The Toxicology of Methadone‐Related Death in Infants Under 1 Year: Three Case Series and Review of the Literature

Methadone‐related fatalities occur rarely in infants under 1 year, with five confirmed cases in the literature. The interpretation of pediatric postmortem toxicology relies on adult data; however, infants have crucial physiological differences that may impact interpretation of results. Retrospective case review included scene investigation, interviews, autopsy, and NIH/CDC Sudden Unexplained Infant Death Investigation Reporting Form. Methadone levels were confirmed by liquid chromatography/tandem mass spectrometry (LC‐MS/MS). The fatal blood methadone levels in this case series ranged from 69 to 700 ng/mL. This review of the literature adds toxicological findings of three methadone‐related infant fatalities and reviews the current literature on methadone‐related death in infants under 1 year. With opioid use on the rise in today's society, forensic experts should have a high index of suspicion for the possibility of intentional or unintentional poisoning in infants.     

Sexual Homicide by Older Male Offenders

Recent research has expanded our understanding of sexual homicide offenders (SHOs). However, little exists beyond case reports for older SHOs. We characterized male SHOs ≥ 55 years, comparing them to typical adult male SHOs who are in their 20s. Analysis of 37 years (1976–2012) of US Supplementary Homicide Reports data provided a large SHO sample (N = 3453). Three case reports provide clinical context for the diverse nature and patterns of older SHOs. Only 32 older male SHOs and no older female SHOs were identified. Murders by older SHOs accounted for only 0.5% of US sexual homicides. Unlike typical SHOs that generally target young adult females, over two‐thirds of older SHO victims were ≥40 years, and one‐third were ≥55 years. Sexual homicides by older SHOs, like sexual homicide in general, decreased over the study period. These crimes, while exceedingly rare, do occur, warranting special consideration.     

Forensic Evidence and Criminal Investigations: The Impact of Ballistics Information on the Investigation of Violent Crime in Nine Cities,

We explore the impact of information from ballistics imaging hit reports on the investigation into violent crimes. Ballistics imaging hits link two crimes involving the same firearm by forensically matching tool marks on the fired bullets or cartridge cases. Interview data collected from detectives who received a hit report were used to explore the relationship between the presence of a hit report and outcomes in 65 gun‐related violent crime investigations in nine U.S. police agencies. Findings indicate hit reports rarely contribute to identification, arrest, charging, or sentencing of suspects, because of delays in producing hit reports. On average, hit reports were completed 181.4 days after the focal crime. This delay forces investigations to proceed without the benefit of information from ballistics analysis. Additionally, hit reports rarely contained detailed information that was immediately useful to investigators. Instead, hit reports required additional research by the investigator to unlock useful information.     

Comorbid,sequential, or different desires? Exploring the relationship between somnophilia and necrophilia

Relatively little is known of either somnophilia or necrophilia in comparison to other more commonly presented sexual paraphilias. Despite the overt similarities between the two, somnophilia being characterised as an attraction to the sleeping/unconscious, and necrophilia being characterised as a sexual attraction to the dead, there has been little examination of their concurrence or relationship in a single person. A case is presented here of their relationship with directions for clinical and law enforcement awareness.     

A case of stalking in the workplace and subsequent sexual homicide

A case of stalking in the workplace and subsequent sexual homicide by a 33-year-old male is reported. Following several months of stalking a 38-year-old female, the male subject went to the woman's office after business hours and restrained, raped, and murdered her. The cause of death was multiple stab wounds. The facts of the case reveal that the subject fits a predatory-type stalker, which represents a small subgroup within stalkers that has received little attention. Unlike other types of stalkers, the predatory stalker gives little warning to their victim (or multiple victims), as their stalking behaviors tend not to be very invasive or harassing. In general, most stalkers are not physically violent; however, predatory-type stalkers, given their tendency for sexual violence, are dangerous and the importance of identifying them is emphasized. Factors associated with perpetrators of sexual homicide are discussed.     

