Suicide by self-immolation in Durban,South Africa: a five-year retrospective review

Self-immolation is an uncommon method of suicide, and its occurrence in South Africa is thus far unknown. This study aimed to determine the prevalence of self-immolation deaths and to establish a profile of these cases and the circumstances under which this condition occurs. A 5-year (1996-2000) retrospective review at a mortuary in Durban, South Africa, was conducted. Data were obtained from the Department of Forensic Medicine, the Medical Research Council's National Injury Mortality Surveillance System, and police and hospital records. During the study period, there were 12339 nonnatural deaths, of which 696 (5.6%) were suicides. Self-immolation accounted for 69 (0.6%) of all nonnatural deaths and 69 (9.9%) of all suicides. The subjects had a mean age of 31.2 years and were predominantly female (76.8%) and black (81.2%). The mean burn surface area was 63.3%, and the mean injury severity score was 36.9. Accelerant use was documented in 53 (76.8%) of cases, and paraffin was preferred. All cases occurred indoors. The proportion of suicides due to self-immolation in our study is excessive when compared with international studies that report figures between 0.9% and 2.2% of suicides. Additional studies are necessary to further elucidate the reasons for this discrepancy.     

Fatal salmonella aortitis with mycotic aneurysm rupture

Salmonellae most commonly cause uncomplicated cases of gastroenteritis but have a predilection for damaged blood vessels, especially those damaged by atherosclerosis. The abdominal aorta is most frequently affected. The most serious complication of aortitis is mycotic aneurysm formation with subsequent rupture. The authors present the case of a 61-year-old man who was found unresponsive at home 3 days after discharge from the hospital for treatment of gastroenteritis with bacteremia. Postmortem examination revealed a ruptured mycotic aneurysm with a large retroperitoneal hematoma. Numerous gram-negative rods were embedded in the wall of the aorta and surrounding inflammatory infiltrate, compatible with the patient's previously isolated. Whereas abdominal aortic aneurysm rupture is most commonly associated with atherosclerosis, the isolation of from blood cultures, coupled with radiographic evidence of gas surrounding the aorta, should raise the suspicion of infectious aortitis. Whereas fatal rupture of an aortic aneurysm secondary to atherosclerosis alone or in conjunction with aortitis will not have an impact on the manner of death, infections are reportable and thus have public health implications.     

Death resulting from ruptured cerebral artery aneurysm: 219 cases

To characterize the demographics of ruptured cerebral artery aneurysm as a cause of death and to examine the effect of improved diagnostic and therapeutic techniques on the incidence of sudden death associated with the condition, the authors reviewed 219 autopsies performed at the Dallas County Medical Examiner's Office between 1977 and 1997 in which the cause of death was ruptured cerebral artery aneurysm. Ruptured cerebral artery aneurysms accounted for 1.5% of 15,033 natural deaths and 0.4% of all deaths (45,492) followed by autopsy during this period. The majority (56%) of cases occurred in females, with Caucasian females composing the largest group (38%). Seventy-seven percent of cases occurred in individuals between the ages of 31 and 70 years, with the highest concentration in the 41- to 50-year decade (29%). The most common location for ruptured aneurysms was the middle cerebral artery distribution (39%). Multiple aneurysms occurred in 22 (9.1%) cases. Other factors, such as medical history, coexisting disease, symptoms, activity at onset of symptoms, survival time, and toxicology results are also presented. Compared with literature reports before 1980, when ruptured cerebral artery aneurysms were reported as the cause of death in approximately 4% to 5% of sudden natural deaths, the results of this study suggest that despite improved diagnostic and therapeutic techniques during the past two decades, morbidity and mortality from ruptured aneurysms remain a significant health problem.     

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.     

Luis Alfredo Garavito Cubillos: criminal and legal aspects of serial homicide with over 200 victims

This is the first scientific report on the crimes of the homosexual paedophile sadist Luis Alfredo Garavito Cubillos, based on a research stay of the authors in Columbia, and including discussions with the investigators, and the offender. Between 1992 and 1999, Garavito killed more than 200 children in the core age span between 8 and 13 years (as an exception, 6 to 16 years). His modus operandi remained stable. During daytime, he lured children of a lower social status out of crowded parts of the city into hidden areas that were overgrown with high plants. Garavito promised either payment for easy work, or drugs, or made other socially believable offers. The children were tied up, tortured, raped, and killed by at least one cut in the lateral part of the neck, or by decapitation. During the killings, Garavito was drunk. Even after his arrest (for attempted sexual abuse under a wrong identity) it was not immediately possible to track his crimes since Garavito had frequently changed his places of stay and his jobs. He also grew different hairdos and used wrong names. During his still ongoing confessions, he directs the investigators correctly to all scenes of crime spread over large parts of Columbia. In our report, we give an overview over the course of investigations, hint to similarities in the cases of the German serial killer Denke (1920's) and homosexual paedophile serial killer Jürgen Bartsch (1960's), and give preliminary impressions on the offender's personality. Furthermore, the violent environment and juridical peculiarities in Columbia are discussed. In spite of a total penalty of 2600 years in prison, it is formally well possible that Garavito will be released out of prison within the next 10 to 20 years, i.e. even before the maximum sentence of 40 years will be over.