Suicide with a butcher's bolt

The captive bolt pistol is an atypical firearm exclusively produced and used for butchery of breeding animals, but in some rare cases, it has been used as a lethal weapon for committing suicide by butchers, breeders and other people who have access to such weapons during their professional activities. This study describes the suicide committed by a butcher in the province of Udine (N. Italy) in 2001 who shot himself with his own captive bolt pistol that produced in the right temporal region a circular wound and a bone lesion of the temporal squama with a groove involving the frontal lobe; he died five days later of the fatal consequences of the meningo-encephalic lesions. The medico-legal issues implicated in this case, seen in the light of the data reported in the international literature, illustrate the difficulties faced when diagnosing these types of lesions, bearing in mind their rarity and peculiar nature, and introduce elements of differential diagnosis regarding lesions produced by similar weapons that lead to ascertainment of the event as accidental, suicidal, or homicidal.     

Cardiac concussion: definition, differential diagnosis, and cases presentation and the legal ramification of a misdiagnosis

A cardiac concussion is caused by a sudden, nonpenetrating, localized impact to the chest that is theorized to result in almost simultaneous sudden death from a disruption to the conductive system. The detailed external/internal forensic examination of the body reveals no evidence of structural, pathologic, or histologic signs of trauma to the heart. A cardiac concussion is a rare and often overlooked cause of sudden death. This type of sudden death is typically seen among younger individuals participating in sports involving projectiles and, to a lesser degree, where collisions occur. Cardiac concussions are clinically, pathologically, and chemically different from a cardiac contusion. The objective of this paper will be to define cardiac concussion, differentiate between cardiac concussion and cardiac contusion, and describe the clinical and pathologic features of a 32-year-old white male who died of a cardiac concussion following a collision with a catcher during a softball game. The civil ramification of incorrectly diagnosing the manner of death in cases of death involving a cardiac concussion will also be addressed.     

Medical malpractice: a study of case histories by the Forensic Medicine Section of Bari

The learning objectives of this paper are to study the actual extent of medical malpractice, the medical acts at risk, and their impact on mortality. The number of suits filed against physicians for deaths resulting from alleged malpractice and autopsies ordered by the Judicial Authority in cases of possible therapeutic misadventures are rising. A major factor pushing this trend is public mistrust of healthcare providers and public and facilities. This mistrust is partly fueled by the mass media which, often to gain larger audience shares, sensationalizes single cases of real or alleged iatrogenic injury. Further, the potential for astronomic settlements, either from the single doctor or from the healthcare institution, has increased the number of legal proceedings that start on the basis of mere suspicion. In this context, the autopsy becomes an important instrument for shedding light on the situation, and it must be carried out by highly qualified and experienced professionals capable of ascertaining the cause of death, identifying any possible misconduct, and assessing its consequences. We reviewed the data regarding autopsies performed at the Forensic Medicine Section of the Department of Internal and Public Medicine of the University of Bari over 1991 to 2000. We culled the cases alleged malpractice and, from these, identified those in which the death had truly been caused by medical error. This study also allowed us to understand the incidence of lethal therapeutic misadventures and to identify the medical and surgical branches more frequently involved.     

A novel microsatellite (STR) marker for forensic identification of big cats in India

India is the home to five of the eight majestic big cats of the world. The three major big cats namely, lion, tiger, and leopard are listed in the Schedule I of the Indian Wildlife Protection Act, 1972. Apart from the severe loss of the habitat, these are continuously facing the danger of extinction mainly due to poaching and hunting for their body parts, which are being greatly valued by apothecaries marketing traditional Chinese medicines. With the advent of polymerase chain reaction (PCR), DNA-based markers have emerged as major tools in the arena of wildlife forensics. Microsatellites (short tandem repeats, STRs) are markers of choice because of their polymorphic and co-dominant nature. These strictly follow the Mendelian inheritance and are highly reproducible. We have identified a new microsatellite (STR) locus Ple 46, which shows amplification in a species-specific manner (size of STR) in all the members of the family felidae studied here. This PCR-based, non-invasive method opens a new avenue to forensic identification of big cats.     

Comparability of the MMPI-2 F(p) and F scales and the SIRS in clinical use with suspected malingerers

Relationships among Structured Interview of Reported Symptoms (SIRS) scores and Minnesota Multiphasic Personality Inventory--2 (MMPI-2) F(p) and F scores were examined for 63 suspected malingerers evaluated at either of two psychiatric facilities. Despite differences between facilities in terms of seriousness of subjects' offenses, mean scores on the malingering tests were similar. Cutting scores for F(p) and F resulting in substantial correspondence between these scales and the SIRS were derived. Use of the cut score for F(p) proposed by Arbisi and Ben-Porath (1995) resulted in less agreement with the SIRS than did a lower cut score. No substantial difference between F(p) and F in each scale's overall agreement with the SIRS was observed. A principal components analysis of the SIRS primary scales produced two factors, interpreted as Overreporting of Symptoms and Implausible Symptoms. F(p) was observed to correlate significantly with Implausible Symptoms but not with Overreporting of Symptoms; F was significantly correlated with both factors.