Matricide and Two Sexual Femicides by a Male Strangler with a Transgender Sadomasochistic Identity

Abstract: While violence against sexual minorities is a well‐known phenomenon, sexual homicides committed by men with cross‐dressing or transsexual identity are not, because they are relatively few. We report a 23‐year follow‐up of the case of a transvestite, possibly transsexual, man who killed his mother by strangulation at the age of 20, and later in two separate cases strangled a female victim towards whom he felt sexual desire. He reported being sexually aroused by being strangled himself. The case raises questions concerning legislation which does not allow life‐long control of criminals.     

Patterns of Ecchymoses Caused by Manner of Death and Collateral Injuries Sustained in Bruising Incidents: Decedent Injuries,Profiles, Comparisons,and Clinicopathologic Significance

Abstract: We investigated how ecchymoses could be used to predict other injuries, or help establish the cause of death. Ecchymoses, fractures, lacerations, abrasions, and other data were recorded. Eleven percent of decedents had ecchymoses. Motor vehicle accident by car (MVA‐C) was the most common cause of ecchymoses and showed the most collateral injuries. Decedents of natural causes were more likely to have ecchymoses without collateral injuries. There appeared to be two groups of decedents with ecchymoses: one group is younger, comprised of victims of MVA‐C and homicides, with more injuries related to ecchymoses than others; another is an older group of victims of other accidents, natural causes, and suicide. There were no indeterminate causes of death among decedents with ecchymoses. Therefore, ecchymoses may be a surrogate marker to direct the pathologist to continue to seek a cause of death should be seen, even if the case, otherwise, appears to be indeterminate.     

Shooting Through Clothing in Firearm Suicides

Abstract: There is a longstanding empirical rule that people who commit suicide rarely shoot through their clothing, but rather put it aside to expose the nude skin. Signs of shots through clothing have always been considered suspicious, raising presumptions of the presence of an abettor. Our report, based on a retrospective study of fatal suicidal firearm injuries from the years 1980 to 2007, points out that suicide victims only rarely remove clothing from the site of the future entry wound. The report covered 43 cases with fatal gunshot wounds in the area of the thorax, with only four persons (9%) removing the clothing present in the area of the subsequent self‐inflicted wound. Defects present on the clothing of a victim cannot, therefore, be understood as an absolute criterion for disproving the possibility of suicide, and nor do they necessarily indicate an unfortunate accident or homicide. If, however, the suicide victim removes the clothing from the area of the future wound, then this is almost always an indication of suicide.     

A Catathymic Infanticide

Abstract: A case of infanticide committed by a 37‐year‐old married man, the father of three sons, is reported. Clinically depressed since adolescence, and also diagnosed with obsessive‐compulsive disorder and a dependent personality, the subject began to worry about killing someone a decade before the homicide. Increasingly disabled by his major depression, unable to work, and confined in his home, the idea that his only recourse was to kill one of his sons became fixed and frequent. Following his fourth psychiatric hospitalization, he took his 13‐month‐old son home from day care and drowned him in the bathtub. He then called the police and reported his crime. This sudden act of intentional killing was followed by a period of emotional relief and calmness, clearly illustrating the three stages of chronic catathymic homicide.     

Homicide‐Suicide in Konya,Turkey Between 2000 and 2007*

Abstract: Homicide followed by the suicide of the murderer is a relatively rare lethal incident in which an individual kills another person and subsequently dies by suicide. Cases involving a homicide and a suicide in which death examinations and autopsies were performed at The Konya Branch of the Forensic Medicine Council between 2000 and 2007 were retrospectively investigated. During the studied time period, there were 10 homicide‐suicide cases identified with 10 perpetrators killing 12 victims. Nine of the perpetrators were men and eight of the victims were women. The precipitating motive was an impending divorce in four of the cases. Two perpetrators were described as severely depressed, one had a diagnosis of antisocial personality disorder, and one was a pedophile who had reactive depression. Firearms were used in eight of the homicide cases and seven of the suicides. Constricting the use of firearms may reduce/prevent future homicide‐suicide cases, as it is the most commonly used method to carry out homicide‐suicides.