Fatal Penetrating Injuries Sustained by High-pressure Water Jet Unit

The high-pressure water jet unit is a generator of frequent burst of water jets. The water jet reaches very high speeds and is able to cause wounds similar to those of high-velocity projectiles. In the presented case, unusual fatal injuries sustained by water jet are presented. Operating with the unit, an untrained worker accidentally activated a high-pressure water jet unit, and the extremely high pressure of water liberated the jet unit from his hand and whirled it around him. A jet stream of water ran across his body and caused fatal penetrating injuries in the femoral region. The edges of the wound were mainly sharp with contusion rings on the skin beyond the edges. Exploring the inside of the canals during the autopsy, the left femoral artery and vein were found to be completely transected. The resemblance to a firearm entry wound and the severity of the internal injury make it a noteworthy entity.     

腹部穿透创致腹腔积血的法医学鉴定

在法医学鉴定中,当暴力所致的原发损害与医疗过失行为造成的继发损害并存时,应区别“不可避免的”继发损害和“可以避免的”继发损害,并将原发损害与“不可避免的”继发损害一起,作为损伤程度鉴定的依据,而不能将“可以避免的”继发损害也作为损伤程度鉴定的依据。《人体重伤鉴定标准》第七十二条规定了外伤后腹部积血的鉴定原则,如何应用该条款评定损伤程度,需对原发损害与继发损害加以区别,同时,有必要对这一条款进行必要的修改。     

A fatal elephant attack

A rare case of an elephant attack is presented. A 44-year-old man working as an elephant keeper was attacked by a cow elephant when he tripped over a foot chain while the animal was being medically treated. The man fell down and was consequently repeatedly attacked with elephant tusks. The man sustained multiple stab injuries to both groin regions, a penetrating injury to the abdominal wall with traumatic prolapse of the loops of the small bowel, multiple defects of the mesentery, and incomplete laceration of the abdominal aorta with massive bleeding into the abdominal cavity. In addition to the penetrating injuries, the man sustained multiple rib fractures with contusion of both lungs and laceration of the right lobe of the liver, and comminuted fractures of the pelvic arch and left femoral body. The man died shortly after he had been received at the hospital. The cause of death was attributed to traumatic shock.     

Fatal exsanguination following complete transection of femoral vessels due to angle grinder injury in an industrial accident

Angle grinders are one of the most dangerous and frequently used tools in industrial settings. Angle grinder injuries range from superficial cuts to deep penetrating injuries with underlying fracture-dislocation and vascular trauma. The injuries caused by angle grinders mostly involve the head, face, or upper limbs, while the lower limb is an unusual site. The high-speed rotating disc of the angle grinders does not respect anatomical boundaries or structures; therefore, the injuries caused may be disfiguring, permanently incapacitating, or even fatal. We report a fatal case of an angle grinder injury to the lower limb. The victim sustained a sharp cut over the left thigh while woodworking in an industrial setup. The rotating disc of an angle grinder had transected the skin, subcutaneous fat and muscles, and both the femoral vessels of the left side, which led to fatal exsanguination within 10 min of the incident.     

腹部穿透伤剖腹探查57例法医学鉴定分析

目的 探讨经临床行剖腹探查术的腹部穿透伤的损伤特征,归纳其损伤程度的鉴定要点,为法医临床学鉴定实践及修改相关鉴定标准提供科学、合理的参考依据.方法 对笔者于1990年7月-2011年2月受理的57例腹部穿透伤后行剖腹探查术的损伤案例,根据致伤物、腹腔积血、器官损伤、鉴定结论等方面进行分析总结.结果 对于腹部穿透伤行剖腹...     

