"Homicide by heart attack" revisited

The sudden death of a person caused by an arrhythmia that is induced by physical and/or emotional stress provoked by the criminal activity of another person is sometimes referred to as "homicide by heart attack." Published criteria for such an event relate to situations where no physical contact occurs between the perpetrator and the victim. Situations involving physical contact, but with absence of lethal injuries, are frequently treated is a similar fashion by forensic pathologists. Herein, we propose a set of modified criteria, which include cases where physical contact has occurred. Five examples of so-called "homicide by heart attack" are presented, including a 40-year-old man who was struck in the head with a wooden statue, a 74-year-old man who was punched in the jaw by a robber, a 66-year-old woman who was started awake by a home-intruder, a 67-year-old woman who struggled with a would-be purse-snatcher in a parking lot, and a 52-year-old man who was in a physical altercation with a younger man. In each instance, autopsy revealed the presence of severe, underlying heart disease, as well as absence of lethal injuries. In each case, investigative information was such that the emotional and/or physical stress associated with the criminal activity of another individual was deemed contributory to the death. The presumed mechanism of death in each case was a cardiac dysrhythmia related to underlying heart disease, but initiated by the emotional and/or physical stress.     

Skull and Encephalic Injuries Caused by Beach Umbrellas: Case Reports and Review of Literature

This study reports two unusual cases of skull‐encephalic injuries in bathers that were caused by violent impacts with beach umbrellas. The first case concerned a 36‐year‐old man who, while lying on a sun bed, was struck on his left temple by a beach umbrella, which had been blown away by a gust of wind. The second case concerned a six‐year‐old child who was struck on the right temporal region while he was playing on the sand. Both subjects died. A review of the literature was carried out. Various skull and brain injuries caused by several objects were found, but no injuries caused by beach umbrellas were detected. There were only cases of injuries caused by normal umbrellas. These cases showed that several objects can be responsible for traumas causing skull and brain injuries, therefore forensic investigation must be supplemented by circumstantial data.     

Suicidal Decapitation by Guillotine: Case Report and Review of the Literature

Abstract: Suicidal decapitation is seldom encountered in forensic medicine practice. This study reports the analysis of a suicide committed by a 31‐year‐old man with a self‐fabricated guillotine. The construction of the guillotine was very interesting and sophisticated. The guillotine‐like blade with additional weight was placed in a large metal frame. The movement of the blade was controlled by the frame rails. The steel blade was triggered by a tensioned rubber band after releasing the safety catch. The cause of death was immediate exsanguination after complete severance of the neck. The suicide motive was most likely emotional distress after the death of his father. In medico‐legal literature, there has been only one similar case of suicidal complete decapitation by a guillotine described.     

Comamonas testosteroni meningitis in a homeless man

We report a case of meningitis caused by Comamonas testosteroni in a 54-year-old, alcoholic, homeless man. He, as a pedestrian, was struck by a car and suffered multiple fractures of the facial bones including the left frontal sinus. Over the course of 2-week hospitalization, he was clinically diagnosed with multiple cerebral and cerebellar infarcts resulting in altered mental status. He was pronounced dead 15 days after the injury. At the time of autopsy, diffuse purulent meningitis was found on gross examination. A swab culture of the brain surface was positive for C. Testosteroni, a saprophytic organism commonly found in soil and water. This is the first reported case of fatal meningitis caused by this micro-organism.     

Aqua-eroticum: an unusual autoerotic fatality in a lake involving a home-made diving apparatus

The term Aqua-eroticum was first introduced in 1984 by Sivaloganathan to describe the unusual autoerotic death of a man using submersion as an asphyxia method. This was the first case of that kind, and since then, no other case of autoerotic submersion has been reported, nor other autoerotic fatality in open water. Here we report the case of a 25-year-old man, nude under a home-made plastic body suit, overdressed for the season with winter clothes and restrained by complex bondage. He was submersed, tied underwater to a boat and was using a home-made diving apparatus for air supply. Death was ruled as accidental autoerotic asphyxia from rebreathing, caused by the faulty air-supply device.     

