Fimag: The United Kingdom Disaster Victim/Forensic Identification Imaging System

Abstract:  Imaging is an integral diagnostic tool in mass fatality investigations undertaken traditionally by plain X-rays, fluoroscopy, and dental radiography. However, little attention has been given to appropriate image reporting, secure data transfer and storage particularly in relation to the need to meet stringent judicial requirements. Notwithstanding these limitations, it is the risk associated with the safe handling and investigation of contaminated fatalities which is providing new challenges for mass fatality radiological imaging. Mobile multi-slice computed tomography is an alternative to these traditional modalities as it provides a greater diagnostic yield and an opportunity to address the requirements of the criminal justice system. We present a new national disaster victim/forensic identification imaging system—Fimag—which is applicable for both contaminated and non-contaminated mass fatality imaging and addresses the issues of judicial reporting. We suggest this system opens a new era in radiological diagnostics for mass fatalities.     

Anthropological measurement of lower limb and foot bones using multi-detector computed tomography

Anthropological examination of defleshed bones is the gold standard for osteological measurement in forensic practice. However, multi-detector computed tomography (MDCT) offers the opportunity of three-dimensional imaging of skeletal elements, allowing measurement of bones in any plane without defleshing. We present our experiences of the examination of 15 human lower limbs in different states of decomposition using MDCT. We present our method of imaging and radiological measurement of the bones including sex assessment. The radiological measurements were undertaken by three professional groups--anthropology, radiology, and forensic pathology--both at the site of scanning and at a remote site. The results were compared to anthropological oestological assessment of the defleshed bones. We discuss the limitations of this technique and the potential applications of our observations. We introduce the concept of remote radiological anthropological measurement of bones, so-called tele-anthro-radiology and the role that this could play in providing the facility for standardization of protocols, international peer review and quality assurance schemes.     

The Effects of Body Mass on Cremation Weight*

Abstract: Cremains have become increasingly frequent in forensic contexts, while higher body mass in the general population has simultaneously made cremation a more cost‐effective mortuary practice. This study analyzed the relationship between body mass and bone mass, as reflected through cremation weight. Antemortem data were recorded for samples used in the multi‐regional data set. Each was rendered through commercial crematoriums and reweighed postincineration. Pearson’s correlation demonstrates clear association between body mass and cremation weight (r = 0.56; p < 0.0001). However, multiple linear regression revealed sex and age variables also have a significant relationship (t = 7.198; t = ?2.5, respectively). Regressed in conjunction, body mass, sex, and age contribute approximately 67% of all variation observed in cremation weight (r = 0.668). Analysis of covariance indicates significant regional variation in body and cremation weight. Explanations include bone modification resulting from increased loading stress, as well as glucose intolerance and altered metabolic pathways related to obesity.     

Forensic imaging of projectiles using cone-beam computed tomography

In patients with gunshot injuries, it is easy to detect a projectile within the body due to the high-density of the object, but artefacts make it difficult to obtain information about the deformation and the exact location of the projectile in surrounding tissues. Cone-beam computed tomography (CBCT) is a new radiological imaging modality that allows radio-opaque objects to be localised and assessed in three dimensions. The full potential of the use of CBCT in forensic medicine has not yet been explored.In this study, three different modern projectiles were fired into the heads of pig cadavers (n = 6) under standardised conditions. Tissue destruction and the location of the projectiles were analysed separately using CBCT and multi-slice computed tomography (MDCT).The projectiles had the same kinetic energy but showed considerable differences in deformation behaviour. Within the study groups, tissue destruction was reproducible. CBCT is less severely affected by metallic artefacts than MDCT. Therefore CBCT is superior in visualising bone destruction in the immediate vicinity of the projectile and projectile deformation, whereas MDCT allows soft tissue to be evaluated in more detail.CBCT is an improved diagnostic tool for the evaluation of gunshot injuries. In particular, it is superior to MDCT in detecting structural hard-tissue damage in the immediate vicinity of high-density metal projectiles and in identifying the precise location of a projectile in the body.     

