Fatal pediatric head injuries caused by short-distance falls.

Physicians disagree on several issues regarding head injury in infants and children, including the potential lethality of a short-distance fall, a lucid interval in an ultimately fatal head injury, and the specificity of retinal hemorrhage for inflicted trauma. There is scant objective evidence to resolve these questions, and more information is needed. The objective of this study was to determine whether there are witnessed or investigated fatal short-distance falls that were concluded to be accidental. The author reviewed the January 1, 1988 through June 30, 1999 United States Consumer Product Safety Commission database for head injury associated with the use of playground equipment. The author obtained and reviewed the primary source data (hospital and emergency medical services' records, law enforcement reports, and coroner or medical examiner records) for all fatalities involving a fall. The results revealed 18 fall-related head injury fatalities in the database. The youngest child was 12 months old, the oldest 13 years. The falls were from 0.6 to 3 meters (2-10 feet). A noncaretaker witnessed 12 of the 18, and 12 had a lucid interval. Four of the six children in whom funduscopic examination was documented in the medical record had bilateral retinal hemorrhage. The author concludes that an infant or child may suffer a fatal head injury from a fall of less than 3 meters (10 feet). The injury may be associated with a lucid interval and bilateral retinal hemorrhage.     

Head injuries from short distance falls.

The problem of evaluating injury in childhood as to causation--accidental, inflicted or other--is compounded by conflicting literature. The child presenting with head injury following a short distance fall should be a source of alarm. Some of the key thoughts in the literature are evaluated with presentation of some additional observations, in an attempt to sort out some apparent conflicts.     

Fatal and non-fatal injuries caused by crossbows

Today in modern times, traumatic injuries caused by crossbows are a rarity. The largest collection of cases so far is presented in this study, consisting of four fatalities (two homicides and two suicides) and two non-fatal injuries (grievous bodily harm and an accident). All the victims were male having an age between 31 and 54. The weapons, which were used, were mainly high-performance precision crossbows with telescopic sights and hunting bolts. The parts of the body involved were the facial/head area in three of the cases and the thorax in three of them. There were either deep or total penetration injuries to the cranium and thorax with the bolt remaining in the wound in four out of six cases. The persons with non-fatal crossbow injuries exhibited comparatively few symptoms, despite the sometimes extensive involvement of the interior of the cranium (cerebrocranial penetration, in one instance). The two cases of suicide favoured the body areas often found with gun-users. The aetiological classification of crossbow injuries may be difficult after the removal of the bolt. The external morphology is strongly dependent on the type of tip used. Multiple-bladed hunting broadheads produce radiating incised wounds, whereas conical field tips produce circular to slitlike defects. Correspondingly, the external injuries can be reminiscent of the effects of a violent attack by sharp force or of a gunshot wound. The possibility, supported by clinical data, that the victim might have the ability to act or even to survive for a period of time, even with penetration of the brain, should be taken into account when the cause of death is being investigated.     

Fatal neck injuries caused by blank cartridges.

We report three cases where fatal neck injuries were caused by blanks from starting pistols. The weapons were loaded with blank cartridges or tear gas cartridges. Neither live ammunition nor any form of projectile was used. All three cases involved a contact discharge. The gas pressure caused by firing the weapons created extensive wound cavities in all three cases. Each victim died from blood loss as a result of ruptured cervical vessels; there were no air embolisms. In one case, a man shot himself eight times with two different starting pistols, and the wounds could be matched to each gun by the muzzle imprint marks on the neck.     

Fatal cranial injuries caused by an electric angle grinder

A case of fatal cranial injuries caused by an angle grinder is reported. The scalp lesions were typical of those produced by a cutting disk in a side-slipping movement. On the cranial vault were two bony losses of substance, one of which was deep enough for intracranial penetration of the disk. Signs of deflection of the disk, identical to those found on the scalp, were observed on the external bony table. Because of the circumstances in which the victim was discovered, in particular the damage to the machine which had a broken handle, and the lack of any indication of homicide or suicide, an accident is the most likely hypothesis.     

Fatal injuries caused by glass fragments. Case reports and autopsy findings

The authors report three cases of fatal domestic accidents by falling through glass doors. Multiple cuts and stabwounds in one of these cases primarily suggested a crime of violence. In contrast the bodies of the two other perished persons showed only unsignificant injuries. Causes of death were aerous embolism (1 case) and mechanical bleeding to death (2 cases). The common morphological signs of these glass injuries are exemplified and preventive measures are discussed.     

Fatal head injuries from firearms. An autopsy study of 270 cases

Autopsy findings in 270 fatal head injuries from firearms are reported, including 243 suicides and 27 homicides. The most frequent weapon used for both groups were shot guns which are easily available in Norway. For suicides the most favored sites were right tempoparietal, frontal, and mouth. Twenty-six percent of the victims from homicides had multiple wounds in their head. Suicide by firearms showed marked male predominance, whereas the sex ratio for homicide was rather equal between the two sexes.     

