A single fatal penetrating chest wound from shattered wind-blown glass

The great majority of penetrating wounds of the thorax result from firearms and bladed weapons. Penetrating wounds of the heart and of the great vessels still have a high immediate mortality. While penetrating chest wounds occasionally result from fragments of glass; most severe and fatal wounds from glass result from one's falling into or through architectural (plate) glass, sustaining wounds of abdomen or extremities, or both. A single, fatal penetrating chest wound resulting from a wind-blown fragment of glass is distinctly uncommon. The unique case of this type reported herein is that of a 12-year-old youth who was struck in his home in the left anterior chest by a single, sharp, slender fragment of glass blown from a window which shattered in a thunderstorm. This resulted in a rapidly fatal penetrating wound involving thoracic viscera. The forensic pathologist must thoroughly investigate and document such accidental deaths, modifying his/her autopsy procedure as necessary for these purposes and to avoid accidental injury at the autopsy table.     

An unusual autoerotic accident: sexual pleasure from peritoneal pain

The paper describes a fatal autoerotic accident of a 23-year-old man who derived sexual pleasure from painful irritation of the peritoneum by sharp force. For this purpose he clamped two knife blades into a vice suspended from a rope-pulley construction so that he could lower it to pierce the abdominal skin with the tips of the knives. When one of the ropes broke, the vice with the knives fell onto the man's belly piercing the inferior vena cava and leading to death by exsanguination. This, to the authors' knowledge, has been the first ever report of a fatal autoerotic accident in which sexual pleasure was to be obtained from painful irritation of the peritoneum.     

Bones, blood, pellets, glass, and no body.

A man was found guilty of killing his wife, although her body was never found. The case centered on her car, which contained fragments of bone, glass, shotgun pellets, and dried blood. Deoxyribonucleic acid (DNA) fingerprinting techniques were used to establish the decedent's identity. Examination of the bone fragments revealed that they were from the skull. These two pieces of information, added to other evidence, proved that the defendant's wife had received a fatal injury in her car, and a guilty verdict was rendered.     

Case reports of suicide with an electric drill

In this report, three cases of suicide by an electric power drill are described. In the first case, a man aged 51 was found with four penetrating wounds of the head and chest. The second case involves a 56-year-old man who suffered a penetrating craniocerebral injury and the third case involves a 53-year-old man who suffered one head injury and two chest injuries. In the first two cases, the victims were found dead. In the third case, the victim survived his injuries for 28 hours. The case histories and the post-mortem examinations revealed no evidence of homicide.     

Souvenir knife: a retained transcranial knife blade

Upon necroscopic examination of a homeless male found comatose in the street and pronounced dead at a medical center 12 hours later, a sharp tip of a knife lodged in the right parietal region of his skull was incidentally discovered. The blade transected the diploe and penetrated the cerebral cortex. Subsequent police investigation revealed that this was the remnant of a stabbing attempt on his life several months prior to his death. The cause of death was determined to be unrelated to the metallic blade fragment, thus making it a truly incidental and rare finding of a "souvenir knife." Nevertheless, since the injury sustained in the stabbing was potentially life threatening, the investigation into that assault was reopened.A case report is presented, along with a brief review of the literature on "souvenir objects."     

Study of injuries combining computer simulation in motorcycle-car collision accidents

This paper presents the approach of computer simulation to clarify the questions faced by forensic experts about what causes the various injuries characteristic of two motorcycle victims, including the motorcycle driver and the back seat occupant on the motorcycle, and how to exactly confirm which one of them is the motorcycle driver. Two typical motorcycle-car accident cases were reconstructed to analyze the movement and the load of both the motorcycle driver and the back seat occupant in the collision course. In case one, the back seat occupant suffered fatal head injuries when he fell on the ground after being thrown higher than the motorcycle driver over the top of the car. In case two, the compressive force loaded by the right tibia of the back seat occupant was larger and more durative compared with the motorcycle driver; the back seat occupant suffered a bursting fracture injury of his right tibia. These results might be useful for forensic experts in dealing with similar motorcycle-car collision accidents in the future.     

