Multiple homicides as a result of chloroform poisoning: case report and experimental study.

Two cases (involving five murder victims) of multiple homicide by inhalational chloroform intoxication are reported. In the discussion of the findings the valence of toxicological analyses is underlined with regard to the possibility of forcible external suffocation due to occlusion of the respiratory orifices by means of a chloroform-soaked soft covering. In addition storage experiments were performed at +4, +20 and -20 degrees C with cadaver blood mixed with chloroform. The optimal solution for avoiding volatile losses was stored in glass tubes with ground glass stoppers. In cases of unclear death in which involvement of volatile substances is suspected it is, therefore, advisable to preserve an additional blood sample at -20 degrees C in glass tubes that are only opened for the analysis of volatile substances.     

Commotio cordis as a result of a fight: report of a case considered to be imprudent homicide

The report describes a fatal outcome in a 5-year-old male who died after drinking a fatal dose of ethanol at the party held by his parents. Urine and blood alcohol level of the deceased was 0.4 and 0.5 g/dL, what might explain the sudden death of the child. In addition, the analysis of the boy's hair demonstrated the presence of ethyl glucuronide (EtG), a marker of alcohol consumption; hair EtG concentration levels indicated that the boy might have occasionally imbibed alcohol prior to death. Pathological lesions of the liver observed in histopathology did not contradict such a hypothesis.     

Commotio cordis as a result of a fight: Report of a case considered to be imprudent homicide

Commotio cordis is a clinic-pathological syndrome related to sudden death in young people involved in sports activities. It has been described, mainly, in athletes without previous cardiac anomalies who received a minor blow to the chest which produces ventricular fibrillation and cardiac arrest in the absence of structural damage to the ribs, sternum, or heart. There are few reported cases of commotio cordis associated with violent, non-sports related actions, which are commonly considered to be imprudent homicides. We present the case of a 20-year-old man, who was kicked in the chest during a fight; he suddenly collapsed although advanced cardio-respiratory resuscitation started shortly. Autopsy showed no cardiac lesions concluding that death was due to commotio cordis (blunt trauma to the chest). Toxicological analysis determined the presence of 5.14 mg/L benzoylecgonine in blood. On the basis of medico-legal investigation, the official prosecution considered the death to be imprudent homicide and the aggressor was sentenced to 4 years in prison. We emphasize the importance of the knowledge of the death circumstances through the witnesses’ testimony, prior to beginning the autopsy, to confirm this important medico-legal diagnosis. Arrhythmogenic effects of cocaine and its contribution in the production of these deaths are also exposed.     

Immunohistochemical analysis of forensic evidence from a double homicide

We report the use of immunohistochemical staining for analysis of forensic evidence from a double homicide. A 38-year-old woman and her 7-year-old daughter were murdered by multiple blows to the head and face with a tomahawk, resulting in multiple fragments of brain tissue scattered about the murder scene. The victims' husband and father was the main suspect, who maintained that he was out of town on business during the evening of the murders. However, a shirt taken from the suspect's car on the morning after the murders (secured by the police before the suspect visited the murder scene) was found to have two small stains. DNA analysis on the stains showed the presence of the deceased wife's DNA, and immunohistochemical stains on shirt fragments conclusively documented the presence of deep central nervous system tissue, providing the critical piece of evidence needed to arrest and prosecute the suspect. This report demonstrates that shirt or similar cloth fragments can be processed into paraffin blocks and subsequently immunostained to search for and classify types of tissue fragments that may be present on the fabric.     

A case of suicidal hanging staged as homicide

Suicides staged as homicides are rarely encountered by crime scene investigators. The case of one such staged homicide is presented in which the victim used restraints during a hanging. No other cases of suicidal hangings staged as homicides could be found in the forensic literature. Similar cases should be reported so additional data can be gained from these deaths to help reveal indicators of suicide rather than homicide.     

Aggression homicide and rejection homicide: a communicative classification of homicide

Based on a 10-year sample of homicides (n = 50), the hypothesis was tested that it is possible to differentiate between aggression and rejection homicide. The aggression homicide results from the offender/victim relationship, which is no longer accepted for some reason. In contrast, in the rejection homicide the offender radically strives for a goal which can only be reached if the victim is eliminated. Based on forensic-psychiatric expert opinions (n = 50), the case analyses yielded 31 aggression homicides and 18 rejection homicides, one case could not be classified. Aggression homicides differed significantly from the rejection homicides with regard to their main motives. Hate in quarrel (n = 8), violent occupation of the victim (n = 7), delusions (n = 5), revenge (n = 3), self-defence (n = 2), and jealousy (n = 1) characterized the aggression homicides, whereas rejection homicides were dominated by economic motives (n = 14). Two offenders intended to get rid of the victim and one offender wanted to rescue a third person. From a forensic-psychiatric point of view, the pertinent statistical data (social data, diagnosis, criminal responsibility) are reported and the significance of the differentiation between aggression homicide and rejection homicide for medico-legal or criminological case profiling and for the prognosis of the risk potential is discussed.     