Weapon Use in Korean Homicide: Differences Between Homicides Involving Sharp and Blunt Instruments

On the basis of information regarding 276 homicides committed in South Korea between 1987 and 2008, we compared offenders’ and victims’ characteristics, injury locations, weapon‐related behavior, and offending behavior between homicides involving sharp and blunt instruments. The victims of sharp‐force homicide were much younger relative to those of blunt‐force homicide. In addition, homicides involving blunt instruments were more likely to be committed by offenders who lived with the victims. Most sharp‐force homicides involved injuries to the torso, while blunt‐force homicides involved mainly head injuries. Furthermore, perpetrators of sharp‐force homicides tended to preselect their weapons, while those of blunt‐force homicides were likely to use weapons of opportunity. Logistic regression analysis identified a number of factors, including injury location and body transportation, which significantly predicted weapon type. As this was the first South Korean study to compare sharp‐ and blunt‐force homicides, the results have practical implications for homicide investigations.     

Criteria for homicide and suicide on victims of extended suicide due to sharp force injury

This report is about the findings in association with the extended suicides of nine victims killed by sharp force. All victims were killed by sharp force. The perpetrators were predominantly the parents, the victims their children. Regarding the criteria for differentiating self-inflicted injuries from injuries inflicted by another person, the victims' injuries presented patterns usually found solely in suicides. Thus eight of nine cases presented tentative and hesitation injuries, in three of five cases areas of injury covered by clothing had been exposed beforehand. Despite extremely narrow intercostal spaces in children, injuries to the bones in thoracic stabbing were avoided more often than not (four of seven cases). Only the criterion "defence injury" occurred nearly as often as in homicide victims (three of nine cases). The psychopathology of extended suicide can explain this pattern. The perpetrator's motive is characterised by his pseudoaltruistic belief to save the loved ones from a world that is in his opinion unacceptable. A fusion or integration of the victim into the perpetrator's own self is based on an identity problem. Physical interrelation of forces between perpetrator and victim restricts the victim in his defence and presents an important prerequisite for acquiring the patterns of described injuries.     

指甲伤的类型与形成机制研究

目的探讨人体体表指甲伤的分型与形成机制。方法收集法医实际检案资料51例指甲伤434处,借助放大镜对各处伤进行形态特征观察、归类整理。结果指甲伤可分为条状抓擦伤、片状压擦伤和弧状压挫伤/创3种基本类型,分别有168处、153处和113处,其形态特征改变主要与成伤指甲的结构,作用力的大小、方向、作用时间,伤处皮肤的松驰度、Langer线走向,伤后经过时间等因素有关。结论指甲伤的类型和成份机制判断对加害人意图的分析和案件定性有重要作用。     

Animal-related fatalities--part I: characteristic autopsy findings and variable causes of death associated with blunt and sharp trauma

Animals may be responsible for an array of potentially lethal injuries. Blunt force injuries characteristically involve larger animals such as cattle or horses that may kick, crush, or trample a victim causing head and facial injuries. Farm workers in particular are at high risk of lethal injuries involving the head and torso. Significant blunt trauma may be found in vehicle occupants after collisions with large animals such as camels or moose. Rarely, zookeepers may be crushed by particularly massive animals such as elephants. Sharp force injuries usually involve carnivore bites, most often from dogs with a "hole and tear" pattern of wounding. Injuries from animals such as alligators and sharks may have a significant component of crushing. Incised wounds may result in death from exsanguination and air embolism. On occasion, blunt or sharp trauma from animal activity may be confused with postmortem damage or with inflicted injury from an assault.     

Sharp Force Homicide in Denmark 1992–2016

Sharp force trauma is a common homicide method. The weapon is typically a knife, which is easily accessible and does not require special skills. We have analyzed all 471 sharp force homicides in Denmark during 1992–2016 with special focus on aspects that are relevant to forensic pathologists, including the distribution of wounds and organ injuries. Most homicides were committed inside with a kitchen knife. The front left thorax was the most common area to be affected by sharp force trauma. In 18.9% of the victims, there was only one sharp injury, the majority on the thorax. The most common trajectory for stab wounds was directly posterior with no deviation to the sides or up/down followed by directly anterior. The heart (including pericardium) and lungs (including hemo- and pneumothorax) had injuries in more than 75% of the victims. 67% of victims were males. Female victims had more sharp force injuries and defense wounds than male victims. Most females were killed in domestic homicides (73.7%), most commonly in partner killings (56.4%). In contrast, many male victims were killed in a setting of nightlife/intoxication (34.0%) most by a friend/acquaintance delivering a few stab wounds. The results clearly show strong sex differences in both victims and offenders. This could be useful for shaping policies and public opinion, and as a route for understanding the developments in interpersonal violence. In the narrow setting of death investigation, our results will provide an evidence-based approach to understanding the injury patterns in sharp force homicide.     