The Odontology Victim Identification Skill Assessment System*,†

Abstract: Mass fatality identification efforts involving forensic odontology can involve hundreds of dental volunteers. A literature review was conducted and forensic odontologists and dental educators consulted to identify lessons learned from past mass fatality identification efforts. As a result, the authors propose a skill assessment system, the Odontology Victim Identification Skill Assessment System (OVID‐SAS), which details qualifications required to participate on the Antemortem, Postmortem, Ante/Postmortem Comparison, Field, and Shift Leader/Initial Response Teams. For each qualification, specific skills have been identified along with suggested educational pedagogy and skill assessment methods. Courses and assessments can be developed by dental schools, professional associations, or forensic organizations to teach and test for the skills required for dental volunteers to participate on each team. By implementing a system, such as OVID‐SAS, forensic odontologists responsible for organizing and managing a forensic odontology mass fatality identification effort will be able to optimally utilize individuals presenting with proven skills.     

Modeling Temperature Variations Using Monte Carlo Simulation: Implications for Estimation of the Postmortem Interval Based on Insect Development Times*†

The association between insect development and temperature is well established. Thermal summation using accumulated degree-day measures is commonly used. However, the time at which evidence is collected is important in these estimates. The aim of this study was to provide a simulated model of the effect of temperatures on six dipteran species commonly associated with cadavers, from the death scene to the refrigerator, and finally at the time of autopsy. Temperatures measurements were sampled over a 16-month period from the external environment (external to the mortuary), within the mortuary refrigerator, and within the mortuary autopsy suite. Monte Carlo simulation using accumulated degree-days (ADD) was used to estimate the variations based on the mean and standard deviation of the temperature measurements. It was found that there was a negative correlation between the base temperature of the fly species (lowest temperature at which the flies will survive) and developmental likelihood. Species with high base temperatures (Chrysomya albiceps, Chrysomya chloropyga, and Musca domestica) were less likely to continue development in refrigerators than species with lower base temperatures (Lucilia sericata and Piophila casei). The findings of this study highlight the importance of recording temperature measurements and the period of refrigeration on PMI estimation especially when continued development occurs in spite of a period of cooling of the insect evidence.     

Forensic Approach to an Archaeological Casework of “Vampire” Skeletal Remains in Venice: Odontological and Anthropological Prospectus*

Abstract: During the years 2006–2007, the Archeological Superintendent of Veneto (Italy) promoted a research project on mass graves located on Nuovo Lazzaretto in Venice, where the corpses of plague deaths were buried during the 16th and 17th centuries. The burials were of different stages and are believed to be the remains of plague victims from the numerous outbreaks of pestilence, which occurred between the 15th and 17th centuries. Among the fragmented and commingled human bones, an unusual burial was found. The body was laid supine, with the top half of the thorax intact, arms parallel to the rachis axis, the articulations were anatomically unaltered. Both the skull morphology and the dimensions of the caput omeris suggest the body was a woman. A brick of moderate size was found inside the oral cavity, keeping the mandible wide open. The data collected by the anthropologist were used to generate a taphonomic profile, which precluded the positioning of the brick being accidental. Likewise, the probability of the brick having come from the surrounding burial sediment was rejected, as the only other inclusions found were bone fragments from previous burials in the same area. The data collected by the odontologist were employed for age estimation and radiological dental assessment. The forensic profile was based conceptually on the “circumstances of death” and concluded that the positioning of the brick was intentional, and attributed to a symbolic burial ritual. This ritual confirms the intimate belief held at those times, between the plague and the mythological character of the vampire.     

Watch for those fragments of evidence: the use of an automatic timepiece to help correlate a helicopter crash site from the Vietnam War

This case study illustrates the use of the date function on an automatic wristwatch to help identify a Vietnam War helicopter crash site. The location of a crash incident can sometimes be uncertain because of inadequate or inaccurate wartime records and the passage of time. Artifacts recovered from a prospective crash scene are regularly used to correlate the loss incident. In this case study, a recovered automatic watch displayed a date 2 days later than the reported loss incident. Although the date conflicts with the aircraft crash incident report, it is observed that a fully wound automatic watch continues to work for c. 2 days after movement of the watch ceases. Thus, the watch's date in fact correlates with the aircraft crash incident report. It is noted that automatic watches may also be used to date scenes of crime.     

