Suicide by gunshot while driving a motor vehicle. Two additional cases.

Suicide by means of a motor vehicle occurs more frequently than is generally realized, and may be difficult to prove. Suicide by other means while driving a motor vehicle is far less frequent. Only two cases of suicide by gunshot while driving an automobile have been previously, and recently, reported. The author reports two additional cases of suicide by gunshot while driving a motor vehicle. Each case was a young man who had been suffering from depression; who obtained a firearm apparently for the express purpose of committing suicide; and who shot himself while driving a motor vehicle on an Interstate highway. Contrary to the usual finding in a series of suicides, three of the four cases now reported each left a suicide note or notes. What is apparently a fatal single-vehicle-single-occupant vehicular mishap may in fact be a suicide at the wheel by other means. What is apparently suicide by means of motor vehicle may in fact be an attempt to disguise homicide. Medicolegal offices are urged to routinely perform complete autopsies in fatal single-vehicle-single-occupant vehicular mishaps so that cause and manner of death may be documented without question.

Fatal air transport accidents involving athletic teams from the United States.

Team sports at multiple levels of competition have steadily grown more popular and more economically significant in the United States and Canada during the past 150 years. Year-round competition across these large countries requires continual, reliable, and safe transportation of teams and their supporters, often by air, with the potential albeit small for loss of athletes, coaches, and entire teams in air crashes and other accidents. This paper reviews potential and actual accidents involving United States athletic teams from the 1930s to the present, including four fatal air charter crashes from 1960 through 1977. Common factors in crashes included inclement weather, component failure, human factors, and overloading or misloading aircraft. The safety of commercial and charter aviation has been significantly improved. However, weather, human factors, and ongoing maintenance and inspection of aircraft for safety remain significant problems which call for continued vigilance.

The trials of Steven Truscott.

Determination of time of death (postmortem interval) is one of the most difficult problems confronting forensic pathologists. One noteworthy such case is that of Steven Truscott, a 14-year-old Canadian youth who was convicted of the June 1959 rape-murder of 12-year-old Lynne Harper in rural southwestern Ontario. The two had been seen together on the evening when Lynne was last seen alive. At her autopsy approximately 48 h later, the prosecutor, relying almost entirely on examination of the gastric contents, placed the time of death during the period in which the two were apparently in each other's company. Truscott's defense was unable to refute this opinion, and Truscott was sentenced first to death, then to life imprisonment. Isabel LeBourdais, a Canadian journalist, published a book defending Truscott that eventually led to a judicial rehearing, but his conviction was upheld. The examination of gastric contents is only one measure employed in the often difficult determination of time of death. It has not been made inherently more reliable in this regard since 1959. It is crucial, therefore, to use all available evidence in determining time of death.

The irradiation-associated decline in the in vivo uptake of glucose observed in rats fed fish oil is prevented by feeding a diet enriched in saturated fatty acids.

Previous in vitro studies have shown that abdominal irradiation diminishes the uptake of many nutrients and that the extent of this effect can be modified by varying the type of dietary fatty acid. This study was undertaken to determine (1) the effect of dietary fish oil fatty acids (FO) on the in vivo absorption of D-glucose and (2) the effect of feeding isocaloric diets containing FO or beef tallow (BT) on the in vivo uptake of glucose 2 weeks after a single 600 cGy exposure to abdominal irradiation from a 137Cs source. Feeding FO reduced the jejunal and ileal maximal transport rate (Vmax) and Michaelis constant (Km) for glucose uptake in nonirradiated control animals. In irradiated rats the Vmax was higher and the Km was lower in animals fed BT than in those fed FO. The passive component of glucose uptake was higher in control rats fed FO than in those fed BT yet was lower in irradiated animals fed FO compared with those fed BT. Although the value of the Km fell with FO, the effective resistance of the intestinal unstirred water layer rose so that the uptake of lower concentrations of glucose was undisturbed. However, FO reduces the uptake of higher concentrations of glucose as a result of a decline in the value of the Vmax that is sufficiently large to override the enhanced passive permeability of the intestine to glucose.(ABSTRACT TRUNCATED AT 250 WORDS)

"Beaten to death". An autopsy series of homicidal blunt force injuries.

