Evaluation of post-mortem estimated dental age versus real age: a retrospective 21-year survey

The aim of the study was to evaluate the reliability of methods used for forensic dental age estimation. We analysed all cases over the last 21 years (1984-2004) of unidentified bodies that were examined for identification purposes (including age assessment), and of which secure identification was subsequently achieved. In total, the study included 51 cases and 7 different methods had been used for dental age estimation, with the Bang/Ramm and the Gustafson/Johanson methods being the most frequently applied. The age estimates had usually been recorded as 10-year intervals. Factual ages at death were in the range of 6-76 years, with the largest concentration of cases being in the age interval of 25-55 years (34 cases). There was good agreement between estimated age interval and factual age at death in 37/51 (72%) of the cases. In eight cases the factual age at death deviated up to +/-5 years from the estimated age, and in six cases by more than 6 years. The average difference between factual age at death and estimated age was 4.5 years. The four subadults in the material were all correctly estimated within an age range of +/-3 years. Our study showed that forensic odontological age estimates are reliable. However, the implementation of the specific methods may need to be adjusted concerning age ranges. In the future we recommend to register anamnestic information and the different steps in the methods used. Clinical evaluation should contain more details about attrition, colour, number and presumed age of the restorations and periodontal status.     

Radiographic age estimation based on degenerative changes of vertebrae

Age estimation is an important component of decedent identification. When assessing adult remains, anthropologists frequently use gross examination of skeletal elements, such as clavicles, ribs, and pubic symphyses. For fleshed bodies, this requires the removal of these elements and maceration prior to analysis. A new method was developed using radiographic imaging to estimate age from degenerative changes of the lower thoracic and upper lumbar vertebrae. This technique will complement anthropological age estimation methods in young and middle-aged adults and may serve as a stand-alone method for older individuals. Digital radiographs from 240 medical examiner cases were evaluated. The sample included 120 females and 120 males between the ages of 18 and 101 years. A 3-phased scoring system was used for the target vertebrae. Transition analysis was conducted on binned average scores and a Bayesian approach was used to assign age intervals. At the 90% credible interval, individuals in Bin 1 were under 36 years of age while those in Bin 3 were over 47 years of age. Individuals in Bin 2 showed too much age variation to be informative. No significant differences were found between males and females. These findings will be especially useful in the age estimation of older adults and may eliminate the need for skeletal sampling in medicolegal cases where advanced degenerative changes are radiographically observed in the lower thoracic and/or upper lumbar vertebrae. This method was developed for use on fleshed individuals but may also be applicable to skeletonized remains.     

一氧化碳中毒血分光光度定量分析法比较

目的比较7种一氧化碳中毒血样分光光度含量测定方法的特点及适用性。方法用空白血添加一氧化碳配制不同浓度的样品,采用双波长法、还原法（3种）、切线法和导数光谱法（2种）进行检测,对各种方法线性范围、重现性和操作中注意事项等内容进行考察,并用实际案件检材验证和比较。结果还原法一在30%~70%、还原法三在20%~100%,其他方法在20%~70%范围内,线性关系良好;样本浓度超过或低于50%,采用切线法有一定误差;导数法及还原法三因需要制备CO饱和样本,操作略微繁琐,但导数光谱法计算结果准确性好。结论几种方法均可用于一氧化碳中毒血的检测,实验结果可为方法的实际应用提供借鉴和帮助。     

Carbon monoxide concentrations in the 2009 Victorian Bushfire disaster victims

Blood was available for the estimation of carboxyhemoglobin saturation (COHb) in 30 of the 173 persons who died in the Victorian bushfires in February 2009. The ages of these 30 deaths ranged from 3 to 80 years and there were 8 females. 13 cases (43%) were considered negative (less than 5% COHb), 12 (40%) were between 5 and 40% COHb, 2 (6.7%) between 40 and 50% and 3 (10%) were greater than 50% COHb. There were 6 persons either found within a building or a car and the COHb in these cases ranged up to 69% (mean 50%). There were 5 cases where the location was unable to be determined as either indoor or outdoor due to the extensive nature of the fire. The remaining 19 deceased persons were all located outside in the open and the concentration of COHb in these cases ranged up to 30% (mean 19%). Hydrogen cyanide was only detected in two deceased persons at concentrations of 0.5 and 2.7 mg/L, respectively. 13 deceased were found to have soot in the airways following necropsy but this did not correlate with the COHb levels.     

