Fatal outcome of poisoning with the benzodiazepines flunitrazepam and diazepam

On a wintry day a 29-year-old woman was found dead beside her car showing head injuries and signs of hypothermia. Several empty packets of sedative and hypnotic drugs were lying inside the car. Toxicological analysis revealed the presence of flunitrazepam (heart blood of the left and right chamber 0.033 mg/L each), norflunitrazepam (left heart blood 0.029 mg/L, right heart blood 0.027 mg/L), 7-amino-flunitrazepam (left heart blood 0.090 mg/L, right heart blood 0.104 mg/L), diazepam (left heart blood 0.395 mg/L, right heart blood 0.386 mg/L), nordazepam (left heart blood 0.112 mg/L, right heart blood 0.115 mg/L) and temazepam (left heart blood 0.034 mg/L, right heart blood 0.033 mg/L). Neither alcohol nor other drugs were found. It was concluded that benzodiazepine intake led to a disturbance of consciousness. Whether the woman died in this situation due to the icy temperature as a result of hypothermia or whether she died or would have died solely due to benzodiazepine overdosage could not be clarified.     

Injury pattern in fatal automobile accident passengers due to rear-end collisions

The article reports on the injury pattern seen in fatally wounded car passengers after rear-end collisions on motorways. The study material included 5 rear-end collisions, in which 9 car occupants (5 drivers and 4 front-seat passengers) were killed. The change in velocity (delta v) was above 60 km/h in all the reported cases. The injury pattern showed the following characteristics: extensive soft-tissue traumatization (subcutaneous haematomas, blood-filled pockets, "décollements") not discernible from outside on the back of the trunk, mostly in the lumbosacral region; dorsal serial rib fractures, often combined with fractures of the spine (including the sacrum and the coccyx) and/or the pelvis; ruptures of the aorta at the typical sites of predisposition; ruptures of the liver and spleen (particularly at the visceral surfaces).     

Validation of a 16-locus fluorescent multiplex system

STR multiplexes have been indispensable for the efficient genotyping of forensic samples. The PowerPlex 16 System contains the coreCODIS loci, D3S1358, D5S818, D7S820, D8S1179, D13S317, D16S539, D18S51, D21S11, CSF1PO, FGA, THOI, TPOX, vWA, the sex determinant locus, amelogenin, and two pentanucleotide STR loci, Penta D and Penta E. This multiplex satisfies the locus requirements for most national databases and is the most efficient currently available system due to its single PCR amplification. To provide the groundwork for judicial acceptance, including the publication of primer sequences, and to evaluate laboratory-to-laboratory variation, a developmental validation for casework on this commercially available system was performed in 24 laboratories and produced the following conclusions. Amplification was reliable on a variety of thermal cyclers and product could be analyzed on either an ABI PRISM 310 Genetic Analyzer or an ABI PRISM 377 DNA Sequencer. Genotyping using single source samples was consistent between 0.25 and 2 ng of input DNA template with a few laboratories obtaining complete genotypes at 0.0625 ng. However, heterozygote allele imbalance (<60% peak height balance) caused by stochastic effects was observed at a rate of 13% with 0.125 ng DNA and 22% at 0.0625 ng DNA. Mixture analyses were done using a total of 1 ng of DNA template. Most alleles were detected in mixtures of 4 to 1 and some minor alleles were detected in mixtures of 19 to 1. Optimum amplification cycle number was dependent on the sensitivity of the detection instrument used and could also be adjusted to accommodate larger amounts of DNA on solid supports such as FTA paper. Reaction conditions including volume, annealing temperature, and concentrations of primer, AmpliTaq Gold, and magnesium were shown to be optimal yet robust enough to withstand moderate variations without affecting genotype analysis. Environmental, matrix and standard source analyses revealed an ability to obtain complete genotypes in all sample types except those exposed to 80 degrees C for 12-48 days. Finally, comparison of genotype results from the PowerPlex 16 System with other commercially available systems on non-probative reference and forensic samples showed consistent results.     

Analysis of ionic ratios in myocardial tissue and their relation to cardiac damage

The authors evaluated the usefulness of the postmortem biochemical analysis of ionic ratios in different parts of the heart and their relation to cardiac damage caused by chest trauma, as observed by anatomopathologic study. Fifty-nine 59 cases were studied, selected from routine necropsies, and samples were taken from different sites of cardiac tissue. The cause of death was trauma in 40 cases and nontraumatic causes in 19 cases. The object of this study was to analyze the levels of Na+, K+, Ca+2, Mg+2, and Zn+2 in different zones of the heart, and the relationship between intracellular and extracellular ion ratios and the different causes of death and any anatomopathologic alterations observed. The biochemical tests revealed a possible relation between the ionic values and cause of death. Alterations in cell membrane permeability and corresponding modification of the ionic ratios were produced earlier than histologic alterations, which need longer to establish themselves whether or not they follow a traumatic process.     

Suspects,Lies, and Videotape: An Analysis of Authentic High-Stake Liars

This study is one of the very few, and the most extensive to date, which has examined deceptive behavior in a real-life, high-stakes setting. The behavior of 16 suspects in their police interviews has been analyzed. Clips of video footage have been selected where other sources (reliable witness statements and forensic evidence) provide evidence that the suspect lied or told the truth. Truthful and deceptive behaviors were compared. The suspects blinked less frequently and made longer pauses during deceptive clips than during truthful clips. Eye contact was maintained equally for deceptive and truthful clips. These findings negate the popular belief amongst both laypersons and professional lie detectors (such as the police) that liars behave nervously by fidgeting and avoiding eye contact. However, large individual differences were present.     

Expert Testimony Pertaining to Battered Woman Syndrome: Its Impact on Jurors' Decisions

Participants (N = 200) were presented with a criminal homicide trial involving a battered woman who had killed her abuser. Within the trial, both the response history (passive, active) and presence of expert testimony pertaining to battered woman syndrome (present, absent) were systematically varied. As well, half of the participants in each of these conditions were provided with a nullification instruction informing them that they were free to disregard the law and acquit should a strict application of the law result in an unjust verdict. Results indicated that, compared to the passive response condition, the mock jurors were no less receptive to the expert testimony in the active response condition. The impact of the testimony on participants' verdicts, however, was moderated by the nullification instruction. That is, although the presence of the testimony did result in greater verdict leniency, this only occurred when the mock jurors had been released from a strict application of the law. The implications of these findings are discussed.     

Recent developments in medicine and law

This article addresses important developments in the field of medicine and law during the period of September 2000 through August 2001. It does not discuss every reported case or piece of legislation but surveys some of the more significant developments in the medicine and law arena.