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Coroner | Medical Examiner

Ligature Mark On Neck: How Informative?

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ABSTRACT

Many a times, a ligature mark may be the only evidence available in cases of asphyxial deaths due either to hanging or strangulation. A through examination of the ligature mark and analysis of the information provided by it, is therefore, a must to arrive at the most probable cause of death and differentiate between hanging and the ligature strangulation. A retrospective study was conducted at the Department of Forensic Medicine and Toxicology, Government Medical College & Hospital, Chandigarh, between 1997 to 2004 to assess the information provided by a ligature mark in such cases. We found that deaths due to hanging constituted 3.4% of the total unnatural deaths subjected to medicolegal autopsy; young adults, of the age group 21 to 25 years accounted for the maximum cases, 27%; and the male: female ratio was 2:1. Chunni was the most common ligature material used. Majority of the victims preferred multiple knots (61%) and fixed knots (58%) and a single loop (93%).

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Near Hanging Presenting To An Accident And Emergency Department

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Abstract

Victims of near hanging are being increasingly seen in accident and emergency (A&E) departments. This paper reports on seven cases of near hanging seen over four years in a district general hospital. The mechanism of injury is ligature strangulation rather than cervical spinal cord injury. All cases of near hanging should be actively and vigorously resuscitated, as initial presenting features bear a poor correlation to eventual outcome. (JAccid EmergMed 1996;13:135-136) Attempted hanging may represent suicidal, parasuicidal, sexual, or attention seeking behaviour. In this paper we present seven patients seen over a four year period in the accident and emergency (A&E) department of a large district general hospital, followed by a short discussion of the epidemiology, pathophysiology, clinical features, and management of such cases.

Case 1
A 14 year old schoolboy with no history of psychiatric problems was found by his father suspended by a rope attached to a beam in his bedroom. He had...

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Near-Hanging Injuries: A 10-Year Experience

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Introduction

Hanging has become the second most common cause of suicide in the United States, accounting for 14% of the over 31,000 suicides that occurred in the year 2002.24 However, there have been relatively few studies on the outcomes and injury patterns in patients after unsuccessful hanging (near-hanging) attempts. The purpose of this study was to evaluate the demographics, injury patterns, and outcomes for near-hanging patients admitted to the Los Angeles County + University of Southern California (LAC + USC) Medical Center.

Methods
The trauma registry at the LAC + USC Medical Center was queried for all patients admitted after attempted suicide by hanging, between 1 January, 1993 and 31 December, 2003. All patients who were dead on arrival or in cardiopulmonary arrest were excluded. The trauma registry is maintained by seven full-time trained nurses, and the quality of data entry is monitored by the Emergency Medical Service of the Department of Health Services of the County of Los s Angeles. Patient variables collected included age, gender, ethnicity,...

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Forensic Human Hair Examination Guidelines

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1. Introduction

Hair examinations and comparisons, as generally conducted by forensic scientists, often provide important investigative and associative information. Human and animal hairs have been used in forensic investigations for over a century. Reports abound in the literature concerning the use of human and animal hairs encountered in forensic casework. These guidelines represent a recommended procedure for the forensic examination, identification, and comparison of human hair. Hairs are readily available for transfer, easily transferred, and resilient. Hair examination may be used for associative and investigative purposes and to provide information for crime scene reconstruction. The ability to perform a forensic microscopical hair comparison is dependent on a number of factors.

  • These factors include the following:
  • Whether an appropriate known hair sample is representative.
  • The range of features exhibited by the known hairs.
  • The condition of the questioned hair.
  • The training and experience of the hair examiner.
  • The usage of the appropriate equipment and methodology.
  • DNA analysis can be performed on hair but should be performed only after an initial microscopical assessment. A full and detailed microscopical comparison with possible known sources of

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The Coroner and the Common Law

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ONE OF THE STATUTES of the State of California (Section 27491 of the California Government Code) declares, "It shall be the duty of the coroner to investigate, or cause to be investigated, the cause of death of any person reported to the coroner as having been killed by violence, or who has suddenly died under such circumstances as to afford a reasonable ground to suspect that his death has been occasioned by the act of another by criminal means, or who has committed suicide." In addition to this basic statement, there is much more to this section of the California Government Code. It establishes the manner in which the investigations may be conducted, and it outlines the powers of the coroner in the effective pursuit of his duties. Together with similar sections of the codes of the several counties, it further authorizes and defines the coroner's official activities. While this codification of the duties of the coroner is relatively new in California,* the office itself and...