Suicide: a ten-year retrospective study

Suicide is a complex phenomenon associated with psychological, biological, and social factors, claiming approximately 30,000 lives each year in the United States. We retrospectively reviewed all cases referred to the Medical Examiners' Office/Forensic Pathology Section at the Medical University of South Carolina from January 1988 to December 1997. The cases of suicide totaled 678. All of the cases were analyzed as to age/race/sex, method of suicide, time of year, and toxicological results. Files were also reviewed to determine if the victim left behind a suicide note. The ages ranged from 12 to 94 years; males comprised 79.5% of the victims, and whites 78.3%. The male to female and white to black ratios were both 3.9:1. The most common methods were gunshot wounds, accounting for 64.6% of the cases. No correlation existed with time of year, and the number of cases was not increased around major holidays. The group of victims 65 years and older and the pediatric group under the age of 18 were also examined separately.     

CHN骨龄在司法鉴定中的应用价值

目的探讨CHN(中国人手腕骨发育标准CHN法)骨龄在司法鉴定中的应用价值,分析影响其准确性的因素及相关问题。方法对522例年龄鉴定者,均选用不同曝光值拍摄两张左手腕部正位X线片,并加照两次斜位片。使用CHN法测评骨龄。结果522例中男性489例,女性33例。男性达CHN骨龄最高值18.4岁者129例,余平均骨龄16.5岁。女性达CHN骨龄最高值17.3岁者14例,余平均骨龄15.7岁。CHN骨龄在16.0岁以上者共388例,占约74.3%。本组资料显示多种因素影响骨龄鉴定的准确性,其中以骨龄片位置及角度的变化等影响最大。结论如能获得高质量的X线片、并能熟练使用CHN法、注意利用位置和角度的变化正确判定骨骺分级,CHN骨龄基本可满足活体年龄鉴定的需要。     

Typing of deoxyribonucleic acid (DNA) extracted from compact bone from human remains.

The application of deoxyribonucleic acid (DNA) typing methods for the potential identification of unknown human remains was investigated. DNA was isolated from compact bone tissue from badly decomposed bodies and from known and unknown human remains, using a decalcification and ion wash procedure. Restriction fragment length polymorphism (RFLP) analysis of variable number of tandem repeats (VNTR) loci yielded results in some cases, but more often the DNA was too degraded to produce RFLP patterns. No RFLP profiles could be obtained from putrefied soft tissues. However, DNA extracted from compact bone tissue of human remains up to eleven years old was successfully amplified using the polymerase chain reaction (PCR) for the VNTR loci D1S80, D17S5, COL2A1, and APO B, as well as the HLA-DQ alpha locus. This is especially significant, since PCR results were obtained from those samples whose DNA had been degraded substantially and had yielded no RFLP patterns. All DNA types determined from the compact bone tissue from decomposed bodies whose identification had been established first by other means (and whose parents or offspring were available for typing) demonstrated mendelian inheritance of the alleles of the loci analyzed. These results suggest that amplification and typing of DNA extracted from compact bone of human remains could be useful in establishing the identity of a person, as well as in excluding possible false identifications.     

An analysis of data curated from 5 years of identifying human remains

An archive of 5 years of cases involving the identification of human remains was curated, collecting information on: The sample type submitted, the number of STR loci yielding interpretable results, the kinship challenge posed, and the outcome for the case. A total of 129 cases of remains ID were investigated using manual DNA extraction and recovery methods with amplification of STR markers using the Power Plex 21 multiplex STR kit from Promega Corp. In 52 cases, blood spots collected by the ME were provided as sample and in 100% of those cases, probabilities of relatedness to the reference samples was ≥99%. In 77 cases, tissue other than blood was provided as a source of DNA. These other samples were grouped categorically into long bones (femur and tibia; 40 cases), skull bones/teeth (11 cases), other bones (16 cases), and tissue (normally adherent to bone) (10 cases). Reference samples provided for cases included alleged parents or child(ren) of the victim (86 cases), alleged full siblings of the victim (38 cases), or alleged second-order relatives (five cases). The overall success rate in confirming the identity of the source of the remains in these cases was 89.2%. Our results demonstrate that a laboratory can be often successful identifying human remains using methods easily implemented in any DNA typing laboratory.     

