Case Report: Medicolegal evaluation in a case of fatal scald where a child fell into a cauldron in rural Nepal

Thermal injuries in young children involving the buttocks, perineum, and lower limbs raise suspicion of child abuse. Determining the manner of death and ruling out homicide in a fatal case of scalding remains a challenge for forensic practitioners. One such issue is reported in the present case report, where a medicolegal evaluation of a fatal scald in a two-year-old girl child is discussed. Young children sustaining serious injuries from scalds is a grave social concern. Such young lives need to be protected from scald injuries whether accidental or purposeful. Differences in injury patterns on the basis of their distribution and their characteristics are important to determine manner of death in such cases.

The Texas State Donated Skeletal Collection at the Forensic Anthropology Center at Texas State

The Forensic Anthropology Center at Texas State (FACTS) began accepting whole-body donations for scientific research and educational purposes under the Texas Anatomical Gift Act in 2008. Research conducted with donated whole bodies involves studies in taphonomy and human decomposition, including reconstructing the postmortem interval. Following decomposition, the skeletal elements of all donors are collected, cleaned, and permanently curated into the Texas State Donated Skeletal Collection (TXSTDSC), which is used for teaching and research by faculty and students at Texas State but is also open to external researchers. To date, FACTS has received 710 donors. Fifty-eight percent of donors are male and 42% are female. Donor ages range from 21 weeks’ gestation to 103 years old at the time of death, with a mean of 66 years, and a median of 68 years. Based on self-identified or family-identified ancestry, 90% of donors are White, 4.5% are Hispanic, 3% are Black, less than 2% are of mixed ancestry, and less than 1% are Asian or Native American. Information collected about each donor includes geographic/residential history; occupational history; socioeconomic status; anthropometrics; parity status; alcohol, tobacco, and drug use history; mobility status; an overall health questionnaire; cause and manner of death.

Retrospective Analysis of Hanging Cases Between 2016 and 2020 in Urban India

Background: Death by hanging is a vital health hazard worldwide; it is classified as violent mechanical deaths resulting from asphyxia. The manner of death in hanging is suicide in the majority of the cases, and accidental hanging is less common, and homicidal hanging is still less common. The study was aimed towards analyzing sociodemographic patterns, precipitating factors for committing hanging at Vijayanagar Institute of Medical Sciences (VIMS), Ballari, India. Methods: A retrospective study was conducted at the mortuary of VIMS, Ballari, Karnataka, India. From January 01, 2016, to December 31, 2020, 356 alleged hanging cases were brought to the mortuary for postmortem examination, and the cause of death was attributed to hanging. The necessary data were collected with the help of history, inquest reports, meticulous postmortem examination, etc. The results were obtained after tabulating and data analyzed with a cross-sectional study. Results: Of 356 cases of hanging, the majority of the cases were in the age group of 31-40 years (140 patients; i.e., 39.32%). Male preponderance was detected in 235(66%) cases, and most victims have married 199(56%) subjects. Concerning seasonal variation, we noted that the maximum number of suicides by hanging was reported in July to September 141(39.60%). Out of 356 hanging cases, 178(50%) were employed. The predisposing factor was Chronic illness in 136(38.20 %) cases, followed by financial stress and psychological problems in 120(33.70%) and 50(14.04%) cases, respectively. Most of the victims belonged to the Hindu religion, 290(82%) cases. Moreover, 320(90%) of cases had no suicide note. Conclusion: Hanging is challenging to prevent due to numerous concomitant factors, but psychological counseling, economic support, and education can reduce the incidence of hanging.

