Wounds from civilian and military centerfire rifles.

This article explores the differences between rimfire and centerfire rifles and the differences in ammunition used. Permanent and temporary cavity wound tracks are explained. Radiographs, intermediary targets, and assault rifles are also discussed.

Centerfire frangible ammunition: wounding potential and other forensic concerns.

Recently developed frangible ammunition of copper particulate construction in .38 Special, 9 mm, and .223 calibers was evaluated for wounding performance by firing into pigs' heads. The ability to match fired bullets with the corresponding gun was also examined. Results showed that wounds caused by 9-mm and .38 Special frangible bullets were comparable in severity to those caused by regular service ammunition of the same caliber. The recovered 9-mm and .38 Special bullets demonstrated class characteristics but not the individual rifling marks necessary for bullet-to-gun matching. High-velocity .223-caliber rifle bullets fragmented extensively within target tissues, causing severe wounding. Radiologic examination of resulting wounds showed images strikingly similar to the lead "snowstorm" picture caused by high-velocity hunting ammunition.

Incidence of coronary thrombosis in sudden death due to coronary artery disease.

Acute coronary thrombosis does not play a major role in the causation of sudden unexpected death due to coronary artery disease. In a study of 500 consecutive autopsies of individuals aged 20-99 years, dying suddenly and unexpectedly of coronary artery disease, only 67 (13.4%) showed an acute thrombosis. In contrast, studies of hospitalized patients with acute transmural infarction of the myocardium showed a rate of coronary artery occlusion > 80%.

Motor vehicle-pedestrian accidents in adults. Relationship between impact speed, injuries, and distance thrown.

Eighty-five fatal motor vehicle-pedestrian accidents involving adults were reviewed in order to establish the relationship of impact speed to amputation of limbs, atlanto-occipital dislocation of the spine, and distance a body is thrown by a vehicle from point of impact to point of rest. In five cases, there was amputation of a limb, in two, transection of the torso. All occurred at highway speeds (> 55 mph). Twenty-six (31%) of victims had atlanto-occipital dislocations. Half of these accidents occurred at street speeds, half at highway speeds. In cases where the point of impact and distance to point of rest of the body was known, this distance averaged 80.8 feet for automobiles and 82.3' for pickups and vans. There was, however, a wide range: 6-355' for cars and 15-207' for vans and pickups.

An unusual entrance wound associated with rimfire rifles.

In many cases of self-inflicted contact wounds of the head with rimfire rifles, we have noted that the entrance wound appears unusual: in 50% of cases studied, a pencil-like extension or zone of blackened and seared skin extends downward from the entrance. The most probable cause for the appearance of this wound is a momentary break in contact between the muzzle and skin as the victim reaches for the trigger with resultant escape of a jet of hot sooty gas. Whereas not unique for rimfire rifles, such a wound from a handgun is uncommon.

Natural death as viewed by the medical examiner: a review of 1000 consecutive autopsies of individuals dying of natural disease.

A study of 1000 consecutive autopsies of individuals dying of natural disease was conducted. Cardiovascular disease was responsible for 60.9% of all deaths with coronary artery disease--not only the main cause of cardiovascular death but also the main cause of all natural deaths--accounting for 45.1% of such cases. Diseases of the central nervous and respiratory systems accounted for 8.7 and 8.6%, respectively, of the natural deaths. Seizure disorders and pneumonia were the main causes of death in these organ systems. There were 124 deaths of children less than one year in age, 91 of which were due to sudden infant death syndrome (SIDS). All of the SIDS deaths were in children less than 10 months old.

Detection of cannabinoids in homicide victims and motor vehicle fatalities.

A gas chromatographic/mass spectrometric (GC/MS) procedure is described for the detection and measurement of delta 9-tetrahydrocannabinol, 11-hydroxy-delta 9-tetrahydrocannabinol, and 11-nor-delta 9-tetrahydrocannabinol-9-carboxylic acid in blood, or 11-nor-delta 9-tetrahydrocannabinol-9-carboxylic acid in urine. About 50% of all homicide victims and motor vehicle drivers killed in Bexar County in 1985 were tested for the presence of cannabinoids. Of 130 homicides and 69 drivers tested, blood was analyzed primarily in all but 15 and 3 cases, respectively. In these latter cases, blood analyzed after urine was found to be positive. Of the homicide victims, 44 (34%), and of all drivers, 19 (28%), tested were positive for one or more of the cannabinoids. As a separate group, 16 motorcycle drivers tested had 38% positive as compared with 25% of the other vehicle drivers. Ethyl alcohol was present in 55% of the drivers, and in 63% of the homicide victims. Drugs other than alcohol or cannabinoids were found in 10% of the drivers, and in 12% of the homicide victims.

A death from fentanyl overdose.

A case of death from self-injection of fentanyl and a method for its detection in autopsy specimens are reported. Fentanyl was measured by extraction of biological samples with ethyl acetate, partitioning into 0.1N HCl, then reextracting into ethyl acetate after alkalinization of the acid phase. After reducing to a residue, the fentanyl was measured by selective ion monitoring gas chromatography/mass spectrometry. Concentrations of 4.8, 6.3, and 4.7 micrograms/L were found in blood, urine, and bile, respectively.

Death in the dental chair: three drug fatalities in dental patients.

Three patients, consisting of a seven year old boy and two adult women, died after administration of presurgical anesthetic medication in an oral surgeon's office. Toxicological analysis for the drugs involved and medical records confirmed the three individuals had all received potentially lethal doses of pentazocine, a narcotic analgesic, along with unusually high and potentially lethal doses of diazepam. All had also received anesthetic doses of methohexital, au ultra-short acting barbiturate and general anesthetic. Doxapram, a respiratory stimulant, was given in all cases without beneficial effect, and caffeine was administered in one case. Narcotic antagonists were not administered in any of the cases. Use of such could very well have prevented death in these cases.

Four deaths due to intravenous injection of cocaine.

Cocaine is a potent psychotropic drug that alters mood and behavior by stimulating the central nervous system. Deaths from abuse of cocaine are relatively rare. Most such deaths appear to be related to the intravenous injection of the drug. Acute fatal cocaine intoxication is characterized by headache, cold sweats, rapid pulse, tremors and nausea, followed by convulsions, unconsciousness and death. The prime mode of death appears to be respiratory paralysis, secondary to the effects of cocaine on the medullary portion of the brain. This paper presents four deaths due to acute cocaine intoxication following intravenous injection. Blood concentrations of cocaine were 0.11, 0.37, 0.36 and 0.75 mg/dl.