Methadone‐Related Deaths – Epidemiological,Pathohistological, and Toxicological Traits in 10‐year Retrospective Study in Vojvodina,Serbia

The number of methadone‐related deaths (MRDs) during a 10‐year period (2002–2011) in the region of Vojvodina, Serbia, was increased. The cases were evaluated according to epidemiological parameters, pathohistological findings, and toxicological screening. The majority of victims were men, aged from 20 to 38. Pathohistologically, the signs of acute focal myocardial damage were present in the heart of victims with drug abuse history shorter than 2 years, while both signs of recent and chronic focal myocardial damage were developed among victims with longer drug abuse history (2–5 years). In postmortem blood samples of 54.84% of victims, methadone was detected in combination with diazepam, both in therapeutic range. Alcohol was absent in most cases. Other detected drugs were antipsychotics and antidepressants in therapeutic concentrations. These findings raise the attention to the concomitant use of methadone and benzodiazepines with the need for further studies to clarify the mechanism of death in such cases.     

Firearm Deaths by Law Enforcement

Abstract:  The use of deadly force during law enforcement is a matter that compels public scrutiny. There were 42 gunshot deaths caused by police over a 4-year period in New York City. The decedents' average age was 31 years and ranged from 17 to 64 years. There were 41 males and one female; and 26 Black, nine Hispanic, and seven White decedents. Ethanol and/or drugs of abuse were detected in 78% (31/40) of the decedents. The vast majority of shootings occurred with the police responding to a crime and 90% of the decedents were armed (26 handguns, six knives, one axe, one metal pipe, and one toy gun). Vehicles were used as weapons in two incidents. A total of 177 bullets struck the 42 decedents. Fourteen decedents sustained single gunshot wounds (GSWs), and the remainder had multiple GSWs ranging from 2 to 21. In the majority of the cases in this study, the number of GSWs of the body was three or fewer. Thirteen decedents had at least one GSW of the back or buttocks, accounting for 25 of the total 177 wounds, and four of the 13 had GSWs of only the back. With the exception of the upper extremities, GSWs of all locations were more likely to penetrate than perforate. Although these deaths may be high profile, the certification is typically straightforward and the cause (i.e., GSW) and manner of death (homicide) are readily apparent. Although police shootings in which the decedent was unarmed and/or sustained numerous GSWs are widely reported by the lay press, these types of shootings were not typical in our study.     

Self‐inflicted Firearm Discharge from Heating Using a Gas Burner

A male in his 70s was found lying dead in the living room of his house. A gunshot entrance wound was observed in the left orbit, with a lead slug and wadding left in the skull, which exhibited fatal cranio‐cerebral trauma. A cartridge had been discharged from a handmade launcher, or zip gun, that had been fixed to a spare gun barrel on a pipe chair, by heating the launcher from the side using a gas burner. The deceased had owned guns for hunting in the past and had returned the license, but he had retained a spare barrel and live cartridges at home. In this unique case of suicide, a zip gun was discharged by heating with a gas burner.     

Trends in Officer‐involved Firearm Deaths in Oklahoma from 2000 to 2015

The purpose of this study was to collect data and disseminate trends in officer‐involved firearm deaths in Oklahoma from 2000 to 2015. The Oklahoma Office of the Chief Medical Examiner (OCME) database was searched for civilian decedents with gunshot wounds inflicted by law enforcement officers and officer decedents with gunshot wounds inflicted by civilians. Five decedents were law enforcement officers, while 274 decedents were civilians. The number of civilian decedents throughout the study followed a quadratic trend. Civilian decedents were most commonly males (95%) between the ages of 20 and 39 (64%), had one or two gunshot wounds (46%), and had an increasing number of gunshot wounds over time. Postmortem toxicology testing most commonly detected ethanol, methamphetamine, cocaine, and PCP. Efforts toward increased tracking by various agencies and more scientific studies like this are needed to facilitate future analysis of trends in officer‐involved firearm deaths.     