The modern holy shroud

Testimonies disclosed that a 44-year-old pedestrian was struck head-on by a truck while she was roaming on the motorway; at the time of collision, the truck was travelling at a speed of about 90 km/h. In the second phase of the collision, the pedestrian was projected about 100 m before her body was run over by the truck and then by a car. The autopsy revealed extensive mutilations, making it impossible to verify the testimonies of witnesses to the collision as regards the pedestrian's position at the moment of the first impact. However, the reports produced by the technical expert and the forensic pathologist were able to confirm the testimonies, based on an impact zone on the front panel of the cab of the truck, where part of the pedestrian's face was reproduced like a "modern holy shroud".     

Killing a wolf--an unusual case of forensic veterinary pathology

During a hunt in Western Pomerania in January 1999 a wolf, injured at the left hind leg, was killed by a shot in the chest region. It was a 2-year-old male that probably came to Germany from Poland by crossing the Oder River. The hunter was reported to the police afterwards, because there were doubts as to the legality of the lethal shot. The hunter pleaded relief by reason of section 22 a German Hunting Law (prevention of avoidable pain or suffering of wild animals). After the shooting there was a number of wrong expert statements by a veterinarian and two zoologists concerning the age of the injury on the left hind leg and the direction of the shot to the chest region, which were corrected by subsequent medico-legal examinations performed on the order of the prosecution.     

Dirty tricks of cross-examination

A mock jury study was conducted to test the hypothesis that perceptions of a witness can be biased by presumptuous cross-examination questions. A total of 105 subjects read a rape trial in which the cross-examiner asked a question that implied something negative about the reputation of either the victim or an expert. Within each condition, the question was met with either a denial, an admission, or an objection from the witness's attorney. Results indicated that although ratings of the victim's credibility were not affected by the presumptuous question, the expert's credibility was significantly diminished—even when the question had elicited a denial or a sustained objection. Conceptual and practical implications of these findings are discussed.This research was supported by funds provided to the first author by the Bronfman Science Center.     

Post-traumatic venous and systemic air embolism associated with spinal epidural emphysema: multi-slice computed tomography diagnosis

A 30-year-old man was admitted with chest trauma after a road traffic accident. The patient was paraplegic and suffered from transient monoparesia of the left arm. The chest X-ray revealed a severe right tension pneumothorax and thoracic spine fractures. Emergency right thoracic drainage was carried out followed by angiography. Unfortunately the patient died and an autopsy was not permitted. Consequently post-mortem multi-slice computed tomography (MSCT) was performed, revealing presence of air inside the right cerebral arteries, bilateral pneumothorax accompanied by a severe right tension pneumothorax, bilateral haematic pleural effusion, pneumomediastinum and bilateral lung contusions. Air was also observed within the right coronary artery, ascending aorta and right ventricle. Thoracic and cervical spinal epidural emphysema were diagnosed. Venous air embolism followed by arterial air embolism producing paradoxical embolism was diagnosed. To the best of our knowledge, this is the first case illustrating by post-mortem MSCT such simultaneous complications after chest trauma as spinal epidural emphysema and cerebral and coronary air embolism.     

Here comes the judge: the influence of judge personal characteristics on federal sexual harassment case outcomes

This study explored the effects of judges' personal characteristics (gender, race, age, and political affiliation) and case characteristics on the outcomes of federal cases of hostile environment sexual harassment. Results revealed that even after controlling for the effects of relevant case characteristics (e.g., severity of the harassment), judges' personal characteristics influenced case outcomes. Specifically, younger judges and Democrat judges were more likely to find for the plaintiff (the alleged victim of harassment). The probability that the decision would favor the plaintiff was only 16% when the case was heard by an older judge but 45% when heard by a younger judge. The probability that the decision would favor the plaintiff was only 18% when the case was heard by a judge who had been appointed by a Republican president but 46% when the judge had been appointed by a Democrat president.     

