗纠纷的鉴定与防范》系由司法部司法鉴定科学技术研究所(上海市法医学重点实验室)夏文涛研究员、朱广友研究员、杨小萍副主任法医师主编。本书主要作者长期从事医疗纠纷鉴定与研究,以理论与实际案例相结合的方式系统阐述了医疗纠纷鉴定的实务与相关法律问题。     

25例冻死案例法医学分析

<正>冻死是指人体长时间处于寒冷环境中,个体保暖不足,散热量远超过产热量,超过人体体温调节的生理限度,物质代谢和生理功能发生障碍所引起的死亡[1]。本文通过分析25例冻死案例,为此类案件的法医现场勘验及法医学鉴定提供理论参考。1案例资料1.1案例来源及一般资料本文收集了黑龙江省公安厅刑事技术总队2012年至2015年间受理的25例冻死案件,案件的发生地均为黑龙江省境内。25例冻死案例中,女性3例,平均年     

临床漏诊眶骨骨折的法医学鉴定分析

<正> 在眼损伤的法医临床学鉴定实践中,有些临床漏诊的眶骨骨折的法医学鉴定案例,已被大多数法医同行所关注。本文作者对32例临床漏诊的眶骨骨折的法医学鉴定资料进行回顾性分析,并对其漏诊原因和法医学鉴定的有关问题进行讨论。     

10.2客机失事遇难者的损伤鉴定及分析

本文报导了1990年10月在广州发生的“10.2”客机失事事件的法医学鉴定情况,重点介绍了对遇难者的损伤鉴定。作者还对近几年国内几次客机失事进行了比较分析,结合本例客机失事情况,阐述了运用法医学鉴定结果,重建失事经过的可能性与可行性。     

钝性暴力致乳头黄斑纤维束损伤3例分析

在法医学鉴定中眼部钝挫伤致乳头黄斑纤维束损伤案例较少见,本文作者报告3a来所遇3例,并就法医学鉴定的相关问题予以分析讨论.     

窒息死亡的法医病理学分析

目的探讨窒息死亡的法医病理学特点。方法对四川大学华西法医学鉴定中心1982年10月1日～2006年9月30日所作160例窒息死亡尸体剖验病理材料进行统计分析。结果窒息死亡案例占整个法医学检案的9.9%,年龄:30～39岁的死者占整个研究对象的29.4%,平均年龄为31.25岁。性别:男性103例,女性57例。男女比例1.81∶1。死亡方式:意外死亡最多(63.1%),其次为自杀(24.4%)和他杀(12.5%)。死亡原因:缢死最多(21.9%),其次为CO中毒(17.5%)、溺死(16.25%)等。医疗纠纷共计39例,均为新生儿窒息,主要发生在乡镇医院和县级医院(76.92%)。结论加强法制教育,提高安全隐患意识等是减少窒息死亡的重要手段。提高城乡医疗水平,加强窒息急诊抢救的临床技能是防止窒息引起医疗纠纷的关键。     

火场中尸体的法医学分析

火场中的尸体是法医病理工作者较常见的案件,在这种案件中,判断是生前烧死还是死后焚尸具有非常重要的意义。本文就相关文献关于火灾死亡案件的尸体内部、外部征象、现场特点、以及以COHb为主的实验室结果加以综述,目的在于阐明这些特征在实际案件中的作用和应用,为法医工作者解决此类案件提供参考。     

Child and adolescent victims in forensic autopsy: a 5-year retrospective study

Children of more than 3 years of age and adolescents have been largely overlooked in the forensic literature, especially the 4-9 age group. Thus, the present study was undertaken to address this particular issue of child and adolescent victims in forensic autopsies. On a 5-year period (2000-2004) in Quebec province (Canada), all forensic autopsy cases of children and adolescents from 4 to 19 years of age were retrospectively studied. A total of 223 cases of child and adolescent deaths (148 males, 75 females; 6.6% of all forensic autopsies) were reviewed. Age, gender, manner of death and cause of death were analyzed for all victims organized into three groups of age: 4-9, 10-14, and 15-19. Moreover, homicide cases (n = 54) are further analyzed in terms of method(s) used (firearm, sharp force, asphyxia, blunt force, intoxication). This 5-year retrospective study may contribute to a better understanding of typical deaths in the 4-19 group of age and therefore, bring a working basis for the forensic pathologist or medical examiner/coroner.     

Establishing the cause of death in finding a corpse on a flight of stairs

A total of 793 forensic medical conclusions concerning corpses found in vestibules are analyzed. The circumstances of death were unknown in the majority of cases. Causes other than injuries were responsible for the majority (72.4%) of deaths: coronary diseases, hanging, alcohol intoxication, or general hypothermia. Strikes with blunt objects and falling on the staircase or floor rank second among causes of death. Injuries caused by falling from staircase and cases with this cause suspected were responsible for 9.6% deaths. Murders with acute objects and guns were recorded in 6% cases. For facilitating differential diagnosis, a list of signs and injuries occurring as a result of falling from staircase and main causes of death in such injuries, made with consideration for the place where the corpses are found, is offered.     

