The role of environmental factors in the causation of sudden death in infants: two cases of sudden unexpected death in two unrelated infants who were cared for by the same babysitter

We report two cases of sudden unexpected death in two unrelated African American female infants, 2 months and 4 months old. Both infants were attended to by the same babysitter in the same apartment and died 39 days apart in the same bed and in the same bedroom. The autopsy of the first infant revealed sudden unexplained death in an infant. Toxicologic analysis for carbon monoxide (CO) was not performed because it was not suspected. When the second infant died, investigation into the ambient air quality within the apartment revealed high levels of CO emanating from a poorly ventilated and defective hot water heater, which was located across a hallway from the bedroom where the two babies died. CO saturation levels in the postmortem blood samples of the two babies were elevated and were similar (13% and 14%). Nicotine and cotinine were not detected in the blood sample of the two infants. Cherry-red livor mortis was absent. Acute CO intoxication was determined to be the underlying cause of these two unexpected deaths. These two cases underscore the need to integrate ambient air analysis and postmortem CO analysis as routine components of the comprehensive death investigation of infants who die suddenly and unexpectedly.     

Harness racing injuries and deaths. Report of a fatal accident and review of 178 cases

A case of a harness racing accident in which the driver died of head injuries is presented. To evaluate the victim's head injury and corresponding helmet damage, a videotape of the race was reviewed and analyzed. Based on calculations of a simplified trajectory analysis and testing of the helmet, it was determined that the helmet design did not provide adequate protection for the victim. The standards for harness helmet design are being re-evaluated by the harness racing industry to ensure the safety of the drivers. A review of 178 harness racing injuries and deaths, current harness helmet research, and recommendations for safer helmets are discussed. A protocol for the forensic investigation of sports-related injuries and/or deaths is also presented to assist medical examiners in fulfilling their roles as practitioners of preventive medicine.     

High cyanide level in a homicide victim burned after death: evidence of post-mortem diffusion.

Elevated levels of carbon monoxide and cyanide serve as evidence of intravital burning in fire victims. Hydrogen cyanide is released by combustion of nitrogen-containing organic material such as plastics and wool. We present a case of a man who died of haemopneumothorax caused by a stab wound. According to several eye witnesses the body was wrapped in a plastic sheet and burned 2 days after death with the aid of gasoline. No coal pigment was observed in the mucosa of the upper airways at autopsy. The blood sample taken from the pulmonary vessels 6 days after death disclosed a level of blood carboxyhaemoglobin of 4% and of blood cyanide of 10 mg/l. The low carboxy-haemoglobin level was consistent with the smoking habits of the victim. The thoracic cavity had been opened by burning of the intercostal soft tissue. This allowed hydrogen cyanide gas to enter the thoracic cavity and diffuse into the blood probably causing the high blood-cyanide level.     

OBSERVATIONS ON POLICE UNDERCOVER WORK*

Law enforcement officers are dependent upon citizens to alert them to criminal violations of the law. When citizens do not willingly communicate information to the police or cannot be induced to do so, police officers themselves adopt fictitious identities of various types. This paper explores police undercover work, a form of covert law enforcement used to gather information about conduct external to the organization. Through interviews with supervisors and practitioners, the benefits and liabilities of the assignment for the officers and the organization are presented. The work enables the police to investigate citizens who are not suspected of criminal activity and therefore lends itself to abuse. The practice itself demands attention as the lack of operational guidelines, standardless selection of operatives, and loose supervision imperil the safety of officers and the rights of citizens.     

Grasping the Commercial Institutional Peace

While the commercial institutional peace research program provides empirical evidence that international institutions, especially preferential trade arrangements, help reduce the incidence of militarized inter-state conflict, it fails to delineate clearly how such institutions matter. Building from the logic that low opportunity costs for fighting, private information, and commitment problems constitute important causes of war, this article explores three interrelated causal mechanisms. First, the state leaders' increased expectations about future commerce create an incentive for these actors to consider peaceful bargains as an alternative to costly war. Second, security coordination under the umbrella of a commercial institution provides fuller information about state military capabilities, thus making inter-state bargaining for dispute resolution more efficient. Third, in bringing together high-level state leaders on a regular basis, commercial institutions may create the trust necessary to overcome commitment problems in inter-state bargaining. I explore how these mechanisms have operated within the Gulf Cooperation Council and the Economic Community of West African States.