Lightning Deaths: A Retrospective Review of New Mexico's Cases, 1977–2009

To better understand lightning deaths, a retrospective review of electronic records from New Mexico's Office of the Medical Investigator database was performed between 1977 and 2009 to update and assess current risk factors. Information on demographics, circumstances, autopsy, and death certificates were collected and analyzed. Fifty‐four decedents were identified, ages 2–71 years old (mean 34 years old), 42 males and 12 females. Common racial/ethnic groups were non‐Hispanic Whites and American Indians (together comprising 72% of all cases). Physical findings were often related to the heat carried by the electrical current including clothing alterations (29.6%) and burning of skin (53.7%). Most deaths occurred on weekend afternoons in summer months, associated with recreational activities or agricultural work, and rural locations (77.8%). Utilizing the demographic information, clustered events, and associated outdoor activities will assist in creating public awareness and provide a framework to support targeted warnings in an attempt to prevent future deaths.     

Deaths Related to Tractor Accidents in Eskişehir,Turkey: A 25‐Year Analysis

This study aimed to analyze deaths related to tractor accidents in Eski?ehir Province and characteristics of these cases to provide data and suggestions along with the literature. The cases involved individuals died due to tractor‐related accidents were retrospectively examined between 1992 and 2016 (25‐year period). Demographic data related to the cases and crime scenes, characteristics of events, and autopsy findings were evaluated. In the 25‐year period, 61 individuals (88.5% males, average age: 48.7 years) died due to tractor accidents in Eski?ehir Province, and approximately 45.9% of these accidents most commonly involved tractor rollover. Deaths due to tractor accidents will be decreased by raising awareness among tractor drivers, preventing young individuals from driving tractors, not allowing individuals to drive without license, making mechanical and physical features of tractors suitable for agricultural activity to be performed, ensuring their safety for travel and use, and avoiding carrying passengers on tractors.     

Fatal Firearm Injuries in Tennessee: A Comparison Study of Tennessee's Two Most Populous Counties 2009–2012

Firearm injuries are a leading cause of violent death in Tennessee. This study was designed to compare the demographic and epidemiologic features of fatal firearm injuries in Shelby County and Davidson County, Tennessee between 2009 and 2012. We identified 1081 gunshot fatalities for the study period in these two counties. Shelby County had a higher overall, age‐adjusted gunshot mortality rate, a higher male age‐adjusted gunshot mortality rate, and a higher age‐adjusted gunshot homicide rate than Davidson. Age groups 25–34 years and 35–44 years had higher crude mortality rates for gunshot deaths in Shelby County than Davidson County. Both counties had higher age‐adjusted gunshot mortality rates for black males than white males, higher homicide rate for black race than white, and higher suicide rate for white race than black. Homicide was the most common manner of death, and handguns were the most common type of firearm used in both counties.     

Evaluation of Non‐Natural Deaths among Veterans: New Mexico Medical Examiner‐Investigated Deaths, 2002–2011

While it is recognized that veterans have increased rates of depression, post‐traumatic stress disorder (PTSD), suicide, and substance use disorders, rates of homicide and unintentional injury deaths in veterans have been minimally investigated. We evaluated all non‐natural deaths in New Mexico veterans between 2002 and 2011 in comparison with non‐natural deaths among non‐veterans. We reviewed all decedents in New Mexico with a history of military service and investigated by the medical examiner, excluding natural deaths and deaths due to fall from standing height. The most common manner of death was unintentional injury (62%), most of these deaths due to motor vehicle accidents (29%) followed by unintentional overdose (26%). Suicide rates among veterans were consistently higher than the general population. The most common mechanism of suicide in men was gunshot wound (72%), and intentional overdose in women (49%). Services are needed for veterans that are tailored to all ages and both sexes.     

