Pelvis and hip joint injuries as a reconstructive factors in car-to-pedestrian accidents.

The pelvic girdles of 371 pedestrian victims of road traffic accidents were evaluated during postmortem examinations. Additionally, 144 hip joints were opened. The pelvic injuries were found in 28% of the pedestrians hit exclusively in their upright position and 52% of the victims run over by a vehicle. The side of the body hit by a car was determined on the basis of the location of blood suffusions within the subcutaneous tissues and muscles of lower limbs as well as the character of injuries found in the knee and upper ankle joints. The findings were verified with the data from court records. It was shown that the injuries of the sacroiliac joints or vertical fractures of the posterior parts of iliac bones were useful parameters for determining the side (left or right) of the body hit by a vehicle. Moreover, it was found that a direct impact on the hip region was evidenced by the ipsilaterally localized fractures of the iliac ala, central hip fractures and intraosseous blood suffusions within the greater trochanter of the femur. The external dislocations of the hip joints (always) and bilateral injuries to the sacroiliac joints (usually) were observed in the victims run over by vehicles.     

Motorcyclists’ fatalities in multiple crashes: Who is responsible for death? (three cases)

In Italy in 2007, 26% of two-wheeled motor vehicle injury/fatalities concerned motorcyclists. However, it is rare (4%) that a motorcycle (MC) crashes with two other road users and even more exceptional is a crash between a MC and three other vehicles. In general, in MC–vehicle crashes, the vehicle driver is at fault in more than 50% of the cases and the motorcyclist in 37%. The study concerns three MC lethal road accidents in which the culpability of the motorcyclist's death was questioned by the prosecutor because it was supposed that one or more vehicles ran over the motorcyclist after a fall. The crucial question in these three cases was if it was possible to assign injuries to a specific crash-aetiology and to assign/exclude the responsibility of motorcyclist's death to a defined subject (motorcyclist himself and/or car drivers) after a crash-dynamics study made by an engineer consultant or by the police authority. Case (1) A 56-year-old motorcyclist on a highway had a front–rear end collision with a car that suddenly stopped; he was therefore projected against a concrete traffic island, thrown on the soil and run over by another car. Case (2) A 29-year-old motorcyclist on the East ring road fell on the soil, perhaps by a supposed front–rear end contact with a car and was run over by two cars in rapid succession. Case (3) A 34-year-old motorcyclist on the North ring road fell suddenly on the soil for unknown reasons; during first aid, the medical team around him was run over by the ambulance which pushed after a rear-end collision with a car. A stepwise analysis of the indicated crash dynamics and an evaluation of all the injuries revealed at autopsy, the study proposed, when possible, injury aetiology for each case and the related responsibility assignments and exclusions.     

Fibromuscular dysplasia of the basilar artery: an unusual case with medico-legal implications

A 28-year-old male car driver was reported to suddenly loose the control over his vehicle, to hit the right and middle crash barrier, and to be unconscious as the car came to a halt in a position at right angles to the road. The car was hit in its left side by an automobile with high velocity, and the 28-year-old driver died. Examination of the brain revealed a massive isolated basal subarachnoid hemorrhage and a complete tearing of the basilar artery. A macroscopically detectable aneurysm was not found. However, histological examination of the large arteries at the base of the brain showed (i) fibromuscular dysplasia (FMD) mostly involving the basilar artery (ii) with a ruptured micro-aneurysm in its upper third part. The observations of the eye witnesses that the driver initially lost control over his car were judged in favour of the accused to be due to that rupture of the micro-aneurysm, while complete transverse tearing of the basilar artery occurred during the car crash due to hyperextension and rotation of his neck. Intracranial FMD is a rare cause in the differential diagnosis of isolated basal subarachnoid hemorrhage. The medico-legal implications of this entity are described in the presented case.     

Location of direct injuries in car drivers and passengers on the front seats

The authors give statistics on most frequent variants of location of primary injuries (LPI) in car drivers (CD) and front seat passengers (FSP) of left-hand wheel cars. There was neither significant intra- and intergroup difference in the incidence of injuries nor LPI both in the groups and between the groups. Prevalence of LPI in CD on the left and in FSP on the right side of the body was not confirmed statistically. Significantly higher frequency of pubic injuries was found in FSP versus CD which is explained by different biomechanical route of the body dislocation in strong primary blow. The authors believe this sign to be distinctive and propose to use it in forensic-medical examinations. They also advocate wider use of section roentgenography and medico-criminalistic methods to raise detectability of characteristic body injuries which is essential because of a great rise in the number of modern cars on the roads decorated with less traumatic materials.     

