Prison mental health services: results of a national survey of standards, resources, administrative structure, and litigation

The formation of adequate mental health systems within prisons has accelerated as a result of successful class action lawsuits. Our recent national survey questioned all state correctional departments about the existence of standards in each system, compliance with such standards, prevalence of class action lawsuits involving the issue of providing adequate mental health services for inmates, issues related to consent decrees, available mental health resources within the correctional system, and the administrative structure of the mental health system. Our purpose was to identify those factors correlated with certified class action lawsuits involving issues related to mental health services. Twenty-one states were involved in such litigation. Only the presence of psychiatric hospitals operated by the department of corrections correlated with the presence of certified class action lawsuits involving mental health services. Prison systems larger than 15,000 inmates were at higher risk for such litigation. Smaller systems having psychiatric hospitals run by the state mental health agency appeared to be at less risk for such litigation.     

Recovery of decomposed and skeletal human remains in the "Green River Murder" Investigation. Implications for medical examiner/coroner and police

The Green River Murder Investigation in King County, Washington, is currently the longest active serial murder investigation in U.S. history. During its course, over 26 separate scenes with from one to five victims each have been processed. The experience of the authors is presented in order to acquaint other agencies with techniques of outdoor scene processing that have evolved during recovery of remains from Green River and other skeletal cases.     

The use of human skin in the fabrication of a bite mark template: two case reports

Comparison of a suspected biter's dental arches with the patterned injury of a bite mark is especially difficult when the bite occurs in an anatomic location with a small radius of curvature or with complex or compound curves. The authors present two case reports in which human skin was used as a template for the reproduction of a bite. In one case the victim's skin was used; in the other, the skin of a anatomically similar person was used. The use of inked dental casts, photography, and transparent overlays significantly reduced the errors common to analysis of bite marks in these highly curved areas.     

Identification of the driver in two-rider motorcycle accidents. Inguinal contusion-laceration as an indication of the driver

In motorcycle accidents involving two riders, medicolegal identification of the driver is necessary when one or both riders die. It is particularly important in the latter case, because the survivor almost always insists that he or she was not driving. One characteristic injury that distinguishes the driver from the passenger is inguinal contusion-laceration (accompanied internally by pelvic fracture). This injury, caused by collision of the pelvis with the fuel tank, identifies the driver.     

Site of discovery in the bath tub. Evaluation of a fatality after four years using postmortem roentgen diagnosis]

On the one hand the following case demonstrates the problems of finding a dead body in the bathroom and on the other hand the importance of postmortem x-ray examinations. The corpse of an 65-year-old woman was discovered in her bath tub. At the body's feet there was a hair dryer. Investigations concerning murder were negative, circumstances appeared to be unsuspicious. That was why a postmortem examination was not performed. -4 years later murder had to be considered. After manual strangling the deceased and the hair dryer were layed into the bath tub. The corpse was exhumed and taken to a forensic autopsy. It was found that the hyoid bone and the superior horn of the thyroid cartilage were both fractured on the right. Damages caused by the preparation itself were excluded by using serial roentgenographs. These observations in combination with histological findings and the results of further investigations convincingly supported the suspicion of strangling by hand.     

Dangerousness of the delusional misidentification of children.

Misidentification syndromes have been studied from a variety of perspectives, including phenomenological, biological, and nosological approaches. More recently, misidentification syndromes have been studied from a psychiatric-legal perspective, especially with regards to the problem of dangerousness. Capgras syndrome and other syndromes of misidentification can lead to hostile mood and subsequent physical violence. Little attention has so far been devoted to children as the objects of the psychotic person's misidentification delusion(s). We provide a review of cases from the anglophonic literature that have children as the misidentified objects, add three new cases, and then discuss the relationship between misidentification and potential harm to these children.     

A rapid gas chromatographic method for the fingerprinting of illicit cocaine samples.

A gas chromatographic (GC) fingerprint method, based on the presence or absence of six congeners, was developed for illicit cocaine samples. The fingerprint utilizes the relative abundances of these congeners towards each other, disregarding cocaine as the main constituent, and can be expressed numerically or graphically in the form of pictograms for rapid visual comparison. The method can be applied directly to a solution of the sample in chloroform, without previous workup procedures. More than 70 unrelated samples were analyzed and a great variation was observed in the parameter composition. On the other hand, a remarkable similarity could be seen between related samples. The GC fingerprint method may be considered an important contribution for sample comparison, as is exemplified by a subdivision of the analyzed samples in different categories, based on the number and types of congeners found.     

A case of sudden infant death due to massive hemorrhage in primitive neuroectodermal tumor.

A case of the sudden death of a 14-month-old girl due to massive hemorrhage in a primitive neuroectodermal tumor (PNET) is presented along with a review of the relevant literature. PNET is a rare, malignant brain neoplasm occurring predominantly in children.