Findings in fatal cases of poisoning attributed to traditional remedies in South Africa.

An analysis of the Johannesburg forensic database over the years 1991-1995 revealed 206 cases in which a traditional remedy was either stated to be the cause of death or was found to be present in a case of poisoning with an unknown substance. The range of toxins detected was wide, with herbal materials being found in 43% of cases, and pharmaceutical or agri-chemicals in 20% and 33% respectively. Since there are as yet no standard methods for the detection of many herbal remedies or their metabolites, careful analysis, using methods such as HPLC/MS, are mandatory for the correct identification of the true cause in cases of poisoning ascribed to traditional remedies.     

Elderly suicide: a 10-year retrospective study

The suicide rate in the 65-year and older age group has been increasing since 1980. The elderly attempt suicide less often than younger people but are successful more often. The authors retrospectively reviewed all cases referred to the Forensic Pathology Section of the Medical Examiners' Office at the Medical University of South Carolina (Charleston, SC) from January 1988 through December 1997. The cases of suicide in victims 65 years and older totaled 78, accounting for 11.5% of all suicides reviewed. Of these 78 cases, 41% were autopsied and 59% were externally examined. All of the cases were initially analyzed as to age, race, sex, and method of suicide. Files also were reviewed to determine time of year of the suicide, toxicology results, psychiatric history, social history, medical history, and whether a suicide note was left. The ages of these suicide victims ranged from 65 to 94 years; men comprised 85% of the victims, and whites, 94%. The male-to-female and white-to-black ratios were 6:1 and 15: 1, respectively. The average age of the victim was 73 years. Gunshot wound was the most common method of suicide, accounting for 80.7% of the cases. Other methods included overdose (6.4%), hanging (3.8%), fall from height (2.6%), incised wounds (2.6%), drowning (2.6%), and carbon monoxide poisoning (1.3%).     

Pediatric drowning: a 20-year review of autopsied cases: I. Demographic features

Drowning is a significant cause of childhood mortality in the developed world. Males and preschool-aged children are overrepresented in most series of pediatric drowning. To obtain a better understanding of age- and gender-related factors, a retrospective review of autopsy records over a 20-year period (1984-2003) for cases of drowning (exclusive of bathtub drownings) was performed. Sixty-three consecutive cases of drowning were identified in 45 males and 18 females (ratio 2.5; P = 0.0007). The ages ranged from 9 months to 17 years, and most cases occurred in the 0- to 4-year age group (57%). Boys tended to be older than girls (5 years 9 months versus 4 years 4 months; P = 0.2133). Sites of drowning were open water (48%) and pools (44%), with children drowning in open water being significantly older than those drowning in pools (6 years 6 months versus 4 years 6 months; P = 0.0462). Most boys drowned in open water (53%), whereas most girls drowned in pools (50%). Resuscitation was attempted after the drowning episode in 84% of cases, with children aged 4 years or less having significantly higher rates than older children (P = 0.0346). The present study highlights differences in the pattern of drowning according to age and sex and may aid in developing targeted educational and preventative campaigns.     

The Reliability of Facial Recognition of Deceased Persons on Photographs

In humanitarian emergencies, such as the current deceased migrants in the Mediterranean, antemortem documentation needed for identification may be limited. The use of visual identification has been previously reported in cases of mass disasters such as Thai tsunami. This pilot study explores the ability of observers to match unfamiliar faces of living and dead persons and whether facial morphology can be used for identification. A questionnaire was given to 41 students and five professionals in the field of forensic identification with the task to choose whether a facial photograph corresponds to one of the five photographs in a lineup and to identify the most useful features used for recognition. Although the overall recognition score did not significantly differ between professionals and students, the median scores of 78.1% and 80.0%, respectively, were too low to consider this method as a reliable identification method and thus needs to be supported by other means.     

