Homicidal hanging in a dyadic death

Homicide by hanging is rare. In this case report, a young man stabbed his wife, hanged his son, and then hanged himself. He was assumed to be mentally ill, consistent with some other studies of family murder-suicide.     

Homicidal drowning

A study of homicidal drownings was performed on the case files of the Office of the Medical Examiner of Metropolitan Dade County in Miami, Florida during the years 1980-1984. A total of 10 cases were analyzed of those which occurred during this time period. These cases are presented in some detail. A discussion then ensues concerning the theoretical and epidemiological implications along with practical considerations of how to approach such a case.     

Homicidal asphyxia

Homicides due to asphyxia are relatively uncommon. To better understand the presentation of such cases, the files of the Bexar County Medical Examiner's Office were reviewed from January 1, 1985, through December 31, 1998, for all such homicides. A total of 133 cases were found. The largest category was ligature strangulation with 48 deaths (21 male, 27 female). Petechiae were present in the conjunctivae and/or sclerae in 86% of the cases; fractures of the hyoid and/or thyroid cartilage were present in 12.5%. There were a total of 41 deaths from manual strangulation (27 female, 14 male). Petechiae were present in 89% of the cases. In cases of manual strangulation, fractures of the hyoid, thyroid, or cricoid cartilage were found in all the male victims and slightly more than one half of the female victims. Twenty-six cases of suffocation were found; 20 of the victims were < or =2 years of age. Only 1 of these children had petechiae and/or scleral hemorrhage. Five deaths were due to choking. Three of the deaths involved adults who were gagged; 2 deaths involved infants with foreign material pushed into the mouth. Other categories of asphyxia were as follows: 9 deaths due to more than one form of asphyxia; 1 death due to hanging, and 3 deaths due to drowning. Rape was the motive in 66% of the female victims of ligature strangulation and 52% of those due to manual strangulation.     

Homicidal Paraquat Poisoning

Paraquat poisoning usually results from suicide, occupational, or accidental exposure. Herein, we report a rare fatal case of homicidal paraquat poisoning. A 58‐year‐old man was poisoned by taking paraquat‐mixed medicine and wearing paraquat‐soaked underwear. In the absence of a history of paraquat exposure, the patient was misdiagnosed with pulmonary infection and scrotal dermatitis and died of respiratory failure 24 days after the initial exposure to paraquat. Ultra‐performance liquid chromatography‐tandem mass spectrometry (UPLC‐MS/MS) was applied to detect and quantify paraquat in postmortem specimens. The concentration of paraquat in postmortem specimens from high to low is lung (0.49 μg/g), brain (0.32 μg/g), kidney (0.24 μg/g), liver (0.20 μg/g), cardiac blood (0.11 μg/mL), and stomach wall (<LOQ). Identification of homicidal paraquat poisoning is not easy for a clinician or a forensic pathologist, it is important to consider the possibility of paraquat poisoning when patients suffer from rapidly aggravating pneumonia of unknown origin.     

Homicidal behavior in schizophrenics

This paper emphasizes that homicidal behavior may be part of the clinical manifestation of schizophrenia. The failure to hospitalize potentially violent schizophrenics contributes to the incidence of psychotic homicide. The tendency to diagnose homicidal schizophrenics as personality disorders combined with legal changes brought about a shift of this population from the mental health system to the criminal justice system.     

Homicidal asphyxia by pepper aspiration

As punishment for lying, the foster mother of a five-year-old white male poured pepper into his throat. He immediately became dyspneic, then apneic, and was pronounced dead about 1 h later. At autopsy, the main stem and several smaller bronchi were occluded with pepper. Mechanisms of asphyxia by pepper include mechanical obstruction of the tracheobronchial tree and mucosal edema caused by the irritant effect of volatile oils in pepper. This rare circumstance represents the second reported fatal case of pepper aspiration and the third reported case overall.     

Homicidal cerebral artery aneurysm rupture

When a normally natural mechanism of death is induced by physical injury or intense emotional stress, it is appropriate to rule the manner of death as something other than natural. When the case-specific circumstances are such that the death occurs as a result of the criminal activity of another person, it is acceptable to rule such deaths as homicides. Presented herein is a case of homicidal cerebral artery aneurysm rupture occuring in an intoxicated, 46-year-old man who was punched in the face by another individual. The details of the case are presented, followed by a discussion of the controversies that exist when dealing with such cases. Guidelines for investigating similar deaths are presented, with emphasis on the timing of the trauma in relation to onset of symptoms due to aneurysm rupture.     

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.     

Homicidal Snake Bite in Children

Snake bites are common in many regions of the world. Snake envenomation is relatively uncommon in Egypt; such unfortunate events usually attract much publicity. Snake bite is almost only accidental, occurring in urban areas and desert. Few cases were reported to commit suicide by snake. Homicidal snake poisoning is so rare. It was known in ancient world by executing capital punishment by throwing the victim into a pit full of snakes. Another way was to ask the victim to put his hand inside a small basket harboring a deadly snake. Killing a victim by direct snake bite is so rare. There was one reported case where an old couple was killed by snake bite. Here is the first reported case of killing three children by snake bite. It appeared that the diagnosis of such cases is so difficult and depended mainly on the circumstantial evidences.     