Examining fatal and nonfatal incidents involving the TASER

Research Summary According to TASER International, nearly 10,000 police departments in the United States have deployed the TASER as a less lethal force alternative in some capacity. Despite the TASER's increasing popularity, serious questions have been raised about the device's physiological side effects; in particular, Amnesty International has reported that more than 300 people have died after being subjected to the TASER. Although a growing body of research has examined the physiological effects of the TASER on animals and healthy human volunteers in laboratory settings, there has been virtually no empirical analysis of “real‐world” fatal and nonfatal TASER cases simultaneously. This article examines all media reports of TASER incidents from 2002 to 2006 through a comprehensive review of LexisNexis and New York Times archives. We compare TASER incidents in which a fatality occurred to TASER incidents in which a fatality did not occur and then employ multivariate analyses to identify the incident and suspect characteristics that are predictive of articles describing TASER‐proximate deaths. Policy Implications Several suspect factors were significantly associated with the reporting of a fatal TASER incident, including drug use (but not alcohol), mental illness, and continued resistance. Multiple deployments of the TASER against a suspect was also associated with the likelihood of the article describing a fatality—especially if the suspect was emotionally disturbed—which raises the possibility that the risk of multiple shocks might not be uniform for all suspects. More research is needed to explore the relationship between mental illness, drug use (illicit or therapeutic), continued resistance, and increased risk of death. In the meantime, police departments should develop specific policies and training governing the use of multiple TASER shocks against individuals who could be in these vulnerable physiological and psychological states.     

DNA Preservation in Skeletal Elements from the World Trade Center Disaster: Recommendations for Mass Fatality Management*,†

Abstract: The World Trade Center (WTC) victim identification effort highlights taphonomic influences on the degradation of DNA from victims of mass fatality incidents. This study uses a subset of the WTC‐Human Remains Database to evaluate differential preservation of DNA by skeletal element. Recovery location, sex, and victim type (civilian, firefighter, or plane passenger) do not appear to influence DNA preservation. Results indicate that more intact elements, as well as elements encased in soft tissue, produced slightly higher identification rates than more fragmented remains. DNA identification rates by element type conform to previous findings, with higher rates generally found in denser, weight‐bearing bones. However, smaller bones including patellae, metatarsals, and foot phalanges yielded rates comparable to both femora and tibiae. These elements can be easily sampled with a disposable scalpel, and thus reduce potential DNA contamination. These findings have implications for DNA sampling guidelines in future mass fatality incidents.     

Accuracy and Reliability of Total Body Mass Estimation Techniques from Stature and Bi‐iliac Breadth in Non‐Hispanic U.S. Whites from the Bass Donated Skeletal Collection

This paper tests the fidelity of a recent method that used the NHANES III dataset as a proxy to estimate total body mass from stature and bi‐iliac breadth in U.S. White males and females. The bi‐iliac breadths of 230 males and 152 females identified as non‐Hispanic U.S. White from the Bass Donated Skeletal Collection were measured, and along with stature from predonor paperwork, total body mass estimates were calculated and then compared to body masses recorded on predonor paperwork. Male and female samples were subdivided by body mass index (BMI [kg/m²]) categories established by the World Health Organization. Our results suggest that total body mass estimates can be accurately assessed provided that the individual is within 18.50 ≤ BMI ≤ 29.99 for White males and 18.50 ≤ BMI ≤ 24.99 for White females. Recommendations on how to report total body mass estimates are also presented.     

Anthropological Measurement of the Juvenile Clavicle Using Multi‐Detector Computed Tomography—Affirming Reliability

Currently, there is no standardized protocol for multi‐detector computed tomography (MDCT) measurement of juvenile remains. Using 33 juvenile clavicles, this paper investigates a protocol to allow MDCT measurements, comparable or supplemental with traditional osteometric measurements, to be acquired for application to previously published algorithms. The results illustrate that there is no significant difference between MDCT measurements and those taken by direct osteometric methods. By presenting such a protocol, this paper takes the first steps toward validation of the process of conversion from measurement of dry juvenile bone to MDCT compatibility and allows the forensic world to take a step forward in standardizing the way MDCT is used for forensic practice. This paper assesses the limitations and potential applications of this virtual approach and offers some suggestions for where further work might progress the conversion of these new approaches into legally admissible anthropological techniques of age estimation.     