Sex assessment from the carpals bones: discriminant function analysis in a 20th century Spanish sample

Sex assessment is one of the first essential steps in human identification, in both medico-legal cases and bio-archaeological contexts. Fragmentary human remains compromised by different types of inhumation or physical insults may frustrate the use of the traditional sex estimation methods, such as the analysis of the skull and pelvis. Currently, the application of discriminant functions to sex unidentified skeletal remains is steadily increasing. However, several studies have demonstrated that, due to variation in size and patterns of sexual dimorphism, discriminant function equations are population-specific [1,2,5,12,61]. In this study, in order to improve sex assessment from skeletal remains and to establish population-specific discriminant functions, the diagnostic values of the carpal bones were considered. A sample of 100 individuals (50 males and 50 females) of known sex and age was analyzed. They belong to a 20th century identified collection from the Municipal Cemetery of "San José", Granada (Spain) and housed in the Laboratory of Anthropology, Faculty of Medicine, University of Granada (Spain). The age of the individuals ranged between 22 and 85 years. Between four and nine measurements of each carpal bone were performed [41,59]. Discriminant function statistics showed a sex assessment accuracy as high as 97.8%. The results suggest that carpal bones can be used for assessing sex in both forensic and bio-archaeological identification procedures.     

Use of prostate specific antigen in the identification of semen in postmortem cases

Over the past 20 years, the use of prostate specific antigen (PSA) as evidence of the presence of semen in forensic cases has been well established. In this study, we compared a commercially available immunoradiometric assay (IRMA) for the identification of PSA with the identification of spermatozoa in swabs obtained from the vagina of deceased females. There was agreement between the 2 methods in 67 of the 80 cases (84%), including 18 cases where both the PSA was positive and sperm were observed microscopically. The remaining cases had 1 positive result and 1 negative result. We concluded that although there was substantial agreement between the presence of sperm and a positive PSA, there were enough discrepancies between the 2 methods (16%) to justify the use of both methodologies, if possible, to make the determination of sexual activity prior to death.     

Identification of the unidentified deceased: turnaround times, methods, and demographics in Fulton County, Georgia

CONTEXT: Multiple methods may be employed in an attempt to identify deceased individuals who are unidentified when reported to the medical examiner or coroner. The success and turnaround times of various methods differ. OBJECTIVE: To determine the number of deaths initially involving unidentified individuals, their demographics, the methods used and turnaround times for cases in which identification was successful and the portion of cases that remain unidentified for significant periods of time. DESIGN, SETTING, AND PARTICIPANTS: Retrospective case review of all decedents who were initially unidentified when death was reported to the Fulton County Medical Examiner in Atlanta, Georgia, during a 1-year period between May 2003 and May 2004. MAIN OUTCOME MEASURES: Rate per 1000 deaths which involved an unidentified decedent, tabulation of methods used to make identifications, and rate of cases remaining unidentified. RESULTS: Of 2279 deaths reported to the office, 100 were originally unidentified, resulting in a rate of 44 unidentified decedents per 1000 deaths reported. Those who remained unidentified involved 6 cases, resulting in a "cold case" rate of 2.6 per 1000 deaths. Seventy-eight percent were identified within 2 days, and the most common successful methods were visual identification (52%) and fingerprints (31%). Dental (10%), x-ray (4%), and other methods (6%) were least commonly used. Of the 94 persons identified, all identifications occurred within 29 days. DNA procedures were not needed in most cases, and in the few cases where such tests were needed, results were either unavailable or failed to show a match with known samples. CONCLUSIONS: The majority of unidentified deceased individuals were identified within 2 days, with visual verification or fingerprints accounting for about 83% of methods successfully employed. The medical examiner noted a rate of 44 unidentified deceased persons per 1000 death reports, with an ultimate "cold case" (long-term unidentified) rate of about 2.6 cases per 1000 death reports. These data may be useful in developing office policy and procedure regarding the procedural and temporal aspects of investigations centered on achieving identification and making dispositions of unidentified deceased bodies.     

Age Estimation by Amino Acid Racemization in Human Teeth

Abstract: When an unidentified body is found, it is essential to establish the personal identity of the body in addition to investigating the cause of death. Identification is one of the most important functions of forensic dentistry. Fingerprint, dental, and DNA analysis can be used to accurately identify a body. However, if no information is available for identification, age estimation can contribute to the resolution of a case. The authors have been using aspartic acid racemization rates in dentin (D‐aspartic acid/L ‐ aspartic acid : D/L Asp) as an index for age estimation and have obtained satisfactory results. We report five cases of age estimation using the racemization method. In all five cases, estimated ages were accurate within a range ±3 years. We conclude that the racemization method is a reliable and practical method for estimating age.     