Sharp Force Homicide in Denmark 1992–2016

Sharp force trauma is a common homicide method. The weapon is typically a knife, which is easily accessible and does not require special skills. We have analyzed all 471 sharp force homicides in Denmark during 1992–2016 with special focus on aspects that are relevant to forensic pathologists, including the distribution of wounds and organ injuries. Most homicides were committed inside with a kitchen knife. The front left thorax was the most common area to be affected by sharp force trauma. In 18.9% of the victims, there was only one sharp injury, the majority on the thorax. The most common trajectory for stab wounds was directly posterior with no deviation to the sides or up/down followed by directly anterior. The heart (including pericardium) and lungs (including hemo- and pneumothorax) had injuries in more than 75% of the victims. 67% of victims were males. Female victims had more sharp force injuries and defense wounds than male victims. Most females were killed in domestic homicides (73.7%), most commonly in partner killings (56.4%). In contrast, many male victims were killed in a setting of nightlife/intoxication (34.0%) most by a friend/acquaintance delivering a few stab wounds. The results clearly show strong sex differences in both victims and offenders. This could be useful for shaping policies and public opinion, and as a route for understanding the developments in interpersonal violence. In the narrow setting of death investigation, our results will provide an evidence-based approach to understanding the injury patterns in sharp force homicide.     

Criteria for homicide and suicide on victims of extended suicide due to sharp force injury

This report is about the findings in association with the extended suicides of nine victims killed by sharp force. All victims were killed by sharp force. The perpetrators were predominantly the parents, the victims their children. Regarding the criteria for differentiating self-inflicted injuries from injuries inflicted by another person, the victims' injuries presented patterns usually found solely in suicides. Thus eight of nine cases presented tentative and hesitation injuries, in three of five cases areas of injury covered by clothing had been exposed beforehand. Despite extremely narrow intercostal spaces in children, injuries to the bones in thoracic stabbing were avoided more often than not (four of seven cases). Only the criterion "defence injury" occurred nearly as often as in homicide victims (three of nine cases). The psychopathology of extended suicide can explain this pattern. The perpetrator's motive is characterised by his pseudoaltruistic belief to save the loved ones from a world that is in his opinion unacceptable. A fusion or integration of the victim into the perpetrator's own self is based on an identity problem. Physical interrelation of forces between perpetrator and victim restricts the victim in his defence and presents an important prerequisite for acquiring the patterns of described injuries.     

Puncture wounds caused by glass mistaken for with stab wounds with a knife

Three cases are presented where fatal puncture wounds caused by broken glass were very similar to stab wounds inflicted by a knife with a single-edged blade. Thus, all three cases caused a murder investigation to be initiated. It could only be determined that these wounds had been caused by glass after a detailed forensic autopsy. In two of the three cases, the only evidence for this was the identification of glass fragments in the wounds. The importance of X-ray examinations is underlined because modern glass in common use is radiopaque. Glass fragments lodged in the wounds can reduce the loss of blood and thus, prolong the capacity to act despite severe injuries.     

Analysis of 1989-1999 homicide crimes in the catchment area of the Bonn Institute of Forensic Medicine with reference to selected aspects

195 cases of homicide, grouped according to juridical assessment, were retrospectively analysed with regard to individual characteristics of perpetrators and victims, circumstances, and mode of commitment. The involvement of underage victims and perpetrators as well as differences between the urban and rural areas studied were taken into special consideration. To summarise, the majority of the offences studied was carried out by a male perpetrator with a mean age of 35 years driven by personal motives or greed in his immediate vicinity and affected family members or close acquaintances. The fatal injuries were mainly attributable to sharp or blunt force. With regard to killings of children, a higher prevalence of female victims and male assailants, emotional motives and an even higher importance of the social vicinity were found. Particularly in victims younger 12 years of age, manual modes of commitment without application of any tools were predominantly encountered. The comparison of urban and rural areas revealed a higher homicide rate in municipal areas especially of offences with a loose relationship between victims and assailants (greed, sexual assault). In contrast, rural areas exhibited higher rates of bodily harm with fatal consequences as well as offences by highly intoxicated assailants.     

Suicide by pencil

We report an unusual suicide, committed with a common pencil. A 72-year-old male inflicted himself a penetrating thoracic wound while being hospitalized for a hip prosthesis operation. Although the patient was immediately operated, the cardiac injury appeared to be fatal. Cases of suicidal penetrating wounds of the anterior chest wall are rare and they are mostly inflicted by knives, glass fragments, or other sharp instruments. The potential danger of a pencil should be taken into consideration, especially in psychiatric hospitals and imprisonment facilities. We examined the legislation in Italy and Finland concerning the regulation of privacy in special care institutions.     

