Neonatal Limb Amputation-An Unusual Form of Postmortem Canine Predation.

Cases of postmortem canine predation often involve elderly recluses and their dogs. The face, head, and genitalia are targeted. Two unusual cases of postmortem canine predation of abandoned newborns are described to demonstrate an unusual alternative pattern of mutilation related to the small size of the decedents, marked decomposition, and canine scavenging behavior. Both bodies were abandoned/concealed soon after birth and were subsequently disturbed by dogs. Both were markedly decomposed with absent arms. Other injuries included skin and soft tissue defects of the torsos, with loss of distal portions of the right foot and the left lower leg in one case. No interstitial hemorrhage was observed in any of the exposed soft tissue wounds. There were no significant head or neck injuries. These cases show that patterns of postmortem canine predation will vary depending on the age, physical characteristics, degree of decomposition, and location of decedents.

Validation of alternate light sources for detection of bruises in non-embalmed and embalmed cadavers.

Bruising is frequently documented in cases of violence for use as forensic evidence. However, bruises can be overlooked if they are not visible to the naked eye. Alternate light sources such as ultraviolet, narrow band, and infrared have been used in an attempt to reveal the presence of bruising that is not otherwise apparent. However, there is a significant gap in knowledge surrounding this technique as it has not been validated against histology to confirm that bruising is genuinely being enhanced. A recent study evaluated the ability of alternate light sources to enhance visibility of bruises using a pigskin model. However, histological confirmation of bruising in humans using these light sources has not yet been performed. In this study, embalmed and non-embalmed human cadavers were used. Bodies were surveyed with alternate light sources, and enhanced regions that were unapparent under white light were photographed with the alternate light sources and sampled for histological assessment. Immunohistochemical staining for the red blood cell surface protein glycophorin was used determine if the enhanced area was a bruise (defined by the presence of extravasated erythrocytes). Photographs of areas confirmed to be bruises were analyzed using the program Fiji to measure enhancement, which was defined as an increase in the measured transverse diameter. In the non-embalmed and the embalmed cadavers violet alternate light produced the greatest enhancement of histologically confirmed bruises, followed by blue (both p < 0.0001). Regions that were not confirmed as bruises also enhanced, indicating that light sources may not be specific. This suggests that the use of light sources to enhance the visibility of bruising should be undertaken with caution and further studies are required.

Validation of ultraviolet, infrared, and narrow band light alternate light sources for detection of bruises in a pigskin model.

Alternate light sources such as ultraviolet, narrow band, and infrared have been used in an attempt to reveal the presence of bruising that is not otherwise apparent (inapparent). The following study evaluates the ability of alternate light sources to enhance visibility of bruises by employing an objective assessment of digital photography images in conjunction with histology. A pigskin model was employed with bruises created by injection of blood to be not visible or barely visible (inapparent) under white light. The pigskin was photographed using alternate light source illumination. Images were assessed using the program Fiji® to measure enhancement in terms of bruise length (cm). Photography results were compared with histology to confirm the presence of bruising. Violet and blue light sources produced the greatest enhancement, both with a p < 0.0001. Regions that were not bruises were also enhanced with light sources in this study, indicating that light sources are not specific, and that their use to enhance the visibility of bruising should be undertaken with caution.

A comparison of hypothermic deaths in South Australia and Sweden.

Case files from Forensic Science South Australia and the Swedish National Forensic Database were reviewed over a 6-year period from 2006 to 2011 for cases where hypothermia either caused, or significantly contributed to, death. Data were analyzed for age, sex, time of year/season, place of discovery, circumstances of death, and underlying medical conditions. Despite the considerable demographic, geographic, and climatological differences, hypothermic deaths occurred at very similar rates in South Australia (3.9/100,000) and Sweden (3.3/100,000). Deaths from hypothermia in South Australia occurred predominantly indoors at home addresses, involving elderly females with multiple underlying illnesses and limited outside contacts. In contrast, Swedish hypothermic deaths generally occurred outdoors and involved middle-aged elderly males. These data show that hypothermia may be a risk in warmer climates particularly for elderly, socially isolated individuals.

Issues in the diagnosis of hypothermia: a comparison of two geographically separate populations.

