Pathologic features of suicidal deaths caused by explosives

Suicidal explosions that lack a terrorist background are only rarely encountered in the field of forensic pathology. The investigation of explosion-related fatalities can be a substantial challenge in medicolegal casework. Determining whether the manner of death is suicide, homicide, or accident in such cases can present an especially difficult task to the forensic pathologist. This study considers the pathologic features of suicidal deaths caused by explosives without a terrorist background. The modus operandi of the decedents reflected familiarity and proficiency, or at least a degree of specialized knowledge, with the construction and use of explosive devices. All explosions were set off in confined spaces. The injury patterns consisted of a combination of primary blast injuries (e.g. decapitation, traumatic amputation of limbs, gross lacerations of the body surface, blast injuries of gas-containing and hollow organs), secondary blast injuries (e.g. splinter-induced penetrating trauma), tertiary blast injuries (e.g. abrasions and contusions), and burn injuries (mostly of the flash type). The previously described symmetric distribution pattern of injuries in suicidal explosions was apparent only to a certain degree in the present series. Our observation of superficially sharp-edged wound margins with bridging in the depths of the lesion in blast-induced lacerations of the skin should deserve further attention in forthcoming cases of explosion-related fatalities because this finding is a diagnostic possibility that may support the theory of an explosion-related fatality under special circumstances, e.g. when the body has been dumped away from the place of death. Because a terrorist attack may be initially suspected in each case of suicide involving explosives, the importance of a joint inquiry based on expertise from police investigators, bomb experts, and forensic pathologists is evident.     

Diving-related fatalities caused by underwater explosions: a report of two cases.

The authors report two cases of diving-related water blast with fatal outcome resulting from nearby underwater explosions. Water blast with fatal outcome almost exclusively occurs in wars at sea. Underwater explosions are extremely rare in diving because of the limited exposure. Forensic findings in both cases reported included expected injuries to gas-filled organs such as the middle ear, lungs, and intestine; some rarely described injuries such as rupture of the liver, spleen, and kidneys; and also some lesions that were not found in a search of the literature: rupture of the heart and contusion of the hypophysis. Injuries caused by fatal underwater explosions should be carefully evaluated in forensic medicine to provide data that may support a criminal investigation.     

The hydrodynamic effect of gunshots in cranial explosive shots

Case report on five fatal gunshot injuries in which discharge of the cranial contents had occurred owing to a skull blast. Despite an appreciable explosive action with destruction of the bony cranium, the brains were not completely destroyed. In analogy to the "Kr?nlein shot", comparative reflections were made concerning wound ballistics. The case reports show that injury patterns resembling "Kr?nlein shot" may arise in cranial blast shots in rare cases despite destroyed projectile parts and even in a mouth shot.     

Microscopic Pattern of Bone Fractures as an Indicator of Blast Trauma: A Pilot Study

The assessment of fractures is a key issue in forensic anthropology; however, very few studies deal with the features of fractures due to explosion in comparison with other traumatic injuries. This study focuses on fractures resulting from blast trauma and two types of blunt force trauma (manual compression and running over), applied to corpses of pigs; 163 osteons were examined within forty fractures by the transmission light microscopy. Blast lesions showed a higher percentage of fracture lines through the Haversian canal, whereas in other types of trauma, the fractures went across the inner lamellae. Significant differences between samples hit by blast energy and those runover or manually compressed were observed (p < 0.05). The frequency of pattern A is significantly higher in exploded bones than in runover and compressed. Microscopic analysis of the fracture line may provide information about the type of trauma, especially for what concerns blast trauma.     

Saddam's revenge: a post-Gulf War casualty.

Artillery weapons are designed to inflict death and destruction by way of fragmentary and blast injuries. As pieces of modern machinery, they are also capable of causing serious injury by their very complex nature. The authors present a case analysis of an artillery piece that caused a projectile death without a shell.     

Deaths Due to Accidental Air Conditioner Compressor Explosion: A Case Series

In an air‐conditioning system, the compressor is a large electric pump that pressurizes the refrigerant gas as part of the process of turning it back into a liquid. The explosion of an air conditioner (AC) compressor is an uncommon event, and immediate death resulted from the blast effect is not reported in forensic literature. We report three such cases in which young AC mechanics were killed on the spot due to compressor blast, while repairing the domestic split AC unit. The autopsy findings, the circumstances leading to the explosion of the compressor, are discussed in this study.     