Dementia as a risk factor for homicide.

We report a patient with dementia due to B-12 deficiency and syphilis who presented to a forensic hospital after killing his ex-wife with a gun. Despite current awareness on the occurrence of aggression and violence in patients with dementia, there has been no report discussing dementia secondary to an infectious or nutritional origin causing homicide or severe violent behavior. We discuss possible mechanisms and several predisposing factors for violent behavior in the elderly. We also discuss use and access of a gun in demented patients and its complications. We recommend availability of neuropsychiatric assessments in the elderly, limitation of gun access to demented patients and inquiry about weapon possession in the elderly.     

Unexpected double lethal oleander poisoning

Nerium oleander is a very popular urban ornamental plant in Europe, but it is also extremely dangerous because it contains several types of glycosides, accidental ingestion of which can cause cardiac arrhythmias and even deaths. The rarity of such cases makes it difficult to think of oleander poisoning without evidences that suggest this possibility as the cause of the unexpected death. This report concerns the discovery of the bodies of 2 young people, a man and a woman, in a forest in conditions of extreme malnutrition. Medicolegal investigations showed neither pathologic nor traumatic causes of death, but the presence of vegetal remains in the stomach was noticed. A common toxicological analysis resulted negative, but the implementation of more detailed investigations showed the presence of digoxin in the blood of both cadavers, excluding the possibility of a pharmaceutical provenience of digoxin, this laboratory result was interpreted as evidence of ingestion of oleander, which contains oleandrine, the cross reaction of which with digoxin is widely described in the literature. Identification of the 2 subjects, which occurred after 4 years, strengthened the hypothesis of accidental poisoning by oleander because it was ascertained that the 2 young people were vegans--extreme vegetarians who reject the ingestion of foods of animal origin and live by eating only what they find in nature.     

Palynology and mycology as biological evidence in a homicide case

Criminal cases are studied from several disciplines to link a suspect with a criminal act. In this case, a man was reported missing in a coastal area in Buenos Aires Province, Argentina. The victim's relatives pointed to a possible suspect, and the local police carried out the investigation. We contributed to this research by applying palynological and mycological techniques. Palynomorphs and fungal spores offer valuable trace evidence, as they can be easily transferred between objects and crime scenes due to their minute size and persist on them for a long time. The victim was found 25 days later, lying on sandy soil, which partially covered the body, 35 km from where the suspect was arrested. Comparative samples were collected from the crime scene and the suspect's home and belongings (clothes, footwear, and seized vehicle). The palynological associations obtained from the crime scene and the defendant's belongings were dominated by diatoms and acritarchs (Acantomorphitae), all elements of marine origin, and a high CFU number of Bipolaris cynodontis, which allowed the defendant's clothing to be related to the place of corpse discovery. Soil from the defendant's home had an entirely continental composition, and the fungal biota was characteristic of prairie areas which were different from those of the crime scene.     

Decapitation as a result of suicidal hanging

A report is presented on a 47 year old man who committed suicide by hanging himself from a staircase bannister of an apartment house. The man, weighing 144 kg jumped with the noose of a 2 cm thick and 2 m long hemp rope around his neck and was completely decapitated. Death from typical "normal" suicidal hanging is usually due to cerebral ischaemia caused by compression of the carotid (and vertebral) arteries. Except for bleeding at the clavicular insertions of the sternocleidomastoid muscles there are only occasional injuries to the cervical soft parts or hyoid bone and/or laryngeal cartilage. A fall with a noose around the neck, on the other hand, is associated with more frequent injuries to cervical structures through additional axial traction and radial shearing forces of the tightening noose. Complete decapitation can occur in rare cases under extreme conditions (heavy body weight, inelastic and/or thin rope material, fall from a great height).     

Determination of questionable suicide as a homicide by studies of criminal stains

In a woman found dead with cuts on both arms in a domestic sauna plastered with blood were assumed next to a bleed to death. The question self-infliction or by a third party of arm injuries could not be decided. By investigation of blood traces only could be clarified the cause of death. The husband had strangled his wife and inflicted several cuts on both arms with a razor blade to simulate suicide. Afterwards, he also inflicted several cuts on himself with a razor blade with the intention of suicide. He survived these injuries.     