Suicide by skull stab wounds: a case of drug-induced psychosis

Suicide by stabbing to the head and/or driving sharp objects into the skull is of extreme rarity. This article reports the case of a 27-year-old man, who committed suicide by multiple knife stabs and cuts to the head, the torso, one shoulder and the forearms. Autopsy showed a perforating wound of the skull and the 10-cm long broken blade of the knife being still embedded in the right temporal lobe of the brain. The deceased had no history of psychiatric illness but was currently treated by mefloquine, a quinine derivative associated with a high rate of psychiatric adverse effects. Toxicological examination confirmed a recent intake of mefloquine together with chloroquine, another antimalarial drug. To our knowledge, this is the first report of a completed suicide with very strong evidence of mefloquine implication. Discussion focuses upon mefloquine-induced psychiatric disorders and highlights the importance of performing toxicological investigations in cases of unusual suicides.     

Recovery and evaluation of trace material from wound edges in traumatic injury site

A small wound found on the ear of a homicide victim was inflicted by either a knife or a sharp fragment of ceramic. To test the potential usefulness of cytologic examination of wound edges for fragments of inert material from the assault weapon, the wound was rinsed and cytologic filters were prepared from the retained rinsing material. The particulate matter present on filters included microscopic fragments of crockery admixed with blood and other tissue components. This observation supported other physical evidence that the wound was caused by the sharp edge of a ceramic crock rather than by the knife. This case demonstrates the potential usefulness of cytologic examination of wound edges.     

Death by complete decapitation of motorcyclist wearing full face helmet: case report

We describe a case of complete decapitation following a motorcycle accident in which the victim was wearing a full face helmet. A young man lost control of his motorcycle and was thrown about 20 m, hitting his head against the barrier separating a tramline from the road. The resulting trauma caused his decapitation, the only fatal wound ascertained by the various forensic investigations. The authors present this rare case and compare it against the other two cases reported in the literature, providing some observations on the ways in which this injury can come about. The absence of abrasions or signs that the wound edges came into contact with a metal structure, the presence of signs of impact on the side of the helmet and the finding of a transversal fracture at the base of the skull point to the violent action of a side-to-side opposite force, due to the resistance provided by the lower edge of the protective helmet.     

Case report of accidental stab wound to the heart

A 33 year-old Polish field-worker was found by his colleagues kneeling in front of his trailer, with a bloody stab wound in the heart region. In spite of prompt surgical intervention, the man died from his injury a few hours later. Upon examination of the dead man's trailer a blood-smeared vegetable-knife was found in the sink, and on the floor, a pullover with a slit-like cut. On the wall hung a jacket on a hook with a cut in the inner surface of the left breast pocket but not in the outside layer. The examination of the clothes, the autopsy and a reconstruction of the sequence of events led to the following conclusion: The knife had been placed into the breast pocket of the jacket with the tip facing downwards. As the man put down a sack of potatoes, the knife hooked into a pre-existing gap in the sack and was driven into the chest cavity by the pressure weight of the heavy sack.     

Multiple homicides--forensic and criminologic aspects

The interpretation of medicolegal findings in homicide is an important tool of case profiling (so-called "operative case analysis"). In 17 cases of "multiple homicides" involving 22 offenders (21 males, 1 female; mean age 33 years) and 45 victims (21 males, 24 females; mean age 35 years; 41 fatalities, 4 survivors), the autopsy reports and the prosecution authorities' files were retrospectively analysed with regard to individual characteristics of perpetrators and victims, circumstances, and mode of commitment in order to comprehensively characterise relevant forensic and criminologic aspects. 31 victims were found to belong to the close social environment of the perpetrator, and 32 killings were committed in the victim's, perpetrator's or the joint flat. The main motives included greed (n = 7), personal conflicts (n = 5) and concealing of a crime (n = 9). The relevant injuries were attributable to gunshot wounds (n = 13), sharp force (n = 11), blunt force (n = 3), ligature strangulation (n = 3), smothering (n = 6), fire/carbon monoxide (n = 2) and combined impacts (n = 7). In 12 victims, defense injuries were found. The blood alcohol concentration exceeded 1.5 g/l in 5 victims. In 5 offenders, a psychiatric impairment of juridical responsibility was assessed (and 20 German criminal code, n = 1, psychosis; and 21 German criminal code, n = 4; acute alcohol intoxication). As far as data were available, 16 crimes were judged as murder, 12 as manslaughter and one as physical injury with fatal outcome.     