Multiple Symmetric Lipomatosis

A significant number of medicolegal deaths involve ethanol. Deaths may be related to the acute, intoxicating effects of ethanol, either in decedents or within persons responsible for causing the deaths of others. Additionally, deaths may be related to chronic alcoholism. A chronic alcoholic may display characteristic external features which allow an observer, such as a forensic pathologist or other physician, to conclude that he/she is probably an alcoholic. Herein, the authors report two decedents with a rare condition known as “multiple symmetric lipomatosis” (MSL), which has a strong correlation with chronic alcoholism. Identification of the peculiar features associated with MSL should prompt the forensic pathologist to consider chronic alcoholism as a probable diagnosis.     

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.     

Autoerotic deaths in the literature from 1954 to 2004: a review

Autoerotic death by hanging or ligature is a method of autoeroticism well known by forensic pathologists. In order to analyze autoerotic deaths of nonclassic hanging or ligature type, this paper reviews all published cases of autoerotic deaths from 1954 to 2004, with the exclusion of homicide cases or cases in which the autoerotic activity was not solitary. These articles were obtained through a systematic Medline database search. A total of 408 cases of such deaths has been reported in 57 articles. For each case, the following characteristics are presented here: sex, age, race, method of autoerotic activity, cause of death, and location where the body was found. Autoerotic death practioners were predominantly Caucasian males. Victims were aged from 9 to 77 years and were mainly found in various indoor locations. Most cases were asphyxia by hanging, ligature, plastic bags, chemical substances, or a mixture of these. Still, atypical methods of autoerotic activity leading to death accounted for about 10.3% of cases in the literature and are classified here into five broad categories: electrocution (3.7%), overdressing/body wrapping (1.5%), foreign body insertion (1.2%), atypical asphyxia method (2.9%), and miscellaneous (1.0%). All these atypical methods are further discussed individually.     

非典型自杀的法医学鉴定

根据辖区内自杀案件的特点,对其中自杀方式较为特殊或复杂的案件进行分析总结,将之归结为非典型自杀,根据其损伤方式,伤口形态等的不同将其分为多种方式自杀和特殊创伤型自杀,分别进行阐述,通过对这些非典型自杀的法医学特点的分析,为非正常死亡案件性质的正确判定提供帮助.     

Accidental Trauma Mimicking Homicidal Violence

Homicide investigations represent an important function of death investigators. Although recognizing nonobvious homicides is crucial, an equally important role involves the identification of cases that initially present as possible homicides, but are ultimately discovered to not represent homicides. Failure to recognize such cases results in wasted time, squandered resources, false allegations, and potential life‐altering consequences. The authors review a series of cases wherein initial investigation suggested a possibility that the deaths represented homicides. By carefully considering additional information, including scene findings, history, and postmortem examination, each was determined to represent an accidental traumatic death. In addition to highlighting the importance of recognizing accidental traumatic deaths that initially present as homicides, the cases serve to highlight the fact that forensic pathology cannot be practiced without knowledge of appropriate ancillary information. Although guarding against cognitive bias is important in all forensic disciplines, including forensic pathology, access to vital case‐related ancillary information is an essential component of practicing medicine as a forensic pathologist.     

Forensic issues in cases of Diogenes syndrome

Diogenes syndrome is a syndrome described in the clinical literature in elderly individuals characterized by social isolation and extreme squalor. A number of typical features are found in the forensic evaluation of these deaths as the cases usually initiate medicolegal investigations due to the circumstances and the lack of recorded medical histories. Examinations of the death scenes are often difficult as victim's houses are in a state of disrepair, with filth and clutter, and pet dogs may resent the intrusion of strangers. Bodies are often filthy, with parasitic infestations, and are often putrefied due to the social isolation of the deceased and the delay in the finding of the corpse. Bodies may be traumatized from postmortem animal depredation by rodents or pets (eg, cats, dogs), and injuries such as bruises and lacerations may be present from falls associated with terminal illnesses or alcoholism. Blood or putrefactive fluids may be spread throughout the house by pets. Treatable medical conditions are often present in advanced stages, and features of hypothermia may be found. Attending police may suspect robbery due to disarray of the house and homicide due to apparent "bleeding" around the body from purging of putrefactive fluids, injuries from falls, or postmortem animal activity and "blood stains" throughout the house from antemortem injuries and/or fluid spread by animals. Finally, the identification of the deceased may be compromised by decay and/or postmortem animal activity. Thus, in addition to having typical clinical manifestations, such individuals appear to form a distinct subset of forensic cases having characteristic death scene and autopsy features and presenting particular difficulties in postmortem evaluations.