Elevator-Related Deaths

Elevators are mechanical transportation devices used to move vertically between different levels of a building. When first developed, elevators lacked the safety features. When safety mechanisms were developed, elevators became a common feature of multistory buildings. Despite their well-regarded safety record, elevators are not without the potential for danger of injury or death. Persons at-risk for elevator-related death include maintenance and construction workers, other employees, and those who are prone to risky behavior. Deaths may be related to asphyxia, blunt force, avulsion injuries, and various forms of environmental trauma. In this review, we report on 48 elevator-related deaths that occurred in nine different medicolegal death investigation jurisdictions within the United States over an approximately 30-year period. The data represents a cross-section of the different types of elevator-related deaths that may be encountered. The review also presents an overview of preventive strategies for the purpose of avoiding future elevator-related fatalities.     

Touch DNA Collection Versus Firearm Fingerprinting: Comparing Evidence Production and Identification Outcomes

A project by a metropolitan police agency in 2008–2009 had police use touch DNA kits to collect cell samples from seized firearms. To assess outcomes, results of touch DNA swabbing of firearms were compared to fingerprinting firearm evidence. The rationale was that fingerprinting, as the older technology, was the baseline against which to compare touch DNA. But little is known about ways to measure touch DNA productivity compared to fingerprinting. To examine differences between the two requires comparable measurements. Two measures were used: quantity of probative or investigative evidence produced and identification outcomes. When applied to firearms seized within an Indianapolis, IN police district, touch DNA produced a larger volume of evidence than fingerprinting, but identification outcomes for the two methods were equal. Because touch DNA was deployed by police patrol officers, there are implications for firearm forensics and the choice of forensic approaches used by police.     

Cattle‐Caused Fatalities in a Province of Western Turkey: 1996–2010 Autopsy Results

Cattle‐caused injuries and deaths are much more than predicted. The aim of this research is to determine the prevalence of cattle‐caused fatalities and the factors affecting it in a province of western Turkey. The court files on cattle‐caused fatalities during a 15‐year period between 1996 and 2010 were explored. The proportion of forensic‐qualified deaths from the total of 3753 was 0.9% (35/3753). Most of the cases were between the ages of 18 and 65 (60%). Most deaths occurred in the spring and summer months compared with autumn and winter months (9 and 22 vs. 3 and 1, respectively). The mortality rate was much higher in men compared with women (94.3% and 5.7%, respectively). The majority of deaths were caused by injuries on the chest (71.4%). The reason for most deaths was due to hemopneumothorax and lung injury (71.4%). Predicting the behavior of cattle may not always be possible, as such, it is advisable that one wears protective equipment when dealing with cattle.     

Homicide–Suicide in Cuyahoga County,Ohio, 1991–2016

Research on homicides followed by suicides has relied heavily on small samples and relatively short time spans of data. This study helps to fill this gap by examining 26 years of homicide–suicide data from Cuyahoga County, Ohio, between 1991 and 2016. The main data source for the study is medical examiner files. Analyses of the data indicate the rate of homicide–suicide in Cuyahoga County is consistent with other studies but fluctuates considerably across years studied. The majority of victims are female while perpetrators are overwhelmingly male. Black people are overrepresented as victims and offenders. Use of drugs and/or alcohol leading up to the incident is common among perpetrators. Both the homicides and suicides were overwhelming committed with firearms. When comparing our results to the typology of murder–suicides developed by Marzuk, Tardiff, and Hirsch (JAMA 1992;267:3179), we find amorous jealousy is a significant motivating factor in a many cases, including those involving nonintimate partners. Our findings underscore the importance of widespread use of lethality assessment instruments.     

Development and Validation of a Virtual Examination Tool for Firearm Forensics, ,

The transition from 2D imaging to 3D scanning in the discipline of firearms and toolmark analysis is likely to provide examiners an unprecedented view of microscopic surface topography. The digital examination of measured 3D surface topographies has been referred to as virtual microscopy (VM). The approach offers several potential advantages over traditional comparison microscopy. Like any new analytic method, VM must be validated prior to its use in a crime laboratory. This paper describes one of the first validation studies of virtual microscopy. Fifty‐six participants at fifteen laboratories used virtual microscopic tools to complete two proficiency‐style tests for cartridge case identification. All participating trained examiners correctly reported 100% of the identifications (known matches) while reporting no false positives. The VM tools also allowed examiners to annotate compared surfaces. These annotations provide insight into the types of marked utilized in comparative analysis. Overall, the results of the study demonstrate that trained examiners can successfully use virtual microscopy to conduct firearms toolmark examination and support the use of the technology in the crime laboratory.     