Case reports of suicide with an electric drill

In this report, three cases of suicide by an electric power drill are described. In the first case, a man aged 51 was found with four penetrating wounds of the head and chest. The second case involves a 56-year-old man who suffered a penetrating craniocerebral injury and the third case involves a 53-year-old man who suffered one head injury and two chest injuries. In the first two cases, the victims were found dead. In the third case, the victim survived his injuries for 28 hours. The case histories and the post-mortem examinations revealed no evidence of homicide.     

电警棍致皮肤损伤的实验研究

本研究系用电警棍电击实验动物（猪），观察电击部位的皮肤喷涂金属显色剂后的颜色改变、组织学改变及金属含量的改变。结果表明，电警棍电击机体，不仅可致皮肤产生肉眼可见的损伤，而且可致皮肤细胞产生轻微的极化现象和皮肤金属化，这种金属化可通过金属显色剂喷涂和原子吸收分光光度计检测出来．本实验为电警棍电击伤的定性分析、检材的提取与处理提供了比较好的方法，有利于判定案件的性质和确定电警棍的种类。     

玻璃刺创形态学特点的初步研究

目的研究玻璃刺创的形态学特点。方法分别用3个厚度为0．31cm带尖状突起的啤酒瓶残端及3块厚度为0．29cm有尖的普通窗玻璃碎片按设定的不同方向刺击带皮猪肉组织,重复此过程3次,形成198例创口,观察、编号、拍照、测量各创口。结果198例创口的整体形态可分为5种类型,即“工”型、“”型、“”型、“上”型与“一”型,各型在不同刺击方向的分布上存在差异,其中前4种为主要类型,共约占总数的93％,其共同点为在损伤的中部出现了一段与损伤整体走向垂直的创口,啤酒瓶残端所致垂直创口的长度为0．31±0．Olcm（x±s）,窗玻璃碎片所致垂直创口的长度为0．29±0．Olcm（x±s）。结论损伤中部有与损伤整体走向垂直的短创口是玻璃刺创中易出现的一种形态学特点,垂直创的长度与致伤玻璃的厚度具有一致性。     

Laceration of the stomach by blunt trauma in a child: a case of child abuse

A case of perforation of the stomach following blunt abdominal trauma is described in a two-year-old boy. The abdominal trauma was the result of a blow to the abdomen by the stepfather. The child had ingested a large meal in the hour preceding the injury. The child died from peritonitis and shock 12 h following the injury. The literature on gastric perforation by blunt trauma is reviewed. Injuries to the stomach from nonpenetrating trauma are quite rare and are most often related to vehicular accidents. Gastric injury in a child presenting with a history of a minor home or play injury should arouse suspicion of more significant and perhaps intentional trauma.     

Patterns of breaks in umbilical cords by different mechanisms*

Investigations of perinatal deaths often result in discrepancies between autopsy findings and witness accounts. The mechanism by which the umbilical cord is severed after delivery is a common quandary. Confirming or refuting the mother's stated method frequently has significant investigative importance; however, a surprising paucity of data currently exists to allow an objective opinion about the likely mechanism. Ninety-nine placentas with umbilical cords were examined. By random selection, each cord was severed by one of the following tools or mechanisms: knives, scissors, traction, or crush. Each break was examined and photographed, and a tissue section from the broken end examined microscopically. Differentiation of mechanism was best done grossly based on specific pattern recognition. Umbilical cords severed by blunt force have distinctly different morphology from those severed by sharp force. Even similar-appearing sharp force transections frequently have mechanism-specific distinctive patterns of injury.     