PATTERN OF MEDICOLEGAL AUTOPSIES CONDUCTED AT TIRUPATI, ANDHRA PRADESH: A 3-YEAR RETROSPECTIVE STUDY

Objectives: Death of an individual is a grave loss to the family and community at large. Death may be natural or unnatural. Analysis of unnatural deaths helps in understanding the causes, manner, and modes of deaths, thereby formulate and implement a proper policy to reduce incidence. Methods: This is a retrospective study of autopsies conducted over 3 years (2018–2020) in the mortuary of Sri Venkateshwara Medical College, Tirupati. During this period, 2579 autopsies were performed. Required data were collected from the requisitions of police, inquest reports, case sheets, medicolegal register, and postmortem reports in a preformed pro forma. Results: Out of the 2579 cases, majority were in the age group of 21–30 years (34.62%) followed by 41–50 years (18.06%). Male-to-female ratio was 2.5:1. Majority were Hindus (83.52%) and most of the subjects belonged to the rural areas (62.89%). Majority were married (78.40%). The most common cause of death was road traffic accident (48.04%) followed by poisoning (15.82%). Accidental deaths were the most common manner of death (60.56%) followed by suicides (33.96%). Conclusion: The present study reveals that the most cases were in 21–30 years age group. Males outnumbered females and the subjects were mostly married and were from rural areas. Road traffic accidents were common cause of death in males and poisoning was the common cause of death in females.

Bases of Forensic Pathology Expert Testimony With Emphasis on Iowa v Tyler

Judicial scrutiny of the forensic sciences is increasing. This scrutiny targets the bases for expert opinions. Forensic pathologists must understand that when they express an opinion it must have an articulable underlying basis. Iowa v Tyler provides a cautionary tale where testimony from a forensic pathologist on the cause and manner of death based exclusively on police reports and audio and video recordings of police interviews of the suspect rather than on medical evidence were held to be inadmissible. Tyler has an odd and distinguishable set of facts, but has been widely cited as an example of problematic forensic pathology testimony.

A Statistical Analysis of Forensic Autopsies Performed in the Jungbu Province of Korea in 2020

We analyzed the manner and cause of death in 945 forensic autopsies from the Jungbu province (Central part of South Korea) conducted by the National Forensic Service Daejeon institute in 2020. Analysis of the manner of death revealed that 43.6% (412/945 cases) were natural deaths, 41.6% (393/945 cases) were unnatural deaths, and 14.8% (140/945 cases) deaths were unknown. Among the unnatural deaths, the major manner of death (40.7%, 160/393 cases) were by accidents, 29.5% (116/393 cases) were by suicide, 21.6% (85/393 cases) were undetermined, and 8.1% (32/393 cases) were by homicide. Among the unnatural deaths, the major cause of death (42.7%, 168/393 cases) were by trauma, 19.3% (76/393 cases) were by poisoning, and 16.5% (65/393 cases) were by asphyxia. Falling was the major cause of death by trauma (42.9%, 72/168 cases) and strangulation was the major cause of death by asphyxia (72.3%, 47/65 cases). Among natural deaths, heart disease was the major cause (43.7%, 180/412 cases), followed by vascular disease (18.9%, 78/412 cases). This study is the first statistical analysis of the manner and cause of deaths in the Jungbu province. A time-series statistical analysis of the manner and cause of deaths in this province might allow more advanced interpretations about both public safety and healthcare in the future.

Suicide in Older Adult Men Is Not Related to a Personal History of Participation in Football

Introduction: It is reasonable to estimate that tens of millions of men in the United States played high school football. There is societal concern that participation in football confers risk for later-in-life mental health problems. The purpose of this study is to examine whether there is an association between a personal history of playing high school football and death by suicide.Methods: The subjects were obtained from the Lieber Institute for Brain Development (LIBD) brain donation program in collaboration with the Office of the Medical Examiner at Western Michigan University Homer Stryker MD School of Medicine. Donor history was documented via medical records, mental health records, and telephone interviews with the next-of-kin.Results: The sample included 198 men aged 50 or older (median = 65.0 years, interquartile range = 57–75). There were 34.8% who participated in contact sports during high school (including football), and 29.8% participated in high school football. Approximately one-third of the sample had suicide as their manner of death (34.8%). There was no statistically significant difference in the proportions of suicide as a manner of death among those men with a personal history of playing football compared to men who did not play football or who did not play sports (p = 0.070, Odds Ratio, OR = 0.537). Those who played football were significantly less likely to have a lifetime history of a suicide attempt (p = 0.012, OR = 0.352). Men with mood disorders (p < 0.001, OR = 10.712), substance use disorders (p < 0.020, OR = 2.075), and those with a history of suicide ideation (p < 0.001, OR = 8.038) or attempts (p < 0.001, OR = 40.634) were more likely to have suicide as a manner of death. Moreover, those men with a family history of suicide were more likely to have prior suicide attempts (p = 0.031, OR = 2.153) and to have completed suicide (p = 0.001, OR = 2.927).Discussion: Suicide was related to well-established risk factors such as a personal history of a mood disorder, substance abuse disorder, prior suicide ideation, suicide attempts, and a family history of suicide attempts. This study adds to a steadily growing body of evidence suggesting that playing high school football is not associated with increased risk for suicidality or suicide during adulthood.