Recent Firing Range Suicides in South Australia

Abstract: Two cases are reported from South Australia, where deaths occurred that were due to single self‐inflicted gunshot wounds to the head in individuals who were visiting indoor firearm ranges. Case 1: A 54‐year‐old man visiting an indoor firing range placed a .357 magnum handgun to his head and fired one shot. Case 2: A 23‐year‐old woman who was being instructed in firearm usage at an indoor firing range placed a 9 mm handgun to her head and fired one shot. In both cases, deaths were due to cerebral laceration with skull fracture. Firing ranges may be utilized by individuals who are seeking weapons for suicide attempts, and suicide may be successfully undertaken at such locations even while a victim is under direct supervision. In jurisdictions, where firearm ownership is strictly legislated, it may be that clubs can inadvertently provide access to firearms for this type of activity.     

Determined to Die! Ability to Act Following Multiple Self‐inflicted Gunshot Wounds to the Head. The Cook County Office of Medical Examiner Experience (2005–2012) and Review of Literature

Cases of multiple (considered 2+) self‐inflicted gunshot wounds are a rarity and require careful examination of the scene of occurrence; thorough consideration of the decedent's psychiatric, medical, and social histories; and accurate postmortem documentation of the gunshot wounds. We present a series of four cases of multiple self‐inflicted gunshot wounds to the head from the Cook County Medical Examiner's Office between 2005 and 2012 including the first case report of suicide involving eight gunshot wounds to the head. In addition, a review of the literature concerning multiple self‐inflicted gunshot wounds to the head is performed. The majority of reported cases document two gunshot entrance wound defects. Temporal regions are the most common affected regions (especially the right and left temples). Determining the capability to act following a gunshot wound to the head is necessary in crime scene reconstruction and in differentiation between homicide and suicide.     

Automatic Comparison and Evaluation of Impressions Left by a Firearm on Fired Cartridge Cases

Recent years have been characterized by a series of publications in the field of firearms investigation questioning the reliability and objectivity of such examination. This research investigates new solutions to decrease the subjective component affecting the evaluation that follows the comparison of impressions left by a firearm on the surface of spent cartridge cases. An automatic comparison system based on 3D measurements has been developed and coupled to a bivariate evaluative model allowing assigning likelihood ratios. Based on a dataset of 79 pistols (all SIG Sauer 9 mm Luger caliber), the system shows a very high discriminating power and the LRs that it provides are very indicative of the true state under both the prosecution and the defense propositions. For example, likelihood ratios exceeding a billion are predominantly obtained when impressions originating from the same source are compared. The system is also characterized by relatively low rates (≤1%) of misleading evidence depending on the firearm considered.     

A Comparison of Hypothermic Deaths in South Australia and Sweden

Case files from Forensic Science South Australia and the Swedish National Forensic Database were reviewed over a 6‐year period from 2006 to 2011 for cases where hypothermia either caused, or significantly contributed to, death. Data were analyzed for age, sex, time of year/season, place of discovery, circumstances of death, and underlying medical conditions. Despite the considerable demographic, geographic, and climatological differences, hypothermic deaths occurred at very similar rates in South Australia (3.9/100,000) and Sweden (3.3/100,000). Deaths from hypothermia in South Australia occurred predominantly indoors at home addresses, involving elderly females with multiple underlying illnesses and limited outside contacts. In contrast, Swedish hypothermic deaths generally occurred outdoors and involved middle‐aged elderly males. These data show that hypothermia may be a risk in warmer climates particularly for elderly, socially isolated individuals.