Dog pack attack: hunting humans.

Dog bite-related fatalities, although unusual, accounted for 304 deaths in the United States between 1979 and 1996 and 6 fatalities in Canada between 1994 and 1996. Fatal dog pack attacks and attacks involving human predation are less common. The following describes a dog pack attack on a family of four involving 2 fatalities with predation of the victims. Factors previously identified that contribute to pack attacks and predation, including prior group hunting, social feeding, territorial defense, lack of human interaction, and prey stimuli, are discussed.

Death investigation in Canada.

A survey of death investigation systems in Canada was conducted by questionnaire and included questions on the type of system used (coroner or medical examiner), budget, method of appointment and qualifications of coroners and medical examiners, responsible department of government, training requirements, laboratory facilities, and the utilization of investigators and pathologists by each jurisdiction. Of the population of Canada 81.5% reside in coroner jurisdictions, the primary death investigator in 81% of the population is a licensed physician. The majority of jurisdictions either require or provide training in death investigation. All death investigation systems are under the respective provincial or territorial department of Justice or Attorney General with the chief coroner or chief medical examiner appointed by their respective provincial cabinet. The qualifications of the chief coroner vary with jurisdiction, while in 75% of medical examiner jurisdictions the chief medical examiner must be a pathologist. On a per capita basis medical examiner systems are less expensive to operate than coroner systems.

A fatal case of methotrimeprazine overdose.

Fatal ingestion of methotrimeprazine is unusual, and while therapeutic drug levels are established as concentrations between 0.02 to 0.14 mg/L, fatal levels are not. The following describes a case of fatal suicidal ingestion of methotrimeprazine in which the measured concentration of methotrimeprazine in the blood was 4.1 mg/L. In addition, the major metabolites of methotrimeprazine, desmethylmethotrimeprazine, and methotrimeprazine sulfoxide were also measured at 2.0 and 1.8 mg/L, respectively. Methotrimeprazine and its metabolites were also measured in urine, bile, and vitreous humor. These results are compared with other case reports of methotrimeprazine fatalities reported in the literature.

Esophagopericardial fistula: an unusual cause of sudden unexpected death.

Esophagopericardial fistula is a rare entity, usually associated with benign esophageal disorders. Clinically they present as an acute illness associated with characteristic clinical findings and have an extremely high mortality rate. A case of a chronic esophagopericardial fistula is presented in an individual who remained asymptomatic and presented as a sudden unexpected death secondary to cardiac tamponade from refluxed gastric contents.

Homicide in Newfoundland: a nine-year review.

Newfoundland has one of the lowest homicide rates in North America. The following study examined homicides in the province of Newfoundland for a nine-year period from 1985 to 1993. During this time there were 45 homicides, 25 male and 20 female victims with an average homicide rate of 0.74 per 100,000 persons. Sharp-force either by stabbing or incised wounds was the most common method followed by blunt-force and firearms. For sharp-force homicides the most frequent victim was a male between the ages of 31-40, while for firearm homicide the most frequent victim was female. A positive blood alcohol was found in almost 54% of victims tested but varied with the sex of the victim and the method of homicide used. Illicit drug use was not detected in any victim. The majority of victims knew their assailant, and the most frequent location for a homicide to occur were the victims home. There were two justifiable homicides during the study period.

Sudden death in multiple sclerosis associated with sun exposure: a report of two cases.

BACKGROUND: Two cases of sudden unexpected deaths in patients with multiple sclerosis were investigated by the Office of The Chief Forensic Pathologist. METHOD: Case studies. RESULTS: Marked similarities of the deaths, including circumstances, scene examination, and autopsy findings including a complete drug screen were recorded. CONCLUSIONS: Exposure to high ambient temperature may pose a danger to patients with multiple sclerosis. Mechanisms of death and the potential dangers to patients with clinically widespread disease are discussed.

Congenital diaphragmatic hernia. A case of sudden unexpected death in childhood.

A case is reported in which a congenital posterolateral diaphragmatic hernia of the Bochdalek type was the cause of sudden unexpected death in a 22-month-old girl. This case shows that not all late-presenting diaphragmatic hernias have a favorable prognosis.

Suicidal gunshot wounds.

Suicidal gunshot wounds were reviewed for a 6 year and 6 month period with respect to age, sex, type of firearm, anatomical location of the entrance wound, alcohol use, location of the event and the presence of a suicide note. There was a total of 64 suicidal gunshot wounds, the majority of which were found in males. The most frequently used firearm was a shotgun, and the entrance wound was typically the head, the mouth being the most common although the exact location varied with the type of weapon used. Concomitant alcohol use was higher than in the overall suicide population. Most victims committed suicide in or around their dwelling and the majority failed to leave a suicide note.

Dyadic suicide. A case study.

A young married couple committed suicide by hanging, using an unusual arrangement in which the weight of the other partner's body was essential in successfully completing the suicide. Suicide pacts are unusual and the following case history illustrates features that are somewhat atypical, even considering the infrequent nature of such events.

Asphyxial suicide by propane inhalation and plastic bag suffocation.

A 26-year-old male committed suicide by inducing asphyxia using a combination of plastic bag suffocation and propane-gas inhalation. This method has been reported in the literature, but it remains unusual. Autopsy findings were consistent with a hypoxic event, and blood, brain, and lung tissue tested positive for propane by gas chromatography. Propane, while possessing some narcotic properties, causes death primarily by displacing oxygen in the atmosphere with resultant asphyxia.

Suicidal drowning.

Autopsy protocols at the office of the Chief Forensic Pathologist were reviewed with respect to suicidal drowning. Within the years 1987 to 1991, 247 people have committed suicide in the Province of Newfoundland. Of that number, 22 committed suicide by drowning, representing 8.9% of all suicides, and the fourth leading cause of suicidal death. When considering suicide in the age group of 50 years and older, (n = 68), which accounts for 27.5% of all suicides, drowning represents 25% of all suicidal deaths, and within females in this group represents the most common form of suicidal death (45.5%). The presence of alcohol or other drugs is decidedly unusual in such victims. Of the 22 drowning suicides, 19 were committed in the ocean, two were committed in fresh water and one committed in a residential well. These results contrast to similar studies performed in locations in which access to water could be reasonably considered a factor in choosing a method of suicide.

Nontraumatic acute subdural hematoma. A case report and review of the literature.

A case of an acute subdural hematoma in association with a hypertensive intracerebral hemorrhage is presented. Scene examination, medical history, and autopsy findings support the conclusion that the subdural hemorrhage was the result of natural disease. Although the majority of acute subdural hematomas occurring in cases of sudden unexpected death involve trauma of some type, they can occur as a result of natural processes, or as a spontaneous phenomenon associated with cortical artery rupture. The literature describing nontraumatic causes of subdural hemorrhage is reviewed.

An unusual suicide. The importance of the scene investigation.

In cases of unusual death, scene investigation plays an important role in assisting the investigator to determine the manner of death. The following case history describes an unusual suicide in which scene investigation was essential in assisting the authorities in determining the manner of death.

Acute benzene poisoning: a report of three fatalities.

The toxicity of benzene is well established, particularly its chronic effects on the hematopoietic system and its role as a carcinogen. Acute effects are known but less well documented. This case report describes three cases of acute benzene poisoning resulting from an industrial accident aboard a chemical cargo ship. Complete autopsies were performed on all three victims, who showed evidence of cutaneous, respiratory and cerebral injury. In addition, body fluids, brain, body fat, liver and lung were analyzed for benzene, levels of which were consistent with the lipid soluble nature of benzene, although body fat showed better correlation with blood levels than brain, liver or bile.