Age Estimation Based on Pulp Cavity to Tooth Volume Ratio Using Postmortem Computed Tomography Images

Pulp cavity size is known to decrease with age and can therefore serve as an indicator for age estimation. Here, we evaluated whether reconstructed images of multidetector‐row computed tomography (MDCT) acquired before forensic autopsy are useful for estimating age at death. Images of 136 mandibular first premolars obtained from bodies of known age at death were analyzed, and the volume of the regions corresponding to pulp cavity and that of the whole tooth were determined using a voxel counting function. The pulp cavity was clearly distinguishable from dental hard tissue on the reconstructed images when using a cutoff value of 1400 Hounsfield units. Regression analysis adjusted for sex showed that estimated age correlated significantly with the pulp cavity to tooth volume ratio (r = 0.76). MDCT is gaining more widespread use in forensic medicine, and analyzing dental images to obtain parameters for age prediction is a practical approach for postmortem identification.     

Medical forensic investigations of body fragments in the situations of the massive arrivals of corpses

We propose for the first time a set of methods for the determination of sex, face shape, body length and weight for the purpose of forensic medical investigations of fragmented corpses from a mass fatality catastrophe site. The study has demonstrated a high degree of reliability of the assessment of the personality group signs based on a wealth of somatometric data with the use of the multivariate statistic methods. This work has no analogy in forensic medical studies.     

Estimation of Living Stature from Selected Anthropometric (Soft Tissue) Measurements: Applications for Forensic Anthropology

Abstract:  Estimation of living stature has obvious utility in the identification process. Typically, anthropologists estimate stature from the measurement of long bone length. This type of analysis is traditionally conducted on skeletonized or badly decomposed remains, so collection of the necessary bone measurements is relatively simple. As the role of anthropologists expands into medical examiner offices and mass fatality incidents, the analysis of fleshed bodies and body parts is a more common scenario. For stature estimation in these types of cases (e.g., analysis of body portions recovered from an aircraft crash site or from intentional dismemberment), the presence of soft tissue on the human remains would usually necessitate dissection to expose skeletal elements to derive metric data for stature estimation. In order to circumvent this step, this paper provides various formulae that allow for standard anthropometric (i.e., soft tissue) measurements to be used in place of skeletal measurements. Data were compiled from several anthropometric studies (National Health and Nutrition Examination Survey [NHANES] and U.S. Army Anthropometric Survey [ANSUR]) and numerous regression models are presented. Results are compared between skeletal measurements and the anthropometric measurements from each study. It was found that the ANSUR models are similar to the skeletal models, while the NHANES models exhibit weaker correlation coefficients and higher standard errors. Overall, this study finds that stature estimates derived from anthropometric data provide good results and remove the necessity for dissection when working with fleshed body portions.     

Fingering a Murderer: A Successful Anthropological and Radiological Collaboration*

Abstract: We illustrate an interdisciplinary approach to identify a victim in a case with complex taphonomic and procedural issues. Burning, fragmentation, species commingling, and examination by multiple experts required anthropological preparation and analysis combined with radiographic adaptations to image and match trabecular patterns in unusually small, burned specimens. A missing person was last seen in the company of a reclusive female on a remote rural property. A warranted search found several burn sites containing human and animal bones. Fragment preparation, analysis, and development of a biological profile by anthropologists enabled examination by the odontologist, molecular biologist, and radiologist, and justified use of antemortem radiographs from one potential victim. Visual and radiological comparison resulted in a positive (later confirmed) identification of the victim by radiological matches of three carpal phalanges. Although some dimensional changes are expected with burning, morphological details were preserved, aided by selection of relatively intact, small bones for comparison.     

