Accidental fire fatality with sustained combustion.

This is a case of a 59-year-old man found with extensive second to fourth degree thermal burns found lying on the ground several feet from a vehicle used as his domicile. Autopsy revealed extensive loss of soft tissue and fragmentation of bone, mostly to the trunk region, with partial sparing of the upper trunk, head, and extremities.The decedent had a history of acute and chronic substance abuse and it was reported that he was participating in a methadone program. Toxicology reports of autopsy blood obtained from the heart indicated methadone levels of 0.4 mg/L at the time of his death.There was also a trace amount of cocaine present and there was no ethanol detected. Sustained human combustion, or the "wick effect," is concisely defined as the partial destruction of a body by fire, where the victim's clothing absorbs liquefied fatty tissue and acts like a wick of a candle by perpetuating a flame that slowly destroys the body with heat. There are few nonexperimental cases describing this process in the world literature.

Sudden cardiac death in a 20-year-old male swimmer.

In young adults, hypertrophic obstructive cardiomyopathy (HOCM) is an acknowledged risk factor for sudden cardiac death (SCD) in an otherwise healthy and active patient. While the incidence of SCD in young people is not high enough for extensive, wide-scale examinations, the potential for prevention of some deaths via pre-exercise imaging may be beneficial in certain patient populations, such as those with a family history of SCD or professional athletes. We present the case of a healthy 20-year-old man with no past medical history who died while swimming in a river, likely secondary to cardiac arrest in the setting of HOCM.