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.     

Rare pattern of injuries after being run over by a railroad train

The article reports on findings after a suicide committed by being run over by the driving unit of an ICE train in a railway station. After recovering the body a fresh abrasion was found on the right upper abdomen with a minor laceration. Some hours later a circular abrasion mark and zones of contusion were discernible on the trunk. Whereas the integument was largely intact, the spine was severed and inner organs of the trunk were ruptured.     

Virtopsy--fatal motor vehicle accident with head injury

A man wearing no protective helmet was struck by a motor vehicle while riding a bicycle. He was loaded on his left side, and the impact point of his head was his occiput on the car roof girder. He was immediately transported to the general hospital, where he passed away. Postmortem examination using multi-slice computed tomography (MSCT) revealed an extensively comminuted fracture of the posterior part and the base of the skull. Observed were deep direct and contrecoup brain bruises, with the independent fractures of the roof of the both orbits. Massive subdural and subarachnoidal hemorrhage with cerebral edema and shifting of the mid-line towards left side were also detected. MSCT and autopsy results were compared and the body injuries were correlated to vehicle damages. In conclusion, postmortem imaging is a good forensic visualization tool with great potential for documentation and examination of body injuries and pathology.     

Was the pedestrian hit in an erect position before being run over?

If a pedestrian was run over by a car, the question can arise whether there was a preceding collision while the pedestrian was in an erect position. From a total of 53 selected autopsy reports, the findings associated with accidents known to involve running over in isolation (n=32) were compared to findings associated with a combined mechanism of a primary impact in an erect position and subsequent running over (n=21). Findings exclusively present in the combined group were wedge-shaped bone fractures ("Messerer"-wedges, 38%), glass fragment injuries (24%), traumatic amputations (10%), traces of car paint on the lower extremities (50%) and abrasions of the shoe soles (17%). These findings can be considered specific for a primary impact in an erect position. Fractures of the cervical and lumbar spine were present in the combined group in 33 and 17%, respectively. In contrast, in the run over group, there was only one case of fracture of the cervical and one of the lumbar spine and both cases involved direct contact with a car wheel. Fractures of the cervical and lumbar spine are, therefore, very indicative for a primary impact. "Bumper injuries", sacroiliac dislocations and fractures of the thoracic spine were approximately 2.5 times more common in the combined group than in the run over group. In the vast majority of cases, a clear differentiation between the two groups is, therefore, possible on the basis of the autopsy findings. This is especially relevant if an inspection of the car cannot be performed after a hit-and-run accident, which occurred in 26% of the cases in this study. In addition, the blood alcohol levels were higher in the run over group (mean=2.14g/l) as compared to the combined group (mean=1.53g/l).     

Identification of the driver in an automobile collision

We report on a three-occupant automobile collision in which one of the two survivors claimed that the deceased had operated the vehicle. We attempted to identify the driver. The left face and neck of the deceased appeared to have struck the vehicle's interior. The survivors were slightly injured on the right side of their faces. In Japan, the passenger side is on the left, and in this case, the right side of the vehicle had been damaged. By comparing the injuries of the deceased and the survivors in relation to the vehicle damages, we concluded that the deceased occupant had probably been a passenger, not the driver.     

Severe Cardiac Rupture by Only One Blow to the Chest in a Young Boy: An Autopsy Case

Cardiac rupture by blunt chest trauma is commonly seen after motor vehicle accidents and falls; however, it is rarely caused by a blow to the chest. We herein report an autopsy case of a high school boy who sustained severe right ventricular rupture by only one knee kick to the chest during a quarrel. He was hospitalized and developed cardiopulmonary arrest. Emergency surgery was performed, but the patient died. The autopsy revealed no external severe trauma or deformation, but the side wall of the right ventricle contained a large V‐shaped laceration. The other thoracic organs had no injuries. This case illustrates that severe cardiac rupture can occur by only one blow to the chest. Blunt cardiac injuries can occur even if no severe injuries are present on the body surface. We should consider the possibility of severe cardiac injuries regardless of the presence of external injuries.     