Mortuary operations in the aftermath of the 2009 Victorian bushfires

On the day of the 2009 Victorian bushfires the Victorian Institute of Forensic Medicine activated its emergency plan. Within 48 h a temporary body storage facility was constructed adjacent to the existing mortuary. This temporary facility had the capacity to store up to 300 deceased persons. Pathologists, anthropologists, odontologists, police and mortuary assistants responded from all around Australia, New Zealand and Indonesia. The existing forensic mortuary and staff were divided into two areas: DVI (disaster victim identification) and "routine operations". A high priority for the mortuary was to ensure the casework of the "routine" deceased persons (those cases which were not related to the bushfires) was handled concurrently and in a timely manner. On admission each set of victim remains was given both a Coroner's case number in addition to the DVI number allocated at the scene. The case was CT scanned, examined by a pathologist, an anthropologist, and odontologist and in some instances a fingerprint expert. Where possible a DNA sample was taken. All processes, samples, labels and paperwork underwent a quality assurance check prior to the case completion. Regular audits were conducted. All of post mortem examinations were completed within 20 days of admission. Occupational health and safety issues of the staff were a high priority; this included correct manual handling, infection control and psychological debriefings. During the operation it was found that some remains were contaminated with asbestos. Procedures were set in place to manage these cases individually and each was isolated to reduce the risk of exposure by staff to asbestos. This overall mortuary operation identified a number of significant challenges, in particular the management of multiple parts of human remains for one individual. A new procedure was developed to ensure that all human remains, where possible, were reconciled with identified deceased persons prior to the release to the funeral director. It also highlighted the need to have well documented plans in place including plans for temporary mortuary facilities.     

Aqua-eroticum: an unusual autoerotic fatality in a lake involving a home-made diving apparatus

The term Aqua-eroticum was first introduced in 1984 by Sivaloganathan to describe the unusual autoerotic death of a man using submersion as an asphyxia method. This was the first case of that kind, and since then, no other case of autoerotic submersion has been reported, nor other autoerotic fatality in open water. Here we report the case of a 25-year-old man, nude under a home-made plastic body suit, overdressed for the season with winter clothes and restrained by complex bondage. He was submersed, tied underwater to a boat and was using a home-made diving apparatus for air supply. Death was ruled as accidental autoerotic asphyxia from rebreathing, caused by the faulty air-supply device.     

Disaster victim identification: new applications for postmortem computed tomography

Abstract:  Mass fatalities can present the forensic anthropologist and forensic pathologist with a different set of challenges to those presented by a single fatality. To date radiography has played an important role in the disaster victim identification (DVI) process. The aim of this paper is to highlight the benefits of applying computed tomography (CT) technology to the DVI process. The paper begins by reviewing the extent to which sophisticated imaging techniques, specifically CT, have been increasingly used to assist in the analysis of deceased individuals. A small scale case study is then presented which describes aspects of the DVI process following a recent Australian aviation disaster involving two individuals. Having grided the scene of the disaster, a total of 41 bags of heavily disrupted human remains were collected. A postmortem examination was subsequently undertaken. Analysis of the CT images of all body parts ( n  = 162) made it possible not only to identify and side differentially preserved skeletal elements which were anatomically unrecognizable in the heavily disrupted body masses, but also to observe and record useful identifying features such as surgical implants. In this case the role of the forensic anthropologist and CT technology were paramount in facilitating a quick identification, and subsequently, an effective and timely reconciliation, of body parts. Although this case study is small scale, it illustrates the enormous potential for CT imaging to complement the existing DVI process.     

The Effect of Body Mass on Outdoor Adult Human Decomposition

Forensic taphonomy explores factors impacting human decomposition. This study investigated the effect of body mass on the rate and pattern of adult human decomposition. Nine males and three females aged 49–95 years ranging in mass from 73 to 159 kg who were donated to the Complex for Forensic Anthropology Research between December 2012 and September 2015 were included in this study. Kelvin accumulated degree days (KADD) were used to assess the thermal energy required for subjects to reach several total body score (TBS) thresholds: early decomposition (TBS ≥6.0), TBS ≥12.5, advanced decomposition (TBS ≥19.0), TBS ≥23.0, and skeletonization (TBS ≥27.0). Results indicate no significant correlation between body mass and KADD at any TBS threshold. Body mass accounted for up to 24.0% of variation in decomposition rate depending on stage, and minor differences in decomposition pattern were observed. Body mass likely has a minimal impact on postmortem interval estimation.