A review of hypothermic deaths was undertaken using cases from the Charité University, Berlin, Germany and Forensic Science South Australia, Australia. There were 16 cases from Berlin (age range 38-96 years; average 68 years; M:F = 13:3) Wischnewski spots were present in all 16 cases (100%), skin discolouration in nine (56%), and acute pancreatitis and muscle haemorrhage in one case each (6%). There were 62 Australian cases (age range 30-89 years; average 67 years; M:F = 13:18). Wischnewski spots were present in 57 (92%), skin discolouration in seven (11%), vacuolization of renal cells in six (10%), and acute pancreatitis in one (2%). Reporting of the pathological findings in hypothermia may vary among jurisdictions influenced by the location and nature of these deaths and also by reliance on particular features to make the diagnosis. In addition, it is possible that the aetiology of these markers is quite complex and involves not only a significant reduction in core temperature, but the variable and poorly-understood interaction of a number of other factors.

Lethal hypothermia in an animal model, not associated with basal renal epithelial vacuolization.

A rodent model was used to evaluate the association between hypothermia and basal vacuolization in renal tubular epithelial cells. 28 Sprague Dawley rats were anaesthetized in non-stressful conditions and placed two at a time into a cooling chamber. Body core temperatures dropped to a minimum of 7-10 °C, causing death under anaesthesia at times varying from 120 to 240 min. The animals were then subjected to necropsy; the kidneys were removed and placed in 10% buffered formalin. Examination of haematoxylin and eosin-stained renal sections failed to reveal basal vacuolization of renal tubular epithelial cells in any of the 28 animals. In this model, no evidence of subnuclear lipid vacuolization of renal tubular cells could be demonstrated despite significant and eventually lethal hypothermia. These results lend support to the hypothesis that the basal vacuolization in hypothermia may be a manifestation of a more complex pathophysiological pathway rather than being due simply to low body core temperatures.

Additional risk factors for lethal hypothermia.

An 86-year-old woman was found dead lying on her back on the floor of an unkempt kitchen. She had last been seen four days before. Her dress was pulled up and she was not wearing underpants. The house was noted to be in "disarray" with papers covering most surfaces and the floor. Rubbish was piled up against one of the doors. At autopsy the major findings were of a fractured left neck of femur, fresh pressure areas over her right buttock, Wischnewski spots of the stomach and foci of pancreatic necrosis, in keeping with hypothermia. No significant underlying organic diseases were identified and there was no other evidence of trauma. Death was due to hypothermia complicating immobility from a fractured neck of femur. This case confirms the vulnerability of frail, elderly and socially-isolated individuals to death from hypothermia if a significant illness or injury occurs. Additional risk factors for hypothermia are also illustrated in this case that involve inadequate housing construction with absent insulation and window double glazing. The approach to hypothermic deaths should, therefore, include checking for these features as well as measuring room and environmental temperatures, evaluating the type and quality of heating and the nature of the floor and its coverings, Given the ageing population in many Western countries, increasing social isolation of the elderly, cost of fuel and electricity, and lack of energy efficient housing, this type of death may become an increasingly witnessed occurrence during the colder months of the year.

Why are Wischnewski spots not always present in lethal hypothermia? The results of testing a stress-reduced animal model.

Hypothermic fatalities in humans are characterized by a range of often subtle pathological findings that typically include superficial erosive gastritis (Wischnewski spots). Experimental studies have been successfully performed using animal models to replicate this finding, however study animals have inevitably been subjected to a variety of additional stressors including food deprivation, restraint and partial immersion in water while conscious. As it is recognised that stress on its own may cause superficial erosive gastritis, a model has been developed to enable the study of the effects of hypothermia in isolation. 42 Sprague-Dawley rats were allowed free social contact and were fed and watered ad libitum prior to being anaesthetized with isoflurane. Once unconscious, rats were placed on drape cloth covering metal mesh platforms in a styrofoam box packed with ice. The apparatus enabled both maintenance of a specific low temperature (26 °C) in 14 animals, and continued reduction of core temperatures in the remaining 28 (who all died of hypothermia under anaesthesia). Examination of the gastric mucosa in both groups macroscopically and microscopically failed to demonstrate typical Wischnewski spots in any of the 42 animals. Thus, in this model, death from hypothermia occurred without the development of these lesions. These results suggest that stress may be a significant effect modifier in the development of Wischnewski spots in lethal hypothermia.

