Deep incisional neck injuries caused by an electric knife

Electric knives, due to the double blades swinging in opposite directions, have a high injury potential. Tissues such as skin can be cut smoothly without cutting motion and with only little pressure. Authors report on the case of a woman of 47 years who cut herself deeply on both sides of her neck with an electric knife, slightly carving a notch into the larynx and a cervical vertebra and opening large blood vessels. With respect to the extent of injuries the capacity to act had to be questioned. However, considering the absence of venous air embolism and the peculiarity of the tool it had to be assumed that the capacity to act lasted for a short time.     

Conceiling the cadaver in masonry and cement

Encasing with concrete and/or bricks are relatively rare forms of hiding or disposing of a body; criminologically, cases of this kind are often treated as "matters involving a missing person" at first. The article describes the circumstances and findings of 2 cases in which bodies were encased with concrete. Under the aspects of reconstruction it is of importance that bodies may be preserved quite well in concrete, which allows not only identification of the victim but also determination of the cause of death even after a prolonged post-mortem interval, the more so as occasionally tools used for committing the offense are also encased together with the body.     

Postmortem distribution of sertraline and desmethylsertraline in a fatality

Sertraline (CAS 79617-96-2) is a relatively safe medication for patients suffering from depression. Data reporting the postmortal distribution of sertraline and desmethylsertraline remain rare as well as reports of risks of side effects following ingestion of the drug. In a case of a young woman found dead in her flat sertraline and desmethylsertraline were identified and quantified in body fluids and tissues by gas chromatography/mass spectrometry and high performance liquid chromatography with diode array detection after alkaline extraction. Sertraline and its desmethyl metabolite were found in the peripheral blood in levels of 0.15 mg/l and 0.20 mg/l, concentrations in liver and bile were markedly higher. By exclusion of other reasons for death a lethal sertraline intoxication was decided. Sertraline is suggested to possess a low inherent toxicity, however, a risk of side-effects which may occur in single cases even under moderate dosages should be considered.     

Satanism and suicide in adolescence--2 case reports

Death cases--suicides as well as homicides--within the context of satanism are meanwhile becoming routine casework for forensic pathologists. Therefore the investigators should be aware of satanic signs and items associated with the occult to identify a satanic background. Based on two suicides of young persons, satanic signs helpful for classification are pointed out.     

Discovery,assessment and reconstruction of homicide with photographs of the murder

Report on a case in which photographs of the murder were the first hint pointing to homicide. Due to the advanced decomposition of the body the photographs were essential for the reconstruction of the homicide, in particular for the differentiation of the intravital injuries against postmortem lesions and the chronological order of the acts of violence.     

Persistence of Biological Traces at Inside Parts of a Firearm from a Case of Multiple Familial Homicide

Backspatter from wounds caused by contact shots against a biological target had before been shown to be propelled into firearms' barrels where they can persist and be retrieved from as relevant forensic evidence. Herein, that insight was applied to the investigation of a case of multiple familial homicide with a firearm. Samples of backspatter were collected from the firearm using DNA‐free swabs. DNA was extracted from the swabs, and 16 STR systems were PCR‐amplified to generate DNA profiles of all victims shot by the firearm. The quality of the resulting DNA profiles was sufficient to exclude the perpetrator as donor and to differentiate the three closely related victims thereby proving that all three victims had been shot by the same firearm from very close or contact distance. A key insight gained from this case was that not only a firearms' barrel inside but other inner surfaces may be charged with profilable DNA.     

Sudden infant death syndrome (SIDS)--standardised investigations and classification: recommendations

Sudden infant death syndrome (SIDS) still accounts for considerable numbers of unexpected infant deaths in many countries. While numerous theories have been advanced to explain these events, it is increasingly clear that this group of infant deaths results from the complex interaction of a variety of heritable and idiosyncratic endogenous factors interacting with exogenous factors. This has been elegantly summarised in the "three hit" or "triple risk" model. Contradictions and lack of consistencies in the literature have arisen from diverse autopsy approaches, variable applications of diagnostic criteria and inconsistent use of definitions. An approach to sudden infant death is outlined with discussion of appropriate tissue sampling, ancillary investigations and the use of controls in research projects. Standardisation of infant death investigations with the application of uniform definitions and protocols will ensure optimal investigation of individual cases and enable international comparisons of trends.     

Medical malpractice as reflected by the forensic evaluation of 4450 autopsies

A multicentre retrospective analysis of 4450 autopsies carried out due to suspicion of medical malpractice in 17 German institutes of forensic medicine from 1990 to 2000 was performed for the German Federal Ministry of Health. During the time period analysed an increase of cases could be mentioned. The main results of the study are: in the cooperating institutes the total number of autopsies due to suspected medical malpractice ranged from 1.4 to 20%. In more than 40% of the cases preliminary proceedings were started because the manner of death was certified as non-natural or not clarified. Hospital doctors were more affected by medical malpractice claims than doctors in private practice. However, the number of confirmed cases of medical malpractice was higher for doctors in private practice than for hospital doctors. Although surgery is still at the top of the disciplines involved in medical malpractice claims the number of confirmed surgical cases was below the average. Mistakes in care were confirmed to be above the average. Medico-legal autopsies are still a very sufficient method to evaluate cases of medical malpractice: 2863 cases could already be clarified by autopsy. Up to now there is no systematic registration of medical malpractice charges in Germany. A systematic registration should be initiated to build up and/or improve error reporting systems and, thus, to improve patient safety. Compared to other sources of medical malpractice claims (arbitration committees of the medical chambers, reference material of health and insurance companies, files of civil courts) the data of the present multicentre study are in so far unique as only lethal cases were evaluated and a complete autopsy report was available as basis of an expert opinion in alleged medical malpractice cases.     

Post-mortem biochemical investigations of vitreous humor

For several decades vitreous humor has been used for post-mortem biochemical investigations with the objective of a post-mortem diagnosis of pre-existing diseases and the clarification of forensic issues, in particular the determination of the post-mortem interval. For the determination of measured concentrations in vitreous humor pre-analytic factors as well as analytical and instrumental variations have to be taken into consideration. The aim of this study was a methodical investigation of two methods of sample pre-treatment as influencing variables. The compared methods were centrifugation and treatment in the ultrasonic bath. The determined parameters were sodium, potassium, chloride, calcium, lactate, urea, glucose and creatinine. Analyses were performed photometrically or by an ion-selective electrode. For some of the analytes a dilution was necessary before analysing. Regarding to the two pre-treatment methods, significant differences in the measured concentrations were not found. The precision proved to be mostly unsatisfying and was clearly better in diluted samples than in undiluted aliquots. A comparison of the vitreous humor of the two ocular bulbs did not lead to significant differences.