Accidental sharp force injury fatalities.

The authors review all accidental sharp force injury deaths investigated at the Southwestern Institute of Forensic Sciences from 1990 to 1999. Twenty-two cases of accidental sharp force injury were identified, accounting for 0.29% of all accidental deaths (9,562) during the 10-year study period. Included in this series are 5 incised wounds, 11 stab wounds, 4 chop wounds, and 2 deaths caused by dog attacks. About half of the cases involved some type of motorized machinery. The victims' ages ranged from 2 years to 71 years, with most deaths occurring in older teenagers and younger adults. Male subjects (17) were involved much more frequently than female subjects (5). In 50% of the cases, ethanol or other drug use was a possible underlying contributing factor in the accident. The cases are briefly reviewed, and the importance of detailed investigation in manner-of-death certification is emphasized.     

Root Morphology and Anatomical Patterns in Forensic Dental Identification: A Comparison of Computer‐Aided Identification with Traditional Forensic Dental Identification*

Abstract: An online forensic dental identification exercise was conducted involving 24 antemortem–postmortem (AM–PM) dental radiograph pairs from actual forensic identification cases. Images had been digitally cropped to remove coronal tooth structure and dental restorations. Volunteer forensic odontologists were passively recruited to compare the AM–PM dental radiographs online and conclude identification status using the guidelines for identification from the American Board of Forensic Odontology. The mean accuracy rate for identification was 86.0% (standard deviation 9.2%). The same radiograph pairs were compared using a digital imaging software algorithm, which generated a normalized coefficient of similarity for each pair. Twenty of the radiograph pairs generated a mean accuracy of 85.0%. Four of the pairs could not be used to generate a coefficient of similarity. Receiver operator curve and area under the curve statistical analysis confirmed good discrimination abilities of both methods (online exercise = 0.978; UT‐ID index = 0.923) and Spearman’s rank correlation coefficient analysis (0.683) indicated good correlation between the results of both methods. Computer‐aided dental identification allows for an objective comparison of AM–PM radiographs and can be a useful tool to support a forensic dental identification conclusion.     

Building faces from dry skulls: are they recognized above chance rates?

Methods of facial approximation have successfully aided the identification of deceased individuals. Successes may be due to either accurate facial approximation techniques or chance. This study aims to determine if any of 16 facial approximations, built using standard techniques, are sufficiently accurate to produce correct identifications of target individuals above chance. Four skulls were approximated using four commonly used methods of facial approximation. The resulting 16 facial approximations were judged by 37 assessors of varying ages. Assessors attempted to identify the target individual of each facial approximation from a face pool of ten photographed faces. Only one facial approximation resulted in true positive identification rates above chance at statistically significant levels. It is concluded that it is rare for facial approximations to be sufficiently accurate to allow identification of a target individual above chance. Since 403 incorrect identifications were made out of 592 identification scenarios, facial approximation should be considered to be a highly inaccurate and unreliable forensic technique. These results suggest that facial approximations are not very useful in excluding individuals to whom skeletal remains may not belong. Evidence from this experiment supports suggestions by others that facial approximation should be used in forensic science when all other methods of identification have failed and only to provide tentative identification.     

Dismemberment and mutilation (2)

31 cases of criminal dismemberment or mutilation were investigated in the period from 1959 to 1987 at the Institute of Forensic Medicine in Hamburg. With regard to all legal autopsies the average frequency was about 1:500. A distinct increase of the number of cases is noticeable within the last years; i.e. 1984 there were 6 victims. Our study enclosed the autopsy findings, the police investigations and the available court records. 12 cases were classified as defensive and 14 cases as offensive dismemberment of bodies; 2 cases of necrophilous dismemberment occurred after stealing the corpse and 3 victims were killed by intravital decapitation or mutilation. The victims were of all ages, but mainly between 20 and 60 years old; 22 of them were female and 9 male. 23 perpetrators could be identified; 18 of them were male and 5 female, most of them were between 30 and 40 years of age. The psychiatric expertises classified 17 of the perpetrators as "normal", 3 as abnormal and 3 as psychotic. Many morphological and criminological details concerning victims, perpetrators, used instruments for killing and dismembering, elimination and identification of the dismembered bodies and some juridical aspects are presented.