睾丸损伤的法医学鉴定

本文结合5例睾丸损伤检验鉴定，论述了睾丸损伤对阴茎勃起功能及生殖能力的影响，并对睾丸损伤法医学鉴定的若干问题进行了讨论。     

Accidental head explosion: an unusual blast wave injury as a result of self-made fireworks

A 33-year old hobby pyrotechnician sustained a lethal craniofacial trauma secondary to a salute fireworks blast. He was examining a misfire of a self-constructed salute gun, when it detonated, causing an explosively rupture of his forehead, which led to his immediate death. An autopsy was performed to achieve knowledge of the injury and to be able to reconstruct the events that lead to it. The pressure effect of the explosion caused a shredded rupture of the forehead with a regional spread of brain tissue and small polygonal skull fragments up to 30m from the detonation site. Furthermore multiple cinderlike fragments of black powder were embedded in the skin of the face and the anterior aspect of the neck (s.c. blast tattoo). The complete destruction of the forehead in combination with the multiple blast tattooing suggested that the explosion detonated while he was leaning over the device.     

汽车安全气囊的使用与损伤

交通事故已经成为导致死亡和致残的首要原因,气囊的产生和使用明显的降低了交通事故中的死亡率和致残率。虽然气囊可以降低交通事故中人员的死亡率和损伤程度,但同时也引起很多非致命性的损伤。本文主要阐述了气囊的作用机制,引起的损伤类型以及机制,并提出减少和降低与气囊相关的损伤和死亡的建议。     

Driver and front seat passenger fatalities associated with air bag deployment. Part 1: A Canadian study

Real world motor vehicle collision research of injuries due to deployment of "first-generation" air bags has been conducted by Transport Canada since 1993. Fifty-three fatal crashes (36 frontal impacts; 17 side collisions) involving 48 drivers and 10 right front passengers were reviewed. In the Canadian data, air bag deployment in five of nine low severity frontal crashes (delta-V (deltaV) < 25 km/h or 15 mph) was linked to five deaths, four of whom were autopsied (four adults with craniocervical (basal skull and C2 fracture with brainstem avulsion; "closed head injury"--no autopsy) or chest trauma (aortic or pulmonary artery tears); one child with atlanto-occipital dislocation). An occupant who is close ("out-of-position") to the air bag at the time of deployment is at risk for injury. In 27 high severity frontal impacts, unusual (e.g., pulmonary "blast" hemorrhage in one autopsied case) or isolated potentially survivable injuries (e.g., clinically documented ruptured right atrium; probable flail chest observed during the autopsy on a decomposed body) localized to the head, neck or chest in three possibly out-of-position drivers pointed to the deployed air bag as a source of injury. In one of 17 side collisions an out-of-position driver sustained a radiographically confirmed C1-C2 dislocation in a minimally intruded vehicle.     

Injuries of motorcyclists and bicyclists examined at autopsy.

Few studies of autopsy findings of persons dying of head and neck injuries in cyclists have been published. We performed a retrospective analysis of injury severity and the relation between head and neck injuries and helmet use. Seventy-six bicyclists and motorcyclists were collected from among the forensic autopsy at the Jikei University School of Medicine. From autopsy findings and accident reports, the abbreviated injury scale (AIS) and the injury severity score (ISS) were calculated and analyzed epidemiologically. As a result, helmet use significantly decreased the severity of head and neck injuries but had no effect on overall injury severity or the severity of injuries to other body regions. Furthermore, helmets had little effect on injuries remote from the point of impact, injuries resulting from angular acceleration, or injuries at the junction of the head and neck. These findings may be useful for both forensic pathologists and clinicians evaluating injuries in bicyclists and motorcyclists.     