Although gunshot is by far the most common means of homicide in the United States, significant numbers of homicides are also perpetrated by other means. Blunt-force injuries are produced by a variety of objects, including hands and feet and many different weapons. Some of these objects produce distinctive patterns of injury of potential evidentiary value. This paper presents a series of 20 consecutive blunt-force homicides in adults. Seventy percent (14 cases) of the victims were men. Thirty percent (six cases) followed an argument or altercation. A number of the weapons used were "weapons of opportunity" seized in the course of the incidents. Sixty-nine percent (nine cases) of known assailants were acquainted with their victims. Few characteristic patterned injuries were seen. Not surprisingly, craniocerebral trauma was the most common cause of death. One half (10 cases) the victims survived their assaults for varying periods of time. Homicides due to blunt-force injury still pose a significant challenge for the forensic pathologist, who must obtain a complete and accurate history of the fatal incident, interpret patterns of injury and other findings at autopsy, and correlate all of the findings to make an accurate ruling of the cause and manner of death.

Dietary omega-3 fatty acids partially correct the enhanced in vivo uptake of glucose in diabetic rats.

This study was undertaken to determine the effects of feeding isocaloric semisynthetic diets high in saturated fatty acids from beef tallow (BT) or high in polyunsaturated fatty acids from fish oil (FO), on the clinical control and the in vivo uptake of varying concentrations of D-glucose into perfused jejunal and ileal loops of intestine of rats with streptozotocin diabetes. Jejunal and ileal weights were greater in diabetic than in control rats fed BT or FO, but the percentage of the intestinal wall comprised of mucosa was lower, resulting in a similar mass of mucosa in diabetic and in control animals. Feeding FO increased the jejunal unstirred water layer (UWL) resistance in control rats but decreased ileal UWL in diabetic animals; UWL was lower in diabetic than in control rats fed FO but was similar in those fed BT. The passive permeability coefficient (Pd) of the intestine for L-glucose was greater in diabetic than in control rats fed BT but not in those fed FO; Pd was higher in control rats fed FO than BT. The maximal transport rate (Vmax) and Michaelis constant (Km) of jejunal D-glucose uptake were lower in control rats fed FO than BT. Jejunal Vmax was lower in diabetic than control rats fed BT, yet was higher for those fed FO. The ileal Vmax for D-glucose uptake was greater in diabetic than in control animals fed BT or FO.(ABSTRACT TRUNCATED AT 250 WORDS)

The Grand Canyon midair collision. A stimulus for change.

Commercial aviation in the United States developed rapidly from a nucleus of pilots who returned from World War I, barnstormed and flew primitive airmail routes, and were hired by the new commerical airlines of the 1930s. The death of U.S. Senator Bronson Cutting in a 1935 crash was an important stimulus to improved governmental regulation of civil aviation. The air traffic control system, primitive until and throughout World War II, was soon proven to be inadequate for postwar demands. The midair collision of two large airliners over the Grand Canyon in June 1956 that killed the 128 persons on board was itself a strong stimulus for serious efforts, particularly in improving air traffic control systems. This and many other difficult problems in aviation safety have been addressed in the subsequent 33 years, some with success, although it has not always been immediate, and with major accidents still occurring. Commercial air travel is safe and widely accepted, however, and there is promise for additional important advances here.

Suicide by gunshot while driving an automobile.

Suicide by a motor vehicle occurs more commonly than is realized, and may be difficult to prove. Suicide by other means while driving a vehicle is far less common. An automobile driven by a young woman left a road at high speed, became airborne, and came to rest on its top in a front yard. This was initially assumed to be a fatal traffic accident. Upon righting the vehicle, a .357 revolver was found on the ground beside it. A single, fatal, self-inflicted gunshot wound was found in the decedent's midanterior thorax. A suicide note was found in her purse. She had been chronically depressed and had twice attempted suicide. Vehicular suicides may constitute 10-30% of fatal single-vehicle crashes, and must be considered in any vehicular mishap lacking another reasonable explanation. Suicide by other means while driving is far less common than suicidal vehicular collision and suicidal death from carbon monoxide in motor vehicles. An autopsy should be performed in each of these sometimes-low-priority single-vehicle deaths in order to certify vehicular accidents correctly; to discover and document vehicular suicides; and to detect homicides disguised as vehicular mishaps.

