Deaths due to tired bullet injuries: Evaluation from medical, legal, and social perspectives.

BACKGROUND: In Türkiye, as in other parts of the world, there is a rising trend in individual armament and firearm violence, resembling an epidemic. When fired into the air, bullets eventually lose the initial speed with which they left the barrel and begin to accelerate downwards under the influence of gravity as they fall to the ground. At this point, these projectiles are referred to as 'tired bullets,' which cause serious injuries and fatalities. This study evaluates autopsy cases of deaths due to tired bullet injuries. We aimed to raise social awareness and contribute to the literature by exploring the forensic, legal, and social dimensions of tired bullet injuries. METHODS: From 2013 to 2022, 695 forensic autopsies of gunshot wounds were reviewed at the Trabzon Forensic Medicine Group Presidency. Nine cases were identified where individuals had undergone autopsies and the cause of death was attributed to tired bullet injuries. The data for the cases included in the study was sourced from our archive records and the UYAP (National Judicial Network Project) system. The second stage involved analyzing reports of falling bullet injuries from local and national newspaper websites. In the third stage, the Supreme Court decisions regarding perpetrators of tired bullet incidents were examined. RESULTS: The study included six male and three female cases, with an average age of 32.5 years. Injuries were predominantly located in the head in seven cases, the eye in one case, and the inguinal region in another. In eight cases, the bullet trajectory was from top to bottom. The incidents predominantly occurred in residential areas. It was observed that all cases received coverage in both national and local media, and campaigns against tired bullet injuries were organized. The perpetrators of these injuries were frequently sentenced for murder with probable intent. CONCLUSION: Tired bullet injuries represent a significant public health issue that necessitates comprehensive preventative measures addressing medical, legal, and social dimensions. There should be national and international campaigns led by the media, involving all public institutions, organizations, and non-governmental organizations to promote individual disarmament, highlight the dangers of firearms, and stress the importance of these initiatives.

Fatal land hunting-related injuries in the Eastern Black Sea region-Turkey.

BACKGROUND: Hunting requires the use of various weapons or tools as professionals according to the characteristics of the creature to be hunted. Deaths during hunting activities may occur as a result of different reasons (firearm wounds, falling from a height, wild animal attack, or natural, etc.). These events' forensic reports are prepared by the physician who performed the first intervention. Identification of wounds, taking measurement photographs of the wounds before treatment, specifying the shape/sizes of foreign bodies in radiological imaging will be beneficial for determining the type of firearm, the number of shots, and the shooting distance. METHODS: The cases that performed autopsy between 2007 and 2016 at The Council of Forensic Medicine Trabzon Group Chairmanship were analyzed, retrospectively. Twenty-six (4.1%) deceased were examined. Crime scene investigation reports, hunting equipment, wound characteristics, and causes of death were investigated. RESULTS: All of our cases consisted of men (92.3%; n=24) with a mean age of 42.5 years (14-81; SD: ± 17.4). It was determined that 42.3% of the incidents occurred in winter, 80.8% (n=21) occurred in the daytime, 69.2% occurred in open areas such as fields, and 26.9% occurred in forested land. It was found that 88.5% of the deaths were caused by shotgun pellet/buckshot injuries, 7.7% (n=2) by falling off a cliff, and 3.8% by wild boar attacks (vascular injury). It was determined that 57.7% of the shots were made from long shooting distance, 19.2% were made from close range, and 11.5% were made from contact distance. It was found that 73.9% of the perpetrators were other hunters and 26.1% were the deceased person himself. It was determined that 42.3% of the injuries occurred in the chest and 38.4% in the head-and-neck region. It was determined that 96.2% of the cases did not undergo first aid intervention even though there were eyewitnesses in approximately ¾ of the cases. Ethyl alcohol was detected in only 3 cases (11.5%). CONCLUSION: It is thought that similar deaths can be prevented to a certain extent thanks to the hunting and medical first aid training to be given by the local governments. Risk control mechanisms must work properly. Besides, it is necessary to ensure that forensic experts can access the results of the proceedings in such cases. It is thought that this will be more beneficial in terms of developing new behavior styles in similar events.

Evaluation of the fire-related deaths: Autopsy study.

BACKGROUND: The fire is a public health problem that occurs because of various reasons, threatens the lives of organisms, and may cause economic losses. The forensic investigation and the crime (event) scene investigation and first medical examination to be performed for the persons in the fire scene might reveal important evidences. METHODS: The autopsy reports prepared in Trabzon Branch Office, The Ministry of Justice Council of Forensic Medicine, for the death cases found in fire scene between 2007 and 2016 were retrospectively examined. RESULTS: As a result of analyzing the 10-year archive data, it was determined that 100 (63.3%) of 158 cases, which have been found in the fire scene and undergone forensic autopsy, were male and 58 (36.7%) were female. By excluding the group of cases with undetected origin, it was determined that there was a statistically significant difference between the homicide-caused deaths and the deaths with other causes (accident and suicide) in terms of the carboxyhemoglobin (HbCO) levels. By grouping the fire scene as outdoor and indoor areas, the comparison made between the HbCO levels of cases is presented in table. The difference between the two groups was found to be statistically significant (p<0.05). CONCLUSION: Starting from the crime scene investigation, a detailed radiological, toxicological, and pathological investigation must be performed for the persons taken out from the fire scenes. It was observed that the HbCO levels can be used in determining the space in which death occurred, the origin, and the comorbidities of the individual.

Medicolegal evaluation of cases with burn trauma: Accident or physical abuse.

INTRODUCTION AND OBJECTIVE: Burns are thermal injuries that may have a wide variety of clinical consequences from simple injuries to mortality. There are many aspects that must be medicolegally addressed in both non-survivors and survivors from burn injuries. The objective of this study was to determine sociodemographic characteristics, injury patterns, treatment requirements and prognoses of patients with burn injuries to evaluate the findings of neglect-abuse and forensic reporting processes. This study also aimed to contribute to the medicolegal classification criteria in respect of the factors that have an effect on the prognosis in the analyses. MATERIAL AND METHOD: The study was conducted by retrospective review of digital files and paper records of patients who received therapy in the Burns Unit of KTU Farabi Hospital between 1st January, 2013, and 31st December, 2017. RESULTS: Evaluation was made of a total of 1225 patients, comprising 769 (62.8%) males and 456 (37.2%) females, with a mean age of 21.8 ± 23.8 years (range, 1-89 years). The mean burnt body surface area was 14.29 ± 13.74. A trauma-related psychiatric disorder was diagnosed in 60 (4.9%) patients during treatment. When the medical history and physical examination findings were evaluated together, burn injuries suggested physical abuse in 54 patients (4.4%). The doctors who evaluated the patients with burn injuries in the emergency room and those who applied treatment in the Burns Unit made a forensic notification for 379 (30.9%) patients. The mean age of non-survivors was significantly higher than that of patients who survived to discharge (56.54 ± 28.60 years for non-survivors and 19.39 ± 23.12 years for survivors; p < 0.001). CONCLUSION: Burn injuries are frequently encountered, and they require precautionary measures. Burn injuries due to abuse are more frequently observed in the elderly and especially in children. Thus, the findings must be correctly interpreted, and more effort should be made to improve the knowledge of healthcare professionals about forensic reporting. Moreover, regulations should be implemented in respect of the medicolegal classification of trauma.