An unusual case of high-voltage electrocution of a truck driver due to inadvertent contact of the truck with an overhead wire

Electrocution deaths are mostly accidental. However, reconstruction of events in unusual electrocution death is challenging. This article reports an accidental death due to electrocution in a highly unusual circumstance, in which a truck driver reversing his vehicle was electrocuted when his truck inadvertently touched an overhead high-voltage wire. The electric injury marks were present over the sole of the right foot. The scene investigation revealed that the high-voltage wire was loose and was below the level of the prescribed height. The truck was passing over an elevated area made up of dirt and stone. The interior of the cabin of the truck revealed a few non-insulated metallic areas over the floor of the truck, between the accelerator and the brake, which were attributed as the sources of entry of electricity into the body. The electric injury marks were different than those usually seen in high-voltage electrocution as there was an intermediate object (truck) involved, and the contact period between the truck and the electric wire was minimal. This fatality was attributed to the non-proper insulation of the interior of the truck, the negligent driving of the truck driver over the elevated surface, and the loose high-voltage wire without proper maintenance.     

Neck injuries caused by being run over by a motor vehicle

We report a homicide involving the use of a motor vehicle and simulating a traffic accident. This observation was the reason for a retrospective analysis of neck injuries in victims of traffic accidents, in which a person has been run over (RO) by a motor vehicle. The autopsy material of two institutes from 1990-1996 was used. The following findings were obtained in 63 victims: laryngohyoid fractures (LH-fx): 10 cases (16%) with a clear difference between the institutes (22% versus 7%). This resulted from examination with special regard to such injuries in many cases at one of the institutes, whereas only autopsy reports were taken retrospectively from the other institute. Five of these cases had suffered only minor LH-fx (as seen frequently in strangulation), although extensive run over (RO) injuries of the other cervical tissues were present. All LH-fx were caused by direct compression of the neck; in eight of the cases they were combined with mandibular fractures. Petechial hemorrhages (petH) at the eye lids/conjunctivae were seen in 19 cases (30%); 16 of these were related to thorax RO injuries, three to abdominal RO only. Four cases involved LH-fx, petH as well as cervical skin lesions and additional cervical soft tissue hemorrhages. Interpretation can be extremely difficult with this combination of findings if the character of the event cannot be established as accidental beyond doubt on the basis of the circumstances.     

Chemical burn from alkaline batteries--a case report.

A 2-year-old male was found to have a third degree (full thickness) burn on his rear right thigh. The father discovered the burn at a physician's office where the child was being treated for an ear infection. The physician notified authorities of suspected physical child abuse.     

Cerebral ischemia or post traumatic thrombosis of the A. carotis occuring to a car driver (author's transl)]

A short while after leaving a public-house a 71 year old man as the driver of his car was involved in a head-on collision with another car. On admission to a hospital he was unconscious with a distinct debility for the left side of his body and showed a changing anisocoria. Angiography of the right carotid artery revealed an occlusion. It was suspected that this was the terminal state of a generalized arteriosclerotic occlusion which was considered being the reason for the accident. The autopsy-findings showed, however, a posttraumatic thrombosis (whiplash-trauma of the cervical vertebral column) of the right arteria carotis and of the right arteria vertebralis with thromboembolia in a small pontine artery with an infarct-like ischemic softening. The differentiation from an apoplexia is of importance for the differential diagnosis.     

Stature and sex estimate using foot and shoe dimensions

The aim of the study was to develop a formula to estimate the stature and sex of an individual using foot and shoe dimensions. To this aim the stature, right and left shoe sizes, and maximum and minimum feet length and width measurements of a target group of 569 individuals were taken. The group was composed of 294 males and 275 females. The highest correlation coefficient was found in length measurements. A notable difference between males and females existed with regard to both right and left foot and shoe length and width averages and shoe sizes (p < 0.001). Among the group, a significant correlation was found in regard to stature and right shoe length (r = 0.591, p < 0.001), with the correlation between stature and right foot length and stature and right shoe length being 0.579 (p < 0.001); as for the female group, there was a significant correlation between stature and right foot length and stature and right shoe length (r = 0.460, p < 0.001). Thus the regression formula obtained are as follows: for the right side: sex = 69.169 + 0.173 (maximum foot length) - 0.368 (maximum foot width) - 0.820 (shoe length) + 0.224 (shoe width) - 1.280 (shoe number). For the left side: sex = 69.551 + 0.276 (maximum foot length) - 0.504 (maximum foot width) - 0.739 (shoe length) + 0.344 (shoe width) - 1.360 (shoe number). In application of the formula, if sex is lower than 0.50, the shoe belongs to a male, if higher, then to female. The formula which was obtained in regression analysis in order to estimate the stature when the measurements of shoe and foot were known. For the right side, stature = 47.93 + 1.083 (maximum foot length) + 0.788 (shoe length) 1.813 (shoe number) (SEE:31.410). For the left side: stature = 47.33 + 1.139 (maximum foot length) + 0.593 (shoe length) x 1.924 (shoe number) (SEE:31.607). It was understood that foot and shoe sizes are a criteria to estimate the stature of a person that there was a strong relationship between foot and shoe length and width and that these can be used to aid estimation. It was found that in sex estimate, foot and shoe lengths are better in helping the estimate than width measurements, and that the use of shoe measurements rather than bare foot measurements are better to obtain meaningful results.     