Suicide by ethylene glycol/brake oil poisoning—a case report

Background Brake fluid is used for automobiles. It is a mixture of different glycol derivatives including ethylene glycol and diethylene glycol (DEG) which are metabolized into various toxic metabolites. Fatalities following brake fluid ingestion are rare in forensic practice. Here, we report a case of suicide by brake fluid ingestion complicated with severe renal failure and esophageal and gastric erosions. Case presentation A 52-year-old male, with a history of alcohol dependence and comorbid moderate depression, ingested a bottle of brake fluid (100ml) mixed with alcohol. He had defaulted psychiatric follow-up. He developed severe metabolic acidosis and acute renal failure which necessitated intensive care, other supportive management, and the antidote; ethyl alcohol. On the 2nd day of admission, he developed upper gastrointestinal bleeding with melena. He also had seizures and cardiovascular complications. He died 12 days after hospital admission, and the manner of death was concluded as suicidal. The autopsy revealed congested and edematous brain, flabby and pale heart without evidence of infarction, erythematous trachea, bilateral diffuse pulmonary edema, congested liver, ulcer over the lower 1/3 of the esophagus, and few ulcers in the stomach. Also, the kidneys were edematous, diffusely necrosed, and there were adrenal hemorrhages. Conclusions This case report highlights the severity of effects of brake fluid poisoning including the corrosive effect on gastrointestinal mucosa which is rarely encountered in clinical practice.

A prospective study of medicolegal autopsies to establish profile of burn deaths

Burns injuries have been a one of the major cause of concern since prehistoric time to the present era of modern medicine. Burn is considered to be the commonest cause of unnatural death in India.Burns are injuries produced by application of dry heat such as flame, radiant heat or some heated solid substance like metal or glass to the body. Dry heat, application of hot bodies, licking by flames resulting in simple burns causes local injury to the body. Moist heat leading to scalds, corrosive poisons resulting in corrosive burns. Electric spark, discharges, flashes and lightning leads to electric burns.Present study aim to know the magnitude of burn deaths in the region of southern marathwada region. Two years prospective study was conducted at Government Medical College Latur. Study of medico legal autopsies to establish the profile of burn deaths was carried out. In the present study, it is found that burns are commonly found in female (72.04%) than in females. Housewives (43.52%) were common victims followed by works (9.80%). Most of the incidences took place in morning hours (45.53%). Most common place of incidence was house (83%). Kerosene (57.63%) was the most common accelerant used to cause burn. If percentage of burn increases, the survival period decreases and vice versa. Most common alleged manner of death was accident (53, 6%).

Thank God it’s Friday?—Correlation of the beginning and end of the week in general and Christmas holidays in particular with manner of death

Objective We evaluated the phrase “Thank God it’s Friday” (TGIF) from a forensic pathologist’s view, i.e. the correlation between the beginning and end of the week in general and Christmas Holidays in particular and the manner of death. Material and methods We retrospectively analyzed 758 consecutive autopsy cases from January 2017 to June 2019. Results There was no correlation between natural deaths and the beginning or the end of the week. One of our main findings in terms of a weekday effect was a profound increase in homicides towards the end of the week. In terms of a Christmas Holiday effect, we sadly observed a profoundly higher rate of suicide cases during Christmas Holidays compared with the rest of the year. Conclusion The TGIF phrase should be modified towards something like “Thank God, it’s Monday” (TGIM). We also should look out for our lonely and mood-susceptible fellow human beings in particular during Christmas Holidays.