A fatal case of oleandrin poisoning

The study presents a case of fatal poisoning with oleander leaves in an adult diabetic male. After repeated vomiting, and gastrointestinal distress the patient was admitted at the hospital with cardiac symptoms 1h after the ingestion. Urine samples were assayed immunochemically and by GC-MS for drugs of abuse and for general toxicological screen. Blood was analyzed for alcohol and volatiles by static head space GC-MS. Blood and oleander leaves were analyzed by LC-MS/MS for oleandrin and related compounds, the main cardiac glycosides of Nerium oleander. Oleandrin was detected by LC-MS/MS in the blood sample at a concentration of approximately 10 ng/ml. Another cardiac glycoside with pseudo-molecular ion of m/z 577, a likely structural isomer of oleandrin, was also detected in the blood and oleander leaves. However, by using the response as a function of concentration for oleandrin, this cardiac glycoside was roughly estimated at a concentration of approximately 10 ng/ml in the deceased blood. This would give a total fatal blood concentration of cardiac glycosides of about approximately 20 ng/ml in the deceased blood.     

Murder and robbery by vehicular impact: true vehicular homicide

True vehicular homicides are defined as those occurrences in which a motor vehicle is intentionally used as a weapon in taking of a life. A case is presented in which the deceased was traveling in the front passenger seat of a motor car that was deliberately rammed by a heavy jeep that came in the opposite direction, resulting in a serious frontal collision. Immediately after the impact, while the occupants of the car were lying in a dazed condition, the two persons riding in the jeep escaped with a bag containing money that was in the car, leaving the jeep behind. The impact mainly involved the driver's sides of both vehicles. The driver of the car sustained serious injuries but was found to be alive, whereas the front-seat passenger, who did not show any serious external injuries, was found to be in a collapsed state and was pronounced dead on admission to the hospital within 30 minutes of the accident. The autopsy revealed that death was caused by closed hemopericardium from a ruptured right atrium. The evaluation of the external and internal injuries confirmed that the fatal injury and a few serious internal injuries were caused by the seat belt (tertiary-impact injuries). The ruptured right atrium was attributed to blunt abdominal trauma by impacting against the lap belt. The case was a true vehicular homicide in which a motor vehicle had been used as a weapon to kill a person. Various aspects pertaining to road accidents, the safety of the occupants, and the advantage and disadvantage of the safety devices are discussed.     

Dual examinations for identification of urine as being of human origin and for DNA-typing from small stains of human urine

Concurrent methods for identification of urine as being of human origin, and for DNA-typing from small stains of human urine were examined. A urine stain was extracted with phosphate-buffered saline (PBS), and the extract was filtered using a Centricon-100 device. The filtrate was subjected to electrospray ionization liquid chromatography-mass spectrometry (ESI-LC-MS) for identification of human urine and a DNA-typing sample was obtained by dialfiltration of the residue using a DNA purification kit. After the purified residue was treated with an AmpflSTR Profiler PCR amplification kit, the DNA-types were analyzed by capillary electrophoresis using a Genetic Analyzer. It was possible to identify a urine stain as being of human origin, and complete DNA profiles could be successfully obtained from a urine stain which had been created by 50 microL of female urine. Serial analyses of urine stains found at a crime scene provide effective information for forensic investigation. This method is recommended for stain identification and for DNA-typing from a urine stain.     

Risk factors for sexual victimization among male and female homeless and runaway youth

Risk factors associated with the likelihood of being sexually victimized by a stranger or friend/acquaintance since being on the street was examined among 372 homeless and runaway youth. Young people were interviewed on the streets and in shelters by outreach workers using a systematic sampling strategy. Youth who engaged in more high-risk behaviors were expected to be at greater risk for sexual victimization by both known and unknown assailants. Results indicated that for females, running from home for the first time at an earlier age was associated with sexual victimization by both a stranger and friend/acquaintance. However, engaging in deviant subsistence strategies, survival sex, and grooming predicted being sexually victimized by a friend/acquaintance. For males, survival sex and grooming predicted stranger sexual victimization, whereas sexual orientation was associated with sexual victimization by a friend/acquaintance. Overall, 35% of the sample had been sexually victimized.     

扫描电子显微镜/能谱法对铊盐的检验

目的建立投毒案件中铊元素的一种快速定性检验方法。方法：在扫描电子显微镜下用背散射电子探头（BSE）观察处理后的样品,观察图像中根据元素衬度差异挑选出可能含铊元素的区域,用能谱仪做该区域的元素定性检验。结果能谱分析仪可以很快对各种元素做出准确的定性检验。结论扫描电子显微镜/能谱法对疑似铊中毒案的检验快速、灵敏、准确。     

A newly designed apparatus for testing blood levels of fuel vapor

An apparatus for exposure of laboratory animals to fuel vapor was designed, manufactured and set up for routine experiments. Gasoline was vaporized by warming and was introduced into a series of chambers in which the concentration was regulated and stabilized, using air pumps. Concentration of the vapor in a chamber was controlled and experiments on rats showed a positive correlation between blood levels and vapor concentration at the time of exposure. A case of suicide by gasoline poisoning was briefly described.     

