A soft-tissue calcification: differential diagnosis and pathogenesis

An autopsy of a 72-year-old white male revealed a 30.5 x 5.1 cm vertically aligned heterotopic ossification just deep to a 30.5 cm midline abdominal scar. The ossified mass was determined to be a heterotopic ossification or myostitis ossificans (MO) traumatica resulting from an abdominal surgical incision during life. While, MO traumatica is relatively common accounting for roughly 60-75% of patients with soft-tissue ossification, heterotopic ossification of abdominal incisions are relatively rare and thus infrequently reported. This article details the manifestation of this relatively large heterotopic bone and provides a comprehensive review of the literature and pathogenesis of this unusual ossification. A review of the English literature from 1920 to the present produced only a handful of articles for a total of 185 reported cases. All had bone formed within vertical incisions, usually within 1 year of surgery, and 89% were males. Knowledge of this phenomenon and the variable size at presentation is useful to both the autopsy pathologist and the anthropologist in generating a diagnosis for abnormal calcifications.     

Using a Five-Stage Model to Evaluate Workplace Discrimination Injuries

Psychological assessment for workplace discrimination injuries is often complex, as each complainant has a particular personal history and context, including different coping skills, psychopathologies and unique life circumstances. A five-stage model based on best practice guidelines can assist forensic assessment practitioners in determining compensatory damages for psychological or psychiatric injuries and in formulating defensible, evidence-based reports that meet legal standards. The model incorporates legally relevant theories of causation to guide the evaluating psychologist to discern the nature and extent of any injury, and whether discrimination was the likely proximate cause. The focus is not on diagnosis but on functional performance (cognitive, affective, interpersonal and physical) in four key contexts: activities of daily living, relationships, the workplace and hedonic pursuits. This assessment method compares functioning in the complainant’s life until the “day before” the alleged discrimination event with the complainant’s condition at the time of the alleged discrimination, and any symptoms or reactions experienced subsequently. The five-stage model provides a systematic method to examine compensatory damages claims and increase the comprehensiveness and accuracy of the forensic evaluation.     

The Rise of Digital Justice: Courtroom Technology,Public Participation and Access to Justice

This article addresses a little discussed yet fundamentally important aspect of legal technological transformation: the rise of digital justice in the courtroom. Against the backdrop of the government's current programme of digital court modernisation in England and Wales, it examines the implications of advances in courtroom technology for fair and equitable public participation, and access to justice. The article contends that legal reforms have omitted any detailed consideration of the type and quality of citizen participation in newly digitised court processes which have fundamental implications for the legitimacy and substantive outcomes of court‐based processes; and for enhancing democratic procedure through improved access to justice. It is argued that although digital court tools and systems offer great promise for enhancing efficiency, participation and accessibility, they simultaneously have the potential to amplify the scope for injustice, and to attenuate central principles of the legal system, including somewhat paradoxically, access to justice.     

Revoking consent: A ‘blind spot’ in data protection law?

The flow of personal data throughout the public and private sectors is central to the functioning of modern society. The processing of these data is, however, increasingly being viewed as a major concern, particularly in light of many recent high profile data losses. It is generally assumed that individuals have a right to withdraw, or revoke, their consent to the processing of their personal data by others; however this may not be straightforward in practice, or addressed adequately by the law. Examination of the creation of data protection legislation in Europe and the UK, and its relationship with human rights law, suggests that such a general right to withdraw consent was assumed to be inbuilt, despite the lack of express provisions in both the European Data Protection Directive and UK Data Protection Act. In this article we highlight potential shortcomings in the provisions that most closely relate to this right in the UK Act. These raise questions as to the extent of meaningful rights of revocation, and thus rights of informational privacy, afforded to individuals in a democratic society.     

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.     

Massive systemic fat embolism detected by postmortem imaging and biopsy*

Postmortem computed tomography (pmCT) and pmCT angiography (pmCTA) provide a minimally invasive method to determine the cause of death. Postmortem image-guided biopsy allows for precise sampling of histological specimens. This case study describes the findings of lethal systemic fat embolism (FE) on whole-body unenhanced pmCT, pmCTA, and image-guided biopsy, with autopsy and histopathologic correlation. Unenhanced pmCT revealed a distinct fat level on top of sedimented layers of corpuscular blood particles and serum in the arterial system and pulmonary trunk. Subsequent pmCTA showed reproducible results, and image-guided biopsy confirmed fatal FE. pm CT/pmCTA combined with image-guided biopsy established the cause of death as right heart failure as a result of systemic fatal FE prior to autopsy. All imaging findings were consistent with traditional autopsy and histological specimens. This unique case demonstrates new imaging findings in massive, fatal FE and highlights that postmortem imaging, supplemented by image-guided biopsy, may detect the cause of death prior to traditional autopsy.