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Haemorrhage Into The Lungs In Cases Of Death Due To Trauma

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When changing circumnstances bring a lesion to the notice of a morbid anatomist as a manifestation of a new atiological factor it is well to review the past experience of the lesion and to detail, so far as possible, the variations that have been observed. Under war conditions fatalities have occurred in which the outtstanding postmortem finding has been haemorrhage into the tissue of the lung. Reviewing the peacetime incidence of haemorrhage into the lung in association with death from trauma, it must be recalled that such a lesion may occured in various conditions. Peacetime Injuries Blood may be inhaled after haemorrhage from lesions of the upper air passages or nasopharynx, or even from a fracture of the base of the skull. The blood in these cases will be found in the bronchi, bronchioles, and filling the respiratory bronchioles and alveoli in a lobuile, giving the appearance of haemorrhagic areas approximately wedge-shaped but with lobulated margins. These bloody foci are likely to be...

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Clinical Longitudinal Standards For Height, Weight, Height Velocity, Weight Velocity, And Stages Of Puberty

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Growth standards based only on cross-sectional survey data are different in form from standards which represent individual longitudinal curves of growth. The two are not interchangeable over the ages at which the adolescent growth spurt may occur, that is from about 7 years onwards in girls and 9 years onwards in boys. The difference is particularly marked in standards for growth velocity. The longitudinal-type standards are those which should be used in following the individual child, whether in the paediatric or adolescent clinic or as a routine monitoring procedure in healthy children. The cross-sectional values are the appropriate ones to use in making comparisons between population groups each studied only in cross-sectional surveys. They give misleading assessments for children followed individually due to the distortion introduced by some children having their adolescent growth spurt early and others late. Mixed longitudinal and cross-sectional data require a more sophisticated combination of these two approaches (Tanner, 1951). pproaches (Tanner, 1951). When we first introduced longitudinal-type standards for clinical use...

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Hanging As A Method Of Suicide Retrospective Analysis Of Postmortem Cases

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Abstract

This retrospective study was conducted on 145 postmortem cases of hanging victims at government medical college morgue over a period of two years. The objective of this study was to find out the pattern of hanging cases as a proper method of suicide and to evaluate the present situation of hanging in this capital city. Out of 145 cases, 41% were male and 51% were married. One hundred and one victims hanged themselves at night, while 44 at day time. In 72 victims, stomachs were found empty. Most (97%) of the bodies were recovered from inside the living rooms. Ninety seven percent had complete suspension. One hundred and forty two (98%) cases had ligature mark in neck. Thirty nine cases had fracture of hyoid bones, 27 cases had fracture of thyroid cartilages. Most of the victims (45%) were from the age group 20- 30 years. Dopatta (orna) was the commonest (35%) ligature material. Quarrel among husband and wife was the commonest (31%) cause...

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Study Of Ligature Mark In Cases Of Hanging

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INTRODUCTION

Violent asphyxial deaths is one of the most important cause for unnatural deaths amongst which hanging and strangulation are commonly encountered in day to day autopsy. Hanging is that form of asphyxia, which is caused by suspension of the body by a ligature around the neck, the constricting force being the weight of the body. Deaths resulting from hanging show features amongst which the ligature mark in the neck is considered to be decisive. The ligature mark is a pressure abrasion on the neck at the site of the ligature which appears as a groove. Character of the ligature mark depends on various factors like the nature of the ligature, body weight, length of time the body has remained suspended and the number of turns of the ligature round the neck. The course of the ligature mark depends on whether a fixed or running noose has been used. In typical hanging, the ligature mark is situated above the level of thyroid...

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Medicolegal, Legal and Social Issues in a Case of Hanging

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Introduction

Death by hanging is not uncommon and occurs in all parts of the world. Hanging is that asphyxia which is caused by suspension of the body by ligature which encircles the neck, the constricting force being the weight of the body. When body is fully suspended and no part of the body touched the ground then it is called complete hanging, where constricting force is weight of whole body. On the other hand in incomplete hanging or partial hanging, the body is partially suspended, the toes or feet touching the ground or are in a sitting, kneeling, lying down, prone or any other posture with only head and chest off the ground. On the basis of position of knot, hanging can be classified into: typical hanging, where knot of ligature should be at the nape of neck on the back and a typical hanging, where knot of the ligature may be at any site other than the nape of the neck....

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National Coroners Information System (Ncis) Database Search

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Data Sources – Coronial
The data contained in the NCIS is sourced from the coronial brief created as part of the investigation conducted by a Coroner into the death of an individual. The purpose of the investigation is to determine the identity of the deceased and the cause of death and where appropriate, to make recommendations to prevent similar deaths from occurring.

The NCIS database contains both coded and non-coded data as well as searchable legal, medical and scientific reports such as the coroners finding, post mortem report, toxicology report and police summary of death report.