Spousal homicide and the subsequent staging of a sexual homicide at a distant location

The case of a 63-year-old man who killed his 52-year-old wife and then staged a sexual homicide at a distant location is reported. A review of all evidence, a forensic psychological interview, and psychological testing indicated that the murder was the result of a narcissistic rage reaction during which the subject beat his wife to death with a paint can, a clothing iron, and a rock. He then drove her body to a field 87.3 miles away, and positioned it in a manner that exposed her breasts and her underwear. He turned himself into the police two days later. There is no controlled empirical research on staging, although this single case supports the criminal investigative theory that staging exists, and is done to deliberately mislead homicide investigations (Douglas et al., 1992).     

Cross-national comparison of homicide: Age/sex-adjusted rates using the 1980 U.S. homicide experience as a standard

Cross-sectional studies of crime have typically relied on crude crime rates when making comparisons between countries. Crude rates control for population size but implicitly assume that all members of the population are equally at risk. Empirical studies have shown that, cross-nationally, risk varies by age and sex. Standardization of crime rates removes the confounding effects of variable age and sex population distributions. Since age/sex-specific crime rates are generally unavailable for many countries, the method of indirect standardization is the most desirable technique. Age/sex-adjusted homicide rates for 76 countries are presented, and two comparative measures are suggested. It is shown that while the United States has a higher homicide rate than all but 15 countries; in most cases, the magnitude of the difference, not controlling for age/sex differences, is overestimated. Crude rates underestimate differences between the United States and countries with higher rates of homicide.     

Unexpected death as a result of infective endocarditis

Thirteen cases of infective endocarditis (IE) diagnosed for the first time at autopsy or, in those patients with a previous diagnosis of IE, not thought to be active at the time of death, are presented. Of the six patients who died within 24 h of the onset of symptoms, two died of obstruction of a valve orifice, two died of sepsis, one died of sepsis and alcoholic cardiomyopathy, and one died of a coronary artery embolus. Of the five patients with symptoms lasting more than 24 h, three died of sepsis and congestive heart failure. One died from sepsis alone and one died from congestive heart failure (CHF). In two patients whose duration of symptoms is unknown, one died of sepsis and CHF, and in the other the mechanism of death is unknown. Predisposing factors present in 11 of 13 patients included alcoholism (three), intravenous (IV) drug abuse (three), prosthetic valves (three), aortic stenosis (two), past rheumatic fever (one), and nonstenotic congenitally bicuspid valves (two). The reasons for no antemortem diagnosis were a missed or incorrect clinical diagnosis in three patients seen by a physician shortly before death, no signs or symptoms or found dead (four), non-specific signs and symptoms (three), refusal of medical treatment (one), and a solitary lifestyle (one); there was insufficient information about one patient. Individuals with needle tracks, generalized petechiae. Osler's nodes, splinter hemorrhages, intravenous catheters, pacemaker wires, and infected aortic-valve (A-V) shunts are at risk of IE. Blood and the vegetations should be cultured. The attending physician should be notified of the diagnosis in such cases.     

The future of homicide offenders. Results from a homicide project in Copenhagen

As a part of a Copenhagen homicide project, 52 released homicide offenders were followed during a mean period of 9 years. Pessimistic expectations were confirmed as post-release rates of criminality, psychiatric admission, and suicide were all very high. By logistic regression analyses, young age by release, and long stay in prison were found to increase the risk of further criminality, and previous psychiatric admission was found predictive of future admission. The problems in using logistic regression analysis on variables--all of whom may be viewed as "parallel" indicators of a common tendency to adverse behaviors--are discussed. In conclusion, the results have been used for a tentative division of homicide according to the offender-victim relationship into intra-family homicide and extra-family homicide. In intra-family homicide the most important dimension seems to be the psychic state of the offender, in extra-family homicide more impact should be attributed to the social dimension.     

A profile of parental homicide against children

The purpose of this study was to provide a profile of victims and offenders in cases where children were killed by their parents. The data were all incidents (3,459) in which a parent killed a child under age 18, which were recorded in theUniform Crime Reports between 1976 and 1985. In the first week of a child's life, the risk of being killed by a parent was equal for males and females. From 1 week to 15 years, males were the victims in about 55% of all parent-child homicides; the percentage of male victims increased to 77% in the 16–18 age group. Among infants in the first week of life, mothers were almost always the ones who committed the homicide. Between the first week of life and the teenage years, mothers and fathers were about equally likely to kill their child. During the 13–15 year age group, fathers committed 63% of all homicides, and this increased to 80% among the 16–18 year age group. Among very young children, the causes of death tended to be personal weaponds, asphyxiation, or drowning. As age increased, the weapons became predominantly guns and knives.