Fall from height--surprising autopsy diagnosis in primarily unclear initial situations

External post-mortem examination and first police assessments are often not consistent with subsequent autopsy results. This is all the more surprising the more serious the injuries found at autopsy are. Such discrepancies result especially from an absence of gross external injuries, as demonstrated by four examples. A 42-year-old, externally uninjured male was found at night time in a helpless condition in the street and died in spite of resuscitation. Autopsy showed severe polytrauma with traumatic brain injury and lesions of the thoracic and abdominal organs. A jump from the third floor was identified as the cause. At dawn, a twenty-year-old male was found dead on the grounds of the adjacent house. Because of the blood-covered head the police assumed a traumatic head injury by strike impact. The external examination revealed only abrasions on the forehead and to a minor extent on the back. At autopsy a midfacial fracture, a trauma of the thorax and abdomen and fractures of the spine and pelvis were detected. Afterwards investigations showed that the man, intoxicated by alcohol, had fallen from the flat roof of a multistoried house. A 77-year-old man was found unconscious on his terrace at day time; a cerebral seizure was assumed. He was transferred to emergency care where he died. The corpse was externally inconspicuous. Autopsy revealed serious traumatic injuries of the brain, thorax, abdomen and pelvis, which could be explained by a fall from the balcony. A 47-year-old homeless person without any external injuries was found dead in a barn. An alcohol intoxication was assumed. At autopsy severe injuries of the brain and cervical spine were found which were the result of a fall from a height of 5 m. Conclusion: On the basis of an external post-mortem examination alone gross blunt force trauma cannot be reliably excluded.     

Cases of fatal poisoning in post-mortem examinations at the Institute of Forensic Medicine in Greifswald--analysis of five decades of post-mortems

Apparently, fatal poisoning as cause of death are still rarely found in unnatural deaths investigated in the institutes of forensic medicine. In the Institute of Forensic Medicine at the University of Greifswald, 10-15% of the post-mortem autopsies displayed an intoxication during the last several decades with a possible decreasing tendency. Thirteen thousand eight hundred and nineteen autopsies were carried out in our institute-situated in a low populated rural area-during the last 50 years with the confirmed death cause intoxication in 1,589 times. In this study, especially the intoxication causes and the substance classes of the poisonous agents have been investigated. In addition, we analyzed the frequency of intoxications as well as sex and age of the deceased. Surprisingly, CO-intoxications were found most frequently with an incidence of 49% followed by alcohol intoxications with 21%. The latter was not unexpected taking into account the habits of the local population. Medical drugs and narcotics take only the third place, although the abuse of modern narcotics drugs is already visible even in the far east of Germany. The spectrum of substances which are abused, taken accidentally or deliberately is continuously changing, reflecting scientific progress in the pharmaceutical industry as well as fashion tendencies. Therapeutic use is almost always followed by abuse. Our results confirm prior experience concentrating mostly on other poisons like heavy metals or herbicides, etc. In addition, we could demonstrate the influence of political conditions on use and distribution of illegal drugs in Germany. Our study clearly demonstrates that insufficient equipment or analytical methods are no longer the reason for any problems uncovering lethal intoxications. They are rather due to insufficient investigations of the corpses (without considering the possibility of an intoxication as differential diagnosis) and to frequent mistakes of the prosecutor's office in death without signs of physical violence. These facts may explain the above mentioned decreasing tendency of intoxications, but they also clarify that this tendency probably does not correspond to reality.     

Quality awards as a public sector benchmarking concept in OECD member countries: some guidelines for quality award organizers

In many OECD member countries, quality awards have become an important benchmarking instrument for public and especially private sector organizations. Quality awards pursue two main goals: one is to introduce elements of competition in areas of the public and the private sectors that lack of market competition; the other is to encourage organizational learning. The problem is that in a public sector context these aims seem to be mutually exclusive. The aim of the article is to show quality award organizers how to realize the full potential of quality awards by making the appropriate choices in the design of a public sector quality award. The conclusion is that the stage of public sector quality management and the degree of ‘publicness’ of the public sector in a given country will influence the competition‐inducing and learning effect of a national quality award in an adverse way. Nevertheless, the negative effects on one or the other element of quality awards can be counterbalanced by the appropriate choice of the scope of the quality award, the area to be evaluated, the evaluation criteria as well as the benchmarking concept. Last but not least, quality award organizers should keep in mind that quality awards are not a benchmarking instrument for all seasons. Copyright © John Wiley & Sons, Ltd.     

Anforderungen an die Erfassung, Bewertung und Sanierung von Biodiversitätsschäden nach dem Umweltschadensgesetz

Zusammenfassung  Durch das Umweltschadensgesetz wurde eine ?ffentlich-rechtliche Verpflichtung zur Kompensation für gesch?digte natürliche Ressourcen und Funktionen implementiert, die unabh?ngig von der Vorhabenzulassung oder dem Vorliegen eines Eingriffs ist und damit deutlich über die Verpflichtungen aus der naturschutzrechtlichen Eingriffsregelung hinausgeht. Bisher herrscht eine gewisse Unsicherheit im Umgang mit dem neuen Instrument. Vollzugshinweise in den L?ndern fehlen weitgehend. Auch sind F?lle, in denen das Umweltschadensgesetz zur Anwendung gelangte, bisher nicht systematisch erfasst, Rechtsprechung liegt noch nicht vor. Der Beitrag gibt daher Hinweise zur rechtlichen wie naturschutzfachlichen Operationalisierung der zentralen Regelungen zur Erfassung, Bewertung und Sanierung von Biodiversit?tssch?den und bietet Unterstützung für die Umsetzung und den Vollzug des Instrumentariums in den L?ndern.     

Teilhaftung bei alternativer Kausalität mit Zufall

Der Beitrag besch?ftigt sich mit der schadenersatzrechtlichen Problematik der alternativen Verursachungskonkurrenz von Haftungsgrund und Zufall und dabei insb mit der Probleml?sung über eine Teilhaftung für blo? m?gliche Kausalit?t. Neben einer Erl?uterung der einer Teilhaftungsl?sung zugrunde liegenden Gedanken und der anerkennenden Stimmen in Lehre und Judikatur erfolgt eine Darstellung und Würdigung der dazu ergangenen kritischen Stellungsnahmen.