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Coroner | Medical Examiner

Diagnostic Utility Of Postmortem Fine-needle Aspiration Cultures.

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Abstract

BACKGROUND: Microbiological cultures at autopsy have not proved to be very useful. In life, transthoracic and fine-needle aspirations of other tissues have provided better results. The aim of this prospective study was to assess the diagnostic utility of postmortem cultures obtained by fine-needle aspiration puncture (FNAP) of several tissues when punctures were performed in the immediate postmortem period.

METHODS: Comparative analysis was performed between FNAP cultures and those obtained in life and by conventional autopsy. All adult autopsied patients who died at a general teaching hospital in a 3-year period were included. Clinical data, microbiological cultures before death, and pathologic data from autopsies of all patients were recorded, as were results of FNAP performed after death from the heart, right lower lung, liver, spleen, and other areas suspicious for infection. Cultures from the same sites were made at autopsy. Microorganisms were isolated and defined as infectious agents, colonizers, or contaminants according to standard criteria.

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How To Read A Stab Wound

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Most emergency departments do not see much penetrating trauma. But it is helpful to be able to learn as much as possible from the appearance of these piercing injuries when you do see them. This post will describe the basics of reading stab wounds.

Important: This information will allow some basic interpretation of wounds. It will not qualify you as a forensics expert by any means. I do not recommend that you document any of this information in the medical record unless you have specific forensic training. You should only write things like “a wound was noted in the midepigastrium that is 2 cm in length.” Your note can and will be used in a court of law, and if you are wrong there can be significant consequences for the plaintiff or the defendant. This information is for your edification only.

1. What is the length of the wound? This does not necessarily...

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Forensic Autopsy of Blunt Force Trauma

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Overview

Deaths resulting from blunt force trauma are some of the most common cases encountered by the practicing forensic pathologist. Whereas other forms of traumatic death (eg, gunshot wounds, sharp force injuries) occur under a relatively limited number of circumstances, deaths resulting from blunt force trauma occur in a variety of scenarios. For instance, almost all transportation fatalities — including those involving motor vehicle collisions, pedestrians being struck by vehicles, airplane crashes, and boating incidents — result from blunt force trauma. Other deaths resulting from blunt force trauma involve jumping or falling from heights, blast injuries, and being struck by a firm object, such as a fist, crowbar, bat, or ball. Bite wounds and chop injuries may be considered variants of blunt force trauma, sharp force trauma, or a class of injuries untothemselves.

Blunt force trauma is routinely involved in cases classified as accidents, as well as in...

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When Self-Pleasuring Becomes Self-Destruction: Autoerotic Asphyxiation Paraphilia

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Abstract

Autoerotic asphyxia is presented in literature review form. Etiology, prevalence statistics, and a profile of AEA participants is provided. The author identifies autoerotic asphyxia as a form of sub-intentional suicide. Warning signs of AEA are presented. Possible sources of mis-information are given. Prevention and education recommendations for administrators, faculty, and parents are provided. A suggested reading list is provided. A part time computer programmer and full-time mother comes home from the office early on Friday afternoon to share a video and a pizza with her 15 year old son, Lance. His bedroom seems unusually quiet on this afternoon. Absent is the din of his favorite Smashing Pumpkins CD. She saunters down the hallway while calling his name, pushes open his bedroom door and then collapses on the floor in a flood of emotions launched by a graphic scene displayed in the room before her. Lance's lifeless, semi-nude, bluish-white body hangs b...

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An Investigation Into The Correlation Of Knife Damage In Clothing And The Lengths Of Skin Wounds

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Abstract

In determining the possibility that a specific weapon was responsible for a specific injury it is often valuable to examine the damage marks left on any clothing worn by a victim. Correlating this damage both to the skin and clothing with the dimensions of the suspect weapon (if available) may help in determining these possibilities. In this work four different types of knives were used to produce damage marks on various different fabrics both stretched and loose over skin. Statistically significant differences were found between the length of wound on the skin and the corresponding damage to the fabrics when the fabric was stretched over the skin while no statistically significant differences were observed when the fabric was loose over the skin. This was true for all of the knives examined.

1. Introduction

Most deaths, which are attributed to stabbing, are caused by objects whose primary...

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Variability of Undetermined Manner of Death Classification in the US

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Abstract

OBJECTIVES: To better understand variations in classification of deaths of undetermined intent among states in the National Violent Death Reporting System (NVDRS). DESIGN: Data from the NVDRS and the National Vital Statistics System were used to compare differences among states. MAIN OUTCOME MEASURES: Percentages of deaths assigned undetermined intent, rates of deaths of undetermined intent, rates of fatal poisonings broken down by cause of death, composition of poison types within the undetermined-intent classification. RESULTS: Three states within NVDRS (Maryland, Massachusetts, and Rhode Island) evidenced increased numbers of deaths of undetermined intent. These same states exhibited high rates of undetermined death and, more specifically, high rates of undetermined poisoning deaths. Further, these three states evidenced correspondingly lower rates of unintentional poisonings. The types of undetermined poisonings present in these states, but not present in other states, are typically the result of a combination of recreational drugs, alcohol, or prescription drugs. CONCLUSIONS:...

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Drug-Related Deaths With Evidence Of Intracorporeal Drug Concealment At Autopsy: Five Case Reports.

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Abstract

Intracorporeal concealment of illicit drugs is a rare observation at coronial autopsy examinations. The article reports 5 cases of accidental drug overdoses at the Westmead Coronial Morgue, Sydney New South Wales, over a 6-year period with evidence of intracorporeal drug concealment known as body packing or body stuffing. Three different forms of anatomic concealment of drugs are illustrated, Case 2 involving therapeutic medication in the form of glass ampoules for parenteral injection not previously reported. Three deaths were the result of acute toxicity due to polydrug abuse rather than as a consequence of the body packing behavior and rupture of the drug packaging, with the intracorporeal drug concealments an adjunct finding at the autopsy examinations. The cause of death in Case 3 was the direct result of acute cocaine intoxication due to rupture of drug packages in the rectum and mucosal absorption. The article details forensic sociological aspects of drug concealment...

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The Forensic Expertise Of Cadavers Of Females Suspected To Be Victims Of Sexually Motivated Homicide.

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Abstract

According to the author's independent observations, the criminal, as a rule, strangles his victim in sex-related murders. In cases of suspected sex-related murders of women, the female urogenital system needs to be examined as an anatomically whole preparation. It was proven that the spermatozoid structure (in the cadaveric vagina, whose condition was optimal) began to change from week 2 with almost all their heads being destroyed by the end of week 6. When cadavers are found in 1.5-2 months after the event, there is no reason to give up examinations of the sperm from cadaver.

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