Fatal falls from a height: two case studies

Two case studies are presented involving fatal falls of adult females from a height. One involved a launch at low speed from a balcony, and one involved a launch at high speed from the top of a cliff. Crime scene evidence obtained on the balcony itself provided a strong indication of homicide, but subsequent investigation showed that the fall was accidental. No crime scene evidence was obtained for the cliff fall since the fall initially appeared to be just another suicide from a popular suicide spot. Subsequent investigations indicated homicide based on measurements of cliff height, horizontal distance to the impact, and available runup distance, plus measurements of possible run, jump, and throw speeds. It was found that a female weighing 61 kg (134 lb) can be thrown at speeds up to 4.85 m/s by a strong male, more than enough to account for the estimated launch speed (4.5 m/s). Given the available 4.0 m runup distance, it was found that women of better than average rather than elite athletic ability can dive at speeds of about 3.5 m/s or jump feet first at speeds of about 4.0 m/s, both being less than the estimated launch speed. The decedent had no athletic ability and landed head first after falling through a height of 29 m.     

Fatal and near-fatal animal bite injuries

Fatal and near-fatal maulings of humans by pit bulls have recently become a topic of major public concern, resulting in the passage of laws in some jurisdictions that make the owner of a pit bull criminally liable for manslaughter if his or her pet causes a human death. The authors recently investigated two cases in which children were fatally injured by pet dogs. In the first case, a 17-day-old girl suffered fatal abdominal injuries when attacked by a pregnant Siberian husky. A 2-year-old girl expired from neck wounds inflicted by a pit bull or a rottweiler or both. Because no expert would testify as to which dog caused the fatal injury, the owner of the animals was not charged under a statute which specified criminality only if a pit bull caused the fatal injury. We also examined a 12-year-old boy who attempted to pet a circus tiger; the animal grabbed his arm with its claws and bit off the arm at the shoulder. The arm could not be reattached, but the child survived. These cases and the differentiation of animal bites from other injuries will be presented.     

Fatal hunting injuries in North Rhine-Westphalia

The investigation covers 14 fatal hunting accidents which occurred in North Rhine-Westphalia in the last 23 years, among them 13 firearm fatalities. All the accidents happened during the statutory hunting season reaching a peak in the main small game season. 86% of the persons causing the accidents and 73% of the victims were over 41 years and experienced hunters. 36% of the accidents were caused by the victims themselves. The fatal gunshot injuries were inflicted by rifle bullets in 7 cases (54%) and shotgun pellets in six cases (46%). No accidents were due to shotgun slugs or handgun ammunition. The main factors responsible for the fatalities were: covering the victim while swinging on the game (31%), failure to discharge the firearm while descending from the raised hide or transporting the weapon in vehicles (31%), mistaking the victim for game (15%), failure to discharge the weapon during a hunting break or while pressing down obstacles or careless handling of the weapon (23%). In no case was the accident caused by a defective weapon or ammunition. In conclusion aspects of preventing fatal hunting accidents are discussed.     

多人伤法医学检验的探讨

在法医学活体或尸体检验实践中,由多人(有二人或二人以上致伤者)对同一人体所造成的损伤(简称为多人伤),评定其严重程度或进行死因分析,可能存在争议.     

Fatal falls from heights in and around Diyarbakir, Turkey

Falls from high places, such as from a building, are frequently encountered in suicides, in some accidents, and sometimes in homicides. In this study, we evaluated the demographic data, mortality rates, fall causes, and post-mortem findings of individuals who fell from heights. Our cases were collected retrospectively from the files of the Branch of the Council of Forensic Medicine in Diyarbakir between 1996 and 2001. There were 431 accidental and 53 suicidal deaths due to blunt injury resulting from falls. Of the victims, 188 were female and 296 were male. The average age of the 484 victims was 27.05 years (range: 4 months-100 years). For buildings, the height ranged from 3 to 8 stories for suicides and from 1 to 8 stories for accidents. We proceeded to analyse the characteristics of accidental falls as follows. The majority of falls were from balconies or rooftops due to the tendency of people to sit and sleep on these places during the hotter months of the year. Some 54.5% of all falls occurred in May-August. The 53 suicidal jumps all occurred off buildings. The victims ranged in age from 15 to 70 years, and comprised 29 women and 24 men. One of the deceased jumped from the roof of a school in which he was boarding, and another from the seventh story of a hospital in which he was receiving treatment. The remaining 51 jumped from heights ranging from 3 to 8 stories. Psychiatric illness was reported in 18 (33.9%) of the suicide deaths, while 10 (18.8%) of the 53 suicides were single women. The results of this study were at variance with literature data with respect to the following: falls from heights were most common in the 0-5 year age group, females had a higher suicide rate than males, and the majority of accidental falls occurred at home rather than in the workplace.     

Fatal transfusion reactions caused by donor antibodies to recipient leukocytes

Of three patients who suffered episodes of acute respiratory deterioration following blood transfusion, two died. The cause is believed to have been antibody in the donor plasma directed against recipient leukocytes. Autopsy examination of the lungs and serological study of blood donors established the diagnosis. While these transfusion complications are not rare, unfamiliarity with them leads to incorrect diagnosis.