Cases are coded by court appointed staff in each jurisdiction. Coded fields are completed once the coronial investigation is complete. The NCIS conducts a quality assurance review of closed cases to ensure coding is correct and to facilitate searching of the data.

Collection of data to populate the NCIS is a secondary purpose of the coronial investigation and data collection is the result of operational processes which differ between the nine jurisdictions.

Online Resource: National Coronial Information System

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Human Decomposistion Ecology

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Understanding what happens to a body after death is helpful to crime scene investigators in determining when the death occurred. In addition to the actual physical conditions present in the corpse, researchers study the kinds and life stages of insects present in a decaying body to help pinpoint the time of death. There are five decomposition stages. Many factors influence how quickly the decomposition stages progress, such as temperature, moisture and whether the body is exposed or buried. Decomposition is faster at high temperatures, if the body has traumatic injuries, or if the remains are exposed.

The Beginning Two Stages
As soon as death occurs, enzymes within dead body cells begin to break down tissues, a process called autolysis, and bacteria within the digestive tract begin to digest the intestines. During the first stage, called the fresh stage, usually lasting a day or two, the body doesn't change much outwardly, but chemicals released during cellular death begin to attract flies. The second stage begins

Additional Resource: The Stages of the Human Decomposition Process

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An Approach For Removal Of Brain, Brain Stem With Spinal Cord…

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Introduction :

The procedure adopted, so long, for removal of brain entails circumferencial cut across the skull, (beginning with removal of scalp enmasse and then a saw cut around the bare skull bones). The procedure not infrequently results in some of the nerve roots being severed with inevitable damage to the brain stem and more importantly a clear exposure of the posterior fossa is not possible an obvious limitation of the conventional procedure. In view of the above, a new approach albeit an alternative approach for removal of brain with or without spinal cord has been contemplated and this is being practised in this department with good results. Materials & Methods: Cadavers numbering twenty (20), only those with sound physical signs of good embalming were selected for this study. The cadavers were dissected in a span of two (2) years. The work started in North Bengal Medical College, Darjeeling, West Bengal and carried forward in R. G. Kar Medical College, Kolkata, West Beng...

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The Management Of Stab Wounds To The Back.

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Abstract

The management of stab wounds to the back is controversial. There are certain clear indications for exploratory laparotomy, but most cases require a diagnostic workup and a period of observation. In this article, different diagnostic modalities are presented, including local wound exploration, diagnostic peritoneal lavage, abdominal computed tomography (CT) scan, triple-contrast abdominal CT scan, and intravenous pyelography (IVP). Recommendations for management are given, with emphasis on abdominal CT scan and observation.

Management of stab wounds of the back and flank.

Abstract

Abdominal stab wounds are managed on a selective basis with increasing frequency. Retroperitoneal injuries are more difficult to evaluate; hence wounds to the flank and back pose different considerations. A retrospective review of 108 patients with deep stab wounds of the flank and back was compared with a prospective study of 109 patients selectively managed with similar injuries.

See Also: : Management Of Stab Wounds Of The Back And Flank.

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Armed Forces Autopsy

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About the Military Health System

The Military Health System (MHS) is one of America’s largest and most complex health care institutions, and the world’s preeminent military health care delivery operation. Our MHS saves lives on the battlefield, combats infectious disease around the world, and cares for 9.4 million beneficiaries in one of the nation’s largest health benefit plans.

The missions of the MHS are complex and interrelated:

• To ensure America’s 1.4 million active duty and 331,000 reserve-component personnel are healthy so they can complete their national security missions. • To ensure that all active and reserve medical personnel in uniform are trained and ready to provide medical care in support of operational forces around the world. • To provide a medical benefit commensurate with the service and sacrifice of more than 9.4 million active duty personnel, military retirees and their families.

See Also: About the Military Health System

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Forensic DNA Identification from Human Remains Submerged in Water

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ABSTRACT: We describe the successful identification of the remains of a saponified body found in a dam by typing of nuclear DNA. Whereas DNA extracted from soft tissues yielded negative PCR results, DNA extracted from the bone by a slightly modified Qiagen procedure allowed the typing of sex (AMG locus) and of 10 additional STR loci. An identity document was found belonging to a man missing for 3 years and comparison of the results to the DNA profiles of his son and wife confirmed the identity. The longest delay reported until now for successful nuclear DNA genotyping after immersion in river water was 18 months. This case demonstrates a delay of up to 3 years.

Recovery of human DNA from bones of severely decomposed bodies was reported for the identification of unidentified bodies like murder victims (1) or ancient human remains (2). Nevertheless, few studies concern genotyping of bodies immersed in water,the longest reported delay for successful identification being...

Additional Resource: Skeletal Remains Presumed Submerged in Water for Three Years Identified Using PCR-STR Analysis (2975 downloads )

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