Forensic Autopsy of Human Decomposed Bodies as a Valuable Tool for Prevention: A French Regional Study.

Post mortem changes due to putrefaction sometimes make people wrongly consider the autopsy of a decomposed body as unrewarding. A 5-year retrospective study was conducted and included all types of decomposed body subject to medicolegal autopsy, excluding bone remains and charred bodies. Sociodemographic, medical, and forensic data were collected. In the 350 cases included, most were socially isolated mature males discovered at home. The cause of death was determined in 80% of cases, and the manner of death in 86.6%. Identification was considered effective in 99.7% of cases by the chief prosecutor. The authors show that such an autopsy usually answers most questions raised by the investigation but can also be a valuable tool in the prevention, making it possible to define a profile of persons at risk of dying alone. In addition, they underline that forensic scientists should be cautious in their identification of conclusion as diverging views regarding the concept of "presumed identity" may lead to ethical tensions between judiciary and prosecutors as well as the medical community.

Fall from a car driving at high speed: A case report.

In cases of falls, the key issue for forensic scientists is to determine the manner of death. They must distinguish between accidental falls, suicidal falls, falls including blows and falls caused by a blow. Several strategies have been proposed in the literature to help explain injury patterns. Here, we report an original case of a man who died after jumping from a car moving at high speed. A mathematical and modeling approach was developed to reconstruct the trajectory of the body in order to understand the injury pattern and apparent discrepancy between the high speed of the car from which the victim jumped and the topography of the bone fractures, which were limited to the skull. To define the initial values of the model's parameters, a technical vehicle evaluation and several test jumps at low speed were carried out. We studied in greater detail the trajectory of three characteristic points corresponding to the dummy's center of gravity, head and right foot. Calculations were made with and without the air friction effect to show its influence. Finally, we were successful in modeling the initial trajectory of the body and the variation of its head energy over time, which were consistent with the injuries observed.

FORENSIC Autopsy of People Having Committed Suicide in 2002 and in 2012: Comparison of Epidemiological and Sociological Data.

This work compares epidemiological and sociological data on persons having committed suicide in 2002 and in 2012 through a retrospective study of every suicide case having led to an autopsy at the Institute for Forensic Medicine of Lyon in 2002 and in 2012. The study included sociodemographic data, medical data, and toxicological data. A total of 486 cases were included (242 cases in 2002 and 244 cases in 2012). People committing suicide were on average older in 2012 than in 2002 with a larger proportion of over 55. There was also an increase in the proportion of psychiatric antecedents (p < 0.001). Whatever the date of death by suicide, the most affected age range is the 45-54. The results highlight the necessity of bolstering the prevention plans, in particular for people over 45.

A Death Involving a Fired and Deflected Bullet: A Case Report from Lyon University Institute of Forensic Science, France.

In case of gunshot deaths, atypical wounds can make the distinction between entrance and exit wounds harder. They may be due either to anatomical reasons or to diverse cogent ballistic arguments. The reported case pertains to a fatal hunting accident involving an expanded conical point bullet against the neck with both atypical entrance and exit wounds. Ballistic analyses including test firings allowed a better understanding of the external and internal findings. Upon premature impact with an intermediary target, the bullet experienced expansion in the formation of sharp brass petals responsible for a star-shaped entry wound. The trajectory of the deformed high energy projectile through the victim's body was then deviated by the cervical column, causing it to be tangential to the skin when exiting the body. The description of such atypical cases may benefit other experts and may assist in their investigation into similar cases.

Hydrogen sulfide measurement by headspace-gas chromatography-mass spectrometry (HS-GC-MS): application to gaseous samples and gas dissolved in muscle.