Workplace Sexual Harassment in Policing: Perceived Psychological Injuries by Source and Severity

Relatively little is known about employee perceptions of workplace psychological injuries following sexual and nonsexual harassment. In quasi-military occupational organizations, such as policing, the rate of sexual harassment to workplace injuries from other sources is comparatively high. In an exploratory 5?×?2 between-subjects factorial experimental projection study, 220 New South Wales Police Force officers responded to one of ten experimental vignettes in which sources of psychological injury and the gender of the injured worker were systematically varied. Results revealed an unexpected effect of experience. Employees aged 30 years and older were significantly more likely to anticipate psychological consequences and clinically diagnosable symptoms than their younger counterparts. As hypothesized, a main effect of injury source, but not gender of the target, emerged for the severity of psychological consequences: a physical injury was perceived to produce significantly more severe psychological injuries than sexual harassment in the form of coercion and unwanted sexual attention. Contrary to the hypothesis, participants rated gender-based hostility higher than other types of sexual harassment as a source of severe psychological harm. Participants believed that gender-based hostility requires more professional intervention and predicted more negative workplace consequences than other psychological injuries caused by other workplace events. As hypothesized, women employees were generally viewed as significantly more vulnerable to negative workplace outcomes than men. The police officers who participated in this study considered women as more likely to experience workplace problems following sexual coercion than other types of workplace injury. Physical injuries, gender-based hostility, and sexual coercion were distinguished from nonsexual harassment and unwanted sexual attention as significantly more likely to produce clinically diagnosable injuries, irrespective of target gender. Implications of these findings for research, practice, and legal policy are discussed.     

Primary and secondary skeletal blast trauma

This study examines primary (resulting from blast wave) and secondary (resulting from disintegrated, penetrating fragments) blast trauma to the skeleton. Eleven pigs were exposed to semi-controlled blast events of varying explosive type, charge size, and distance, including some cases with shrapnel. Skeletal trauma was found to be extensive, presenting as complex, comminuted fractures with numerous small, displaced bone splinters and fragments. Traumatic amputation of the limbs and cranium was also observed. Fractures were concentrated in areas nearer the blast, but there was generally no identifiable point of impact. Fractures were more random in appearance and widespread than those typically associated with gunshot or blunt force injury events. These patterns appear to be uniquely associated with blast trauma and may therefore assist forensic anthropologists and other forensic examiners in the interpretation of skeletal trauma by enabling them to differentiate between blast trauma and trauma resulting from some other cause.     

Severity of vehicle bumper location in vehicle-to-pedestrian impact accidents

Pedestrian protection is one of the key topics for safety measures in traffic accidents all over the world. To analyze the relation between the collision site of the vehicle bumper and the severity of the lower extremity injuries, we performed biomechanical experiments. We compared the applied external force and the risks of subsequent injuries between the impact of the center and side positions of the front bumper. These comparisons were performed by practical impact tests with eight typical different types of cars which were typical of the current vehicle fleets. The tests were made using the TRL legform impactor which was a mechanical substitute of a pedestrian lower extremity. The TRL impactor is used all over the world for assessing the safety of car bumpers. It was found that the risks of lower extremity injuries in the impacts at the side positions, in front of the vehicle's side member, were significantly higher than those at the center. In the tests, we found that foam materials around the rigid front cross member had a significant effect on reducing the lower extremity injury risks and especially tibia fracture risk against vehicle bumper center collisions, but had little effect at the sides of the bumper over the vehicle's side members where the foam was thinner. We also found that the front shape of the vehicle affected the risk of ligaments injuries. According to these results, the information of impact locations of cars in vehicle-to-pedestrian traffic accidents is valuable for clinicians to diagnose patients with lower extremity injuries in traffic accidents and for forensic pathologists to analyze the accident reconstruction. Furthermore, the results suggest that testing of the bumper area in front of the main longitudinal beams should be included in the car safety legislation to require pedestrian safety.     

Forensic Performance Analysis of Load‐Limiting Devices in Automotive Seat Belt Retractors

The introduction of frontal airbags and seatbelt pretensioners for front seat occupants provided an opportunity to address injuries caused by seatbelt loading by introducing load‐limiters, which were intended to reduce belt loading while maintaining proper restraint. Investigation and forensic analysis of real‐world crashes identified that the implementation of these devices, in some circumstances, increased the potential of injury. This paper focuses on the trade‐offs of load‐limiters, that is, the reduction loading to the occupant versus the corresponding increase in seatbelt webbing and occupant movement. If the additional webbing introduced is not controlled, the risk of injury to the occupant is increased and could result in more frequent and severe injuries rather than a reduction. This paper quantifies the webbing introduced by load‐limiter activation through forensic analysis of the seatbelt involved in real‐world crashes and testing and assesses its effect on the injuries sustained by the occupant.     