Determination of average vehicle speed utilizing reverse projection

Reverse projection photogrammetry has long been used to estimate the height of an individual in forensic video examinations. A natural extrapolation would be to apply the same technique on a video to estimate the speed of an object by determining the distance traveled between two points over a set amount of time. To test this theory, five digital video recorders (DVRs) were connected to a single fixed camera to record a vehicle traveling down a track. The vehicle's speed was measured through Doppler radar by a trained operator and the speedometer of the vehicle was also recorded with a video camera. The recorded video was examined and the frames that best depict the beginning and end of the vehicles course were selected. Two reverse projection photogrammetric examinations were performed on the selected frames to establish the position of the vehicle. The distance between the two points was measured, and the time elapsed between the two points was examined. The outcome provided an accurate speed result with a standard degree of uncertainty. This study proves the feasibility of using video data and reverse projection photogrammetry to determine the speed of a vehicle with a limited set of variables. Further research is needed to determine how additional variables would impact the standard degree of uncertainty.     

Enantiomeric separation of methamphetamine and related analogs by capillary zone electrophoresis: intelligence study in routine methamphetamine seizures

A method for simultaneous enantiomeric separation of ephedrine, pseudoephedrine, and methamphetamine (MA) in a single run by simple capillary zone electrophoresis (CZE) with beta-cyclodextrin as a chiral selector is described. The effects of the buffer pH, phosphate concentration, beta-cyclodextrin concentration, voltage and temperature on the peak resolution were examined. Good enantiomeric resolution was attained for each analyte under our optimized conditions: 15 mM beta-cyclodextrin, 300 mM NaH2PO4 at pH 2.5 with an uncoated capillary (64.5 cm x 50 microm), applied potential at 20 kV and temperature at 30 degrees C. Ultraviolet (UV) detection at a fixed wavelength (200 nm) was employed using a diode array detector. Using phentermine as an internal standard, migration times for all analytes are reproducible within 0.16% for intra-day and 0.6% for inter-day runs. Application of this method to the analysis of confiscated drugs is discussed.     

Tears in the clothing after being run over by an automobile wheel

Clothes taken from 120 bodies of victims in case of death due to car wheel overrunning were examined and in 10 cases shred-shaped tissue ruptures in the form of an angle were detected. They proved to appear in case of oblique direction in overrunning and the angle of a shred turned back was directed to the side of wheel rotatory movements, i.e. contrary to wheel translational movement.     

同一个体发毛角蛋白电泳谱型的分析

用SDS -PAGGE对收集到的 2 0例人体表毛发 (头发、阴毛、腋毛、腿毛 )角蛋白组分进行了分析。结果表明 ,同一个体毛发角蛋白电泳谱型基本相同 ,用激光光密度仪对电泳凝胶板扫描后证实 ,同一个体毛发角蛋白组分相对百分含量也无明显差异 ;人头部不同部位 (顶部、左侧、右侧、额部、枕部 )头发角蛋白的电泳谱型和角蛋白组分相对百分含量也基本相同。同一个体毛发角蛋白组分的分析 ,可为法医物证学鉴定中的毛发个人识别提供重要的依据。     

Stature and Body Weight Estimation from Various Footprint Measurements Among Egyptian Population

Abstract: Analysis of footprints can reveal very important clues which can be used as a forensic evidence and help in the estimation of stature and body weight of an individual. In this work, bilateral footprints were obtained from 50 male Egyptian medical students ranging in age between 18 and 25. Nine measurements were taken on each footprint. The result revealed significant bilateral asymmetry (p < 0.001) except foot breadth at ball. The significant and positive highest correlation coefficients with stature were shown by toe‐5 length on right side (R = 0.58) and with body weight by foot breadth at ball on left side (R = ?0.52). Regression equations presented smaller standard errors of estimate (3.52–4.69) in determination of stature than those in estimation of body weight (4.05–5.28). In conclusion, this study has provided equations that help to estimate stature and body weight from footprint measurements among Egyptians.