The aim of our study was to present a new headspace-gas chromatography-mass spectrometry (HS-GC-MS) method applicable to the routine determination of hydrogen sulfide (H(2)S) concentrations in biological and gaseous samples. The primary analytical drawback of the GC/MS methods for H(2)S measurement discussed in the literature was the absence of a specific H(2)S internal standard required to perform quantification. Although a deuterated hydrogen sulfide (D(2)S) standard is currently available, this standard is not often used because this standard is expensive and is only available in the gas phase. As an alternative approach, D(2)S can be generated in situ by reacting deuterated chloride with sodium sulfide; however, this technique can lead to low recovery yield and potential isotopic fractionation. Therefore, N(2)O was chosen for use as an internal standard. This method allows precise measurements of H(2)S concentrations in biological and gaseous samples. Therefore, a full validation using accuracy profile based on the ß-expectation tolerance interval is presented. Finally, this method was applied to quantify H(2)S in an actual case of H(2)S fatal intoxication.

The interest of postmortem bacteriology in putrefied bodies.

A 27-year-old man was found dead in an advanced decomposition stage at home. On external examination, his body showed petechial hemorrhages of the skin. At autopsy, petechial hemorrhages of the epicardium were found, but no sign of meningitis was detected. Toxicological investigations remained negative. Bacteriological conventional analyses showed no significant result. Neisseria meningitidis serogroup B was finally isolated on cerebrospinal fluid by a specific real-time polymerase chain reaction. To our knowledge, there are no available data about the postmortem diagnosis of an infectious cause of death in a decomposed corpse. In such situations, the polymicrobial overgrowth usually hampers the interpretation of bacteriological conventional methods and questions their diagnostic value. Such molecular bacteriological approaches appear to constitute an important diagnostic tool for forensic scientists and should be widely processed in case of suspected infectious death or sudden death whatever the postmortem interval.

Geometric and harmonic study of the aging of the fourth rib.

One of the current reference methods, namely the Iscan method for estimating age at death, consists in the subjective observation of the sternal end of the fourth rib. In this study, we looked to identify the morphometric characteristics of the sternal end of the fourth rib that were most affected by aging by measuring them in an objective way. For this purpose, we collected measurements from the fourth rib tip of 414 French males and used mathematical algorithms derived from pattern recognition and signal processing to identify variables that reflect both geometric characteristics and serration patterns of the ribs. Completed analysis was carried out on the 284 ribs for which all the variables could be collected. We showed that the three least collinear variables that best explain age objectively are the postero-superior pit depth, the fine serrations of the ovoid (delineating the pit shape), and its posterior flaring. This work provides a useful basis for subsequent studies on aging and age prediction.

Air, water, and surface bacterial contamination in a university-hospital autopsy room.

Today, little is known about the bacteriological environment of the autopsy room and its potential interest for medico-legal practices. Seven hundred fifty microbiological samples were taken from surface (n = 660), air (n = 48), and water (n = 42) to evaluate it in a French University Forensic Department. Median bacterial counts were compared before and during autopsy for air samples, and before and after autopsy for surface samples, using Wilcoxon matched pairs signed ranks test. Bacterial identification relied on traditional phenotypic methods. Bacterial counts in the air were low before autopsy, increased significantly during procedure, and seemed more linked to the number of people in the room than to an important production of aerosol-containing bacteria. Despite cleaning, human fecal flora was omnipresent on surfaces, which revealed insufficient disinfection. Bacteriological sampling is an easy way to monitor cleaning practices in postmortem rooms, but chiefly a way to improve the reliability of medico-legal proofs of infectious deaths.

Sudden death due to a cystic atrio-ventricular node tumour.

Sudden cardiac deaths constitute a major health problem. Most cases are attributed to cardiomyopathies, coronary artery diseases and functional dysregulations. Sudden death in an adult due to a primitive cardiac tumor is a rare occurrence. In the following, we present a case of an adult male who died from an undiagnosed cystic atrio-ventricular node tumour six years after having a pace maker fitted. We focus on the postmortem diagnosis to underline the importance of a systematic histological examination of the cardiac conduction tissue in forensic pathology.