交通事故致胸、腰椎损伤致残等级评定447例分析

目的探讨车祸致胸、腰椎损伤程度与伤残程度的关系,总结伤残评定经验,探寻其规律性。方法选择胸、腰椎损伤的鉴定447例,重新审查诊断,分析治疗措施,评价胸腰部活动度丧失程度及神经功能障碍情况,分析损伤程度与后遗障碍之间的关系,综合评定伤残。结果胸、腰椎损伤类型及数量并不决定其胸、腰部活动障碍程度及神经损伤后遗症严重程度;椎体损伤的部位与胸腰部活动度障碍关系密切;神经损伤主要集中在T1至L2段脊柱损伤;椎体损伤医院误诊率较高。结论伤残评定应分析损伤与后遗症严重程度的因果关系,以损伤所致后遗症为评残依据,重点关注脊柱功能的丧失程度。     

Blast Suppression Foam,Aqueous Gel Blocks,and their Effect on Subsequent Analysis of Forensic Evidence*

In addition to having blast mitigation properties, aqueous foam concentrate AFC-380 blast suppression foam is designed to capture aerosolized chemical, biological, and radioactive particles during render-safe procedures of explosive devices. Exposure to aqueous environments and surfactants may negatively affect forensic evidence found at the scene, but the effects of AFC-380 foam and aqueous gel on the preservation and subsequent analysis of forensic evidence have not previously been investigated. Sebaceous finger and palm prints and DNA samples on paper, cardboard, tape, and various metal and plastic items, along with hairs, carpet and yarn fibers, and inks and documents, were exposed to AFC-380 foam. Similar mock evidence was also exposed to a superabsorbent gel of the type found in aqueous gel blocks used for shrapnel containment. Exposure to foam or aqueous gel was associated with a dilution effect for recovered DNA samples, but quality of the samples was not substantially affected. In contrast, exposure to AFC-380 foam or gel was detrimental to development of latent finger and palm prints on any substrate. Neither the hair nor the fiber samples were affected by exposure to either the foam or gel. Indented writing on the document samples was detrimentally affected by foam or gel exposure, but not inks and toners. The results from this study indicate that most types of forensic evidence recovered after being exposed to aqueous gel or blast suppression foam can be reliably analyzed, but latent finger and palm prints may be adversely affected.     

Blast Injury and the Human Skeleton: An Important Emerging Aspect of Conflict‐Related Trauma

Recent decades have seen an accelerating trend in warfare whereby a growing proportion of conflict‐related deaths have been caused by explosions. Analysis of blast injury features little in anthropological literature. We present a review of clinical literature that includes prevalence of injury to anatomical regions and potential indicators of blast injury which can be used by forensic anthropologists. This includes high prevalence of extremity (22.8–91.2%) and facial (19.6–40%) injury in combat contexts, lower limb fractures (19–74.3%) in suicide bombing, traumatic amputation (3–43%) and diffuse fracture patterns in terrorist bombings. Potential indicators of blast trauma include blowout fractures in sinus cavities from blast overpressure, transverse mandibular fractures, and visceral surface rib fractures. Ability to recognize blast trauma and distinguish it in the skeleton is of importance in investigations and judicial proceedings relating to war crimes, terrorism, and human rights violations and likely to become increasingly crucial to forensic anthropology knowledge.     

An alleged assault by police

A case is presented of self-inflicted injuries alleged to have been sustained during an assault by police. A summary is given of the factors in this case differentiating between self-inflicted injuries and those due to an assault. The desirability of taking photographs of injuries in cases of alleged assault and the importance of keeping an open mind when assessing injuries are emphasised. The need for greater awareness in the medical and legal professions of the advantages of a forensic medical opinion in the assessment of injuries is mentioned.