Motorcyclists’ fatalities in multiple crashes: Who is responsible for death? (three cases)

In Italy in 2007, 26% of two-wheeled motor vehicle injury/fatalities concerned motorcyclists. However, it is rare (4%) that a motorcycle (MC) crashes with two other road users and even more exceptional is a crash between a MC and three other vehicles. In general, in MC–vehicle crashes, the vehicle driver is at fault in more than 50% of the cases and the motorcyclist in 37%. The study concerns three MC lethal road accidents in which the culpability of the motorcyclist's death was questioned by the prosecutor because it was supposed that one or more vehicles ran over the motorcyclist after a fall. The crucial question in these three cases was if it was possible to assign injuries to a specific crash-aetiology and to assign/exclude the responsibility of motorcyclist's death to a defined subject (motorcyclist himself and/or car drivers) after a crash-dynamics study made by an engineer consultant or by the police authority. Case (1) A 56-year-old motorcyclist on a highway had a front–rear end collision with a car that suddenly stopped; he was therefore projected against a concrete traffic island, thrown on the soil and run over by another car. Case (2) A 29-year-old motorcyclist on the East ring road fell on the soil, perhaps by a supposed front–rear end contact with a car and was run over by two cars in rapid succession. Case (3) A 34-year-old motorcyclist on the North ring road fell suddenly on the soil for unknown reasons; during first aid, the medical team around him was run over by the ambulance which pushed after a rear-end collision with a car. A stepwise analysis of the indicated crash dynamics and an evaluation of all the injuries revealed at autopsy, the study proposed, when possible, injury aetiology for each case and the related responsibility assignments and exclusions.     

三甲基硫赶磷酸酯在甲胺磷农药中毒检验中的作用

目的探讨三甲基硫赶磷酸酯在甲胺磷农药中毒检验中的作用。方法利用气-质联用仪器(GC-MS)分析了甲胺磷中毒者的检材(血,胃内容物)。结果检出了O,O,S三甲基硫赶磷酸酯,却未检出甲胺磷。结论研究了这一现象的原因和确定了O,O,S三甲基硫赶磷酸酯(O,O,S-TMTP)可作为甲胺磷中毒的佐证物。     

GC—MS／MS法检验生物检材中的无机氰化物

目的建立一种检验生物检材中无机氰化物的GCMS／MS方法。方法首先将生物检材中的无机氰化物在酸性条件下蒸馏出,用碱性溶液吸收后,氰离子在相转移催化剂作用下被五氟苄基溴（PFB-Br）衍生化,最后用GC-MS／MS法分析衍生化产物。结果衍生化产物PFB-CN的MS／MS质谱图特征性强,定性准确;在20-1500ng／g浓度范围内呈良好的线性关系（r＝0．998）,最低检测限为5ng／g,回收率为82．3％－98．6％。结论本方法简单实用,灵敏度高,准确可靠,适用于生物检材中无机氰化物的检验。     

Testing for alpha-chloralose by headspace-GC/MS. A case report.

A case is presented involving an acute fatality resulting from self-administered alpha-chloralose, a rodenticide. A 18-year-old man was found dead at home, with several stains of vomit on the carpet. An empty box of three bags of 5 g 100% alpha-chloralose (Corbeaux nuisibles, Rh?ne Poulenc) was found near the body. The compound was identified and quantified by headspace gas chromatography coupled to mass spectrometry. Alpha-chloralose was converted by concentrated sulphuric acid into chloral, a volatile compound, that was, after chromatography on a HP5-MS capillary column, identified by the following ions, m/z 82, 111 and 148. Peripheral blood concentration was 175.7 mg/l. Alpha-chloralose was quantified in several tissues, indicating kidney sequestration. No other drugs, including ethanol, were detected.