An unusual pattern of decomposition associated with suicidal electrocution in a bath.

A 51-year-old man was found dead face down and partially submerged in a bathtub alongside two hairdryers. The hairdryers had continued to work, as the victim had bypassed the electrical board of the house prior to dropping them into the water. This had resulted in death due to electrocution, with subsequent heating of the bath water causing marked putrefaction and softening of the immersed body parts. The back and feet, which were not submerged, were preserved. The degree of anterior decomposition was not in keeping with the postmortem interval; however, regional decomposition with sparing of the back and feet provided a clue at autopsy as to the sequence of events. Individuals with training in, or knowledge of, electrical circuitry are capable of modifying domestic wiring so that safety switches and/or fuses can be bypassed ensuring that electrical devices will continue to function even while under water.

An audit of the toxicology findings in 555 medico-legal autopsies finds manner of death changed in 5 cases.

An audit of toxicological analysis in Coronial autopsies performed at Forensic Science South Australia was conducted on the cases of three pathologists. Toxicological analysis had been performed in 555 (68 %) from a total of 815 autopsies. It was found that the proffered manner of death was changed from the provisional report (provided immediately after the post-mortem examination) in five cases (just under 1 %) as a consequence of the toxicological findings. This is a limited study as it is retrospective, not all cases had toxicological analysis and the findings are constrained by the range of the substances that could be detected. Nonetheless, the audit supports the application of toxicological analysis in medico-legal death investigation and suggests that an inclusive policy should be adopted.

The assessment of lethal propeller strike injuries in sea mammals.

Assessment of injuries in marine mammals may be required to help authorities determine whether human activity was involved. Three cases of marine animal deaths involving propeller blade strikes are reported to demonstrate characteristic features of such cases and diagnostic difficulties that may occur. Case 1: A juvenile New Zealand fur seal (Arctocephalus forsteri) suffered two parallel linear incised wounds of the flank and died following small intestinal herniation. Case 2: An Indo-Pacific bottlenose dolphin neonate (Tursiops aduncus) died from a deeply incised wound of the left side of the head with shattering of the skull and laceration of the underlying brain.Case 3: An adult female Indo-Pacific bottlenose dolphin (T. aduncus) died from two parallel chop wounds to the torso with opening of the thoracic and abdominal cavities with fractures of the ribs and vertebrae. Given that some animals may recover, and that the carcasses of those that are killed may simply not be found or reported, it is impossible to provide an estimate of the incidence of this type of injury amongst wild sea mammals. In cases that do come to forensic attention accurate evaluation of the type of injury may potentially have great medicolegal significance. Post-mortem putrefaction and post-mortem feeding by other sea animals may complicate assessments.

An assessment of the usefulness of routine histological examination in hanging deaths.

A retrospective study was carried out on 100 randomly selected medico-legal autopsies of victims who had committed suicide by hanging. All cases had undergone full police and coronial investigation. Complete external and internal examinations had been carried out including routine histological examination of organs. The age range of victims was 15-94 years (average, 41.7 years) with a male-to-female ratio of 7:1. External and internal injuries were consistent with the reported events. Diagnoses based purely on histology included hepatic steatosis (n = 16), asthma (n = 3), lymphocytic thyroiditis (n = 2), and pulmonary and cardiac sarcoidosis (n = 1). A large cell carcinoma of the lung and a rectal adenocarcinoma were confirmed. Histological evaluation was, however, of limited usefulness in contributing to the medico-legal evaluation of cases, with careful scene, external and internal examinations providing the most relevant information. The results of histological examination of tissues were all incidental to the cause, mechanism, and manner of death.

DVI missions in the Carribean-the practical aspects of disaster victim identification.

Human trafficking of young men from Africa to Europe is a crime with often devastating consequences. The African continent loses members of the younger generation and many die during the attempt to reach their destinations. The identification of these victims is often difficult, however the structured and by now well-established procedures utilizing standard disaster victim identification protocols provide a reliable and functional approach. The logistics involved are straightforward, and one of the many functions of the team leader is to monitor and control the flow of cases through the system. The importance of ante mortem data for the purposes of identification is clear-no ante mortem data means no identification. Two different missions conducted in the Caribbean are described to illustrate particular difficulties that may occur.