Using a Five-Stage Model to Evaluate Workplace Discrimination Injuries

Psychological assessment for workplace discrimination injuries is often complex, as each complainant has a particular personal history and context, including different coping skills, psychopathologies and unique life circumstances. A five-stage model based on best practice guidelines can assist forensic assessment practitioners in determining compensatory damages for psychological or psychiatric injuries and in formulating defensible, evidence-based reports that meet legal standards. The model incorporates legally relevant theories of causation to guide the evaluating psychologist to discern the nature and extent of any injury, and whether discrimination was the likely proximate cause. The focus is not on diagnosis but on functional performance (cognitive, affective, interpersonal and physical) in four key contexts: activities of daily living, relationships, the workplace and hedonic pursuits. This assessment method compares functioning in the complainant’s life until the “day before” the alleged discrimination event with the complainant’s condition at the time of the alleged discrimination, and any symptoms or reactions experienced subsequently. The five-stage model provides a systematic method to examine compensatory damages claims and increase the comprehensiveness and accuracy of the forensic evaluation.     

Survival time and acting capability after fatal injury by sharp weapons

Autopsy reports from 109 victims of fatal injury from sharp weapons were investigated with regard to type and number of lesions, blood loss, degree of alcohol intoxication, survival time and acting capability after the injury. Of the 13 who died immediately, nine had penetrating lesions of the heart. This group also had the highest number of lesions. Sixty-four victims survived for some time. The survival time increased with decreasing number of lesions. The greatest blood loss and the highest blood alcohol concentrations were found in those who survived between 0.5 h and 1 h. Twenty-four victims were able to make physical efforts after the injury and the movements varied from a few steps to the running of several hundred meters. Decisive factors for decrease in survival time and acting capability are penetrating lesions to the heart and the great vessels, and multiplicity of injuries.     

Sharp force injuries in clinical forensic medicine--findings in victims and perpetrators

The injury findings in 58 perpetrators and 158 victims surviving bodily injuries due to sharp force are presented here. Defence injuries were found in 45.9% of the victims without any significant differences between males and females. There was no clear predominance of defence injuries on the left forearm and hand, as is known from autopsy studies; the right and the left hands were affected with an almost identical frequency. Regarding other parts of the victims' bodies, the topographic distribution of injuries showed a marked concentration on the left side (63.7%). The thorax, head and neck were frequently affected (45.9%, 15.3% and 15.3%, respectively), and less often the abdomen (11.1%), the lumbar and gluteal region (6.3%) and the lower extremities (6.1%). In surviving victims with only one singular stab apart from the upper limbs, the incidence of additional defence injuries on the hands and/or forearms was significantly higher (28.3%) than in fatalities. When the perpetrators had unintentionally cut their own hands, the frequency of these injuries on the right and left hands was almost equal.     

A comparative and comprehensive analysis of nonsexual assaults

The aim of this study was to make a comparative and comprehensive analysis of nonsexual assaults in 488 medico-legal cases presented to Forensic Medicine Outpatient Clinic of Celal Bayar University Hospital (Manisa, Turkey), between 2005 and 2009. There were blunt force injuries (BFI) in 262 cases (53.7%), sharp force injuries (SFI) in 163 cases (33.4%), and firearm-related wounds (FRW) in 63 cases (12.9%). The results showed significant differences in the monthly distribution of assaults, localization of injuries, and severity of injuries depending on the types of assaults. Most of the injuries were localized to the face, head, and neck in BFI and SFI and to the lower limbs in FRW. The results of this study will help researchers to investigate characteristics of victims, offenders, and injuries and types of assaults because of nonsexual violence.     

Mandibular fracture following stab injury with a knife

Stab injuries of the face accompanied by fractures of the jaws are rare. The report deals with the case of a young man, who suffered a penetrating stab injury to the cheek and fracture of the mandible in an assault. The forensic questions to be answered were if the findings were compatible with a stab and subsequent fracture, if one of the confiscated instruments could have been the causative weapon and if the injury had to be assessed as life-threatening. Both the soft and the hard tissue injury confirmed the assumption that they were caused by a stab. It was not possible, however, to assign the injury to a specific knife from the submitted exhibits on the basis of the clinical findings. In the discussion the serious nature of stab injuries in the facial region is emphasized.