Metal Railing Fences and Accidental Death

Two cases of accidental deaths caused by the sharp ends of fence or gate posts are reported. Case 1: A 47‐year‐old man was found hanging by his ankle in an inverted position on fencing. He had attempted a shortcut to a railway platform by climbing over a metal rail fence. He had slipped and been impaled through his ankle by the sharp end of the fence post, resulting in death from positional asphyxia. Case 2: An 18‐year‐old male slipped while climbing over a gate and died after being impaled on a spear tip finial, which had lacerated his external iliac vein. Death was due to exsanguination. These cases demonstrate two rare examples of accidental deaths from impalement by the ends of sharp fence posts. Mechanisms of death in such circumstances involve suspension with positional asphyxia and vascular injury with exsanguination.     

Planned complex suicide. Report of two autopsy cases of suicidal shot injury and subsequent self-immolation

Two cases of planned complex suicide are presented. In both cases, the suicidal persons shot themselves after making sure that in the sequel their bodies would be burnt. In the first case, a 65-year-old man had shot himself in the mouth and consequently fell into a fire he had lighted before. In the second case, a 43-year-old man set fire to his flat and shot himself directly afterwards. On the basis of the reported cases, a short literature review on planned complex suicides is given.     

A decade of pediatric homicide: a retrospective study at the Medical University of South Carolina.

More than 3 million children are abused and/or neglected each year in the United States. Unfortunately, a significant percentage of these cases result in homicide by child abuse or child neglect. Causes of death range from blunt force trauma and shaking to asphyxia to immolation. We retrospectively reviewed all pediatric forensic cases referred to the Medical University of South Carolina Forensic Pathology Section over the past 10 years, from January 1986 to December 1995. Of these, we looked only at children < or =5 years of age. The majority (342 cases, 69%) of these deaths were classified as natural, 96 (19%) as accident, and 60 (12%) as homicide. Of the homicides, we examined the cause of death; age, gender, and race of the victim; relationship to the perpetrator; time interval between injury and death; and the initial history given as to the cause of the injury. The cause of death fell into nine categories, the number one category being head trauma. Forty-five percent of the homicides were by head trauma, 12% by abdominal or body trauma, 25% by asphyxia (with half of these due to drowning), 10% by carbon monoxide poisoning or thermal injury, and the remaining 8% involving cases of neglect, stabbing, and poisoning. The majority of the homicide victims were male (67%) and black (67%). Forty-six percent were < or =1 year of age. Approximately 25% of the homicide cases were designated as shaken baby syndrome (SBS). In 97% of the cases, the assailant was known to the victim and was a family relative in 77%. Sixty-three percent of the assailants were female and 45% of the assailants were male; in 12%, the assailants were both parents, and in 1 case, the assailant remains unknown. Of the asphyxia deaths, 87% of the assailants were female. The time interval between injury and death ranged from minutes to hours in most cases to months in cases of repeated abuse and chronic injury and sequelae. The time interval between injury and the onset of symptoms remains unknown in most cases due to inconsistencies in the history and lack of credibility of the caretaker. The most common initial history given was "a fall" (20%). We report our findings of a decade of pediatric homicides to increase awareness of the common scenarios and case histories, demographics of the victims, causes of death, and perpetrators of pediatric homicide.     

玻璃刺创形态学特点的初步研究

目的研究玻璃刺创的形态学特点。方法分别用3个厚度为0．31cm带尖状突起的啤酒瓶残端及3块厚度为0．29cm有尖的普通窗玻璃碎片按设定的不同方向刺击带皮猪肉组织,重复此过程3次,形成198例创口,观察、编号、拍照、测量各创口。结果198例创口的整体形态可分为5种类型,即“工”型、“”型、“”型、“上”型与“一”型,各型在不同刺击方向的分布上存在差异,其中前4种为主要类型,共约占总数的93％,其共同点为在损伤的中部出现了一段与损伤整体走向垂直的创口,啤酒瓶残端所致垂直创口的长度为0．31±0．Olcm（x±s）,窗玻璃碎片所致垂直创口的长度为0．29±0．Olcm（x±s）。结论损伤中部有与损伤整体走向垂直的短创口是玻璃刺创中易出现的一种形态学特点,垂直创的长度与致伤玻璃的厚度具有一致性。