Homicidal commotio cordis in two children

This paper's objective is to describe two cases of fatal commotio cordis resulting from the deliberate striking of children's chests by adults with their fists. These deaths involve two male children, ages 3 years and 14 months. The clinical histories, events in the households prior to the deaths, behaviors of the children, autopsy findings, and investigation results are all similar. In both cases, fatal blows were delivered to the anterior chest with a closed fist. Both children collapsed immediately, unable to be resuscitated. Confessions were obtained in both cases by investigators soon after the children's deaths. Autopsies showed chest contusions in only one child, presumably due to knuckle impact. The cardiac rhythms noted by paramedics were ventricular fibrillation and asystole. Due to the lack of physical findings, an immediate and thorough investigation is critical. An accurate history of events preceding death must be obtained.     

Homicidal alcoholic intoxation versus manual neck compression

A case of homicide involving a 49-year-old man is reported. In the course of a booze-up he was forced to excessive consumption of alcohol and was pushed back into a sofa by repeated grasping his neck which finally left him dead. The postmortem examination revealed a small abrasion in the right mandibular region, a contusion of the subcutaneous tissue above the left clavicle, a haemorrhage in the deep muscles of the neck at the right side of the cervical spine, a fatty tissue haemorrhage between the left cornus of hyoid and thyroid cartilage as well as petechiae of the eyelids and conjunctivae. The blood alcohol concentration amounted to 4.00@1000, the urine alcohol concentration to 5.26@1000. Thus, a manual strangulation of the neck versus a lethal alcohol intoxication had to be taken into consideration as cause of death. The morphological findings of the postmortem examination and the pathophysiological concepts of the underlying mechanisms of death in manual strangulation versus lethal alcohol intoxication are discussed with regard to their significance for the juridical assessment.     

Homicidal intoxications by lye- and parachlorcresol-containing disinfectants

In a nursing section for 54 senile, demented inpatients for the period of 3 months, a casual worker committed homicide in 11 cases and attempted homicide in 16 cases by peroral application of lye- and parachlorcresol-containing disinfectants. Autopsies had been performed in nearly all of the fatal cases without detection of the true causes of death. The fatal intoxications could be verified through reexamination of the lung slides and through gas chromatography/mass spectrometry of the formalin-fixed tissue specimens.     

Homicidal electrocution disguised as an accidental death

Deaths due to electrocution are mostly accidental. Homicide by electrocution is rarely reported in the literature. However, the location and pattern of the electrocution wound can raise concern for a possible homicidal manner of death. We are reporting an unusual case wherein the dead body of a middle-aged man was found lying in a suspicious condition on the roadside of desolated area. There were circumferential, grooved electrocution lesions over the left and right second toes with oval electrocution lesions on the medial aspects of both the left and right third toes. There were split lacerations over the right high parietal region, right pinna, and forehead. There was avulsion of the nail of the left thumb. Pressure abrasion was consistent with a ligature mark on the lower part of the left leg. The locations and pattern of these injuries raised the possibility of torture infliction. Death was attributed to electrocution, which was confirmed by histopathology. Autopsy findings and possible inferences were furnished to the police. This case highlights the careful observation of different characterizations and locations of the wounds and deducing inferences about the possible manner of death. This information can be useful to investigating agencies.     

Homicidal Ideation and Individuals on the Autism Spectrum

Interest in the relationship between autism and violence has increased in recent years; however, no link has clearly been established between them. Researchers remain curious if autistic people with certain traits (e.g., a history of trauma) are at greater risk of violence than those individuals with autism alone. In this article, we detail two individuals with homicidal ideation (HI) admitted to inpatient psychiatric units who were found to have a diagnosis of autism without language impairment. These cases illustrate the need for mental health providers to consider autism in their differential diagnosis when evaluating an individual with HI. Broadly, we consider how an autistic individual could be susceptible to developing HI and explore treatments specific to autistic individuals that may be helpful in such cases.     

胃肠外途径投毒的法医学鉴定

本文报告１３例胃肠外途径投毒的法医学鉴定，其中升汞２例（Ｉ．Ｖ．），水银１例（Ｉ．Ｖ．），氰化钾２例（Ｉ．Ｍ．和乳房下注射各１）、氰化钠１例（Ｉ．Ｖ．）、一氧化碳２例（吸入）、铬酸酐１例（阴道内塞入）、敌敌畏１例（心包腔内注射）、矮壮素１例（Ｉ．Ｍ．）、氯丙嗪１例（Ｉ．Ｖ．）和溴氰菊酯１例（Ｉ．Ｖ．）。说明经胃肠外途径引起的投毒案例并不罕见，且毒物种类增多，这在法医病理和毒理工作中应引起注意和警惕。     

Homicidal manual strangulation and multiple stun-gun injuries.

Stun guns are electric shock devices that are used by a number of law enforcement agencies to subdue violent offenders, but sometimes are discharged into human bodies as offensive weapons. We autopsied a 22-year-old woman who was strangled and had many stun-gun injuries on her head, chest, abdomen, arms, and legs. The stun-gun injuries consisted of many pairs of round erythemas with or without central paleness, some of which were accompanied by circumferential abrasions. To determine whether the electric shocks were administered before or after her death, we studied stun-gun injuries on pigs before and after death and found that the shocks after death did not mark the animal skin. Based on this experiment, all of the stun-gun injuries on the victim's body were concluded to have been inflicted before her death.     

519例他杀刺创的回顾性研究

本文对５１９例他杀刺创致死的案例进行了回顾性研究．结果显示死者的年龄在１６至３０岁较为突出；１—２处刺创的死者与多于１０处者在杀人动机、现场位置、罪犯与死者关系、致死手段以及血液乙醇检出率等方面存在差异；死于急性失血性休克的５１３例中，４６７例（９０％）检见左心室内膜下出血斑．