The Podmore case.

On January 10, 1929, in Southampton, England, two men examining the interior of a long-padlocked garage that had been previously used as a storeroom by a local agent of the Wolf's Head Oil Company found the decomposing body of its missing agent, Vivian Messiter. The assistance of Scotland Yard was obtained. Sir Bernard Spilsbury's autopsy revealed that Messiter had died from several severe blunt force craniocerebral injuries, the murder weapon apparently being a blood-encrusted hammer found nearby. Suspicion immediately centered on William Podmore, alias William Thomas, who had been employed by Messiter for 3 days in late October 1928, immediately prior to Messiter's being declared missing. Podmore, who was wanted for fraud and robbery elsewhere in England, was questioned and told a self-serving story. Meanwhile, it had been suspected that he had reported to Messiter sales of oil to fictitious customers, collecting commissions on same, and this was eventually reinforced by the finding of traces of writing in a receipt book. Two fellow prisoners of Podmore stated that he had confessed in their presence. Almost 14 months after the murder, Podmore was charged with it. He was later convicted, and was hanged after some public outcry against the verdict.

Birchall and Benwell. Murder in a Canadian swamp.

On 21 February 1890, two woodsmen working in densely wooded Blenheim Swamp in southern Ontario, Canada, stumbled upon the dead body of a young Englishman who had been killed by two gunshot wounds to the head. He was identified as Frederick Benwell by a married couple, the Birchalls, who had traveled with him and another man, Pelly, from England to New York City by ship about 1 week before. The Birchalls lied regarding Benwell's subsequent movements. Questioning Pelly revealed to Detective John Murray that both Pelly and Benwell had replied separately to Birchall's advertisement for young men of means to become partners with him in a large Canadian farm, a deposit first being required. Birchall had been observed taking Benwell from Buffalo, New York, to Blenheim Swamp, for in reality there was no farm. There he had shot Benwell, leaving the body partially exposed. He then tried unsuccessfully to lure Pelly to his death in Niagara Falls. The Birchalls were arrested. Reginald Birchall was tried, convicted, and hanged. His attempt, including murder, to turn the so-called farm pupil colonization scheme to his own benefit had been frustrated by the dogged work of the master Canadian detective Murray.

Homicidal death following blunt trauma in a vulnerable host, with secondary infections including local tetanus.

An uncommon type of homicide resulted from complications of an ordinarily nonfatal injury after a 59-year-old obese, hypertensive, diabetic man was struck in the face with a two-by-four, sustaining a grossly contaminated laceration. It was cleaned and sutured primarily, and a tetanus booster was given. On the fourth hospital day there was evidence of anerobic wound cellulitis, including Clostridium tetani. The wound was surgically debrided, but 2 days later the patient developed local tetanus. Only then was it discovered that he had never been immunized against tetanus. He did not develop systemic tetanus, but 2 days later he died with bronchopneumonia and sepsis. The assailant was indicted for involuntary manslaughter, but after a contentious trial he pleaded "no contest" to a reduced charge. The decedent was a vulnerable host, his contaminated facial laceration initiating an unbroken course of events that led to his death.

Tragedy at Tunnel 13. The d'Autremont brothers and "The Edison of Crime Detection".

Train robbery was frequent in the United States from the late 1800s through the 1920s. On October 11, 1923, the southbound Southern Pacific Express was halted by three men at Tunnel 13 in southern Oregon just north of the California line. The railway mail car carrying +40,000 was then blown apart by an explosive charge, killing the clerk and rendering the money unobtainable. The men shot three other train crew members before escaping into the mountains. The investigation was headed by Chief Agent Dan O'Connell, who soon asked that California criminalist, Edward Heinrich, examine soiled overalls found nearby. Using primarily botanical evidence, Heinrich identified them as those of a woodsman, leading to the identification of three Oregon d'Autremont brothers as suspects. After an intensive manhunt, one was captured 3 years later in the Philippines and was tried and found guilty. The twins, captured in Ohio, then pleaded guilty. This crime, typical of those in which unforeseen events lead the perpetrators to panic and to murder, helped to establish criminology and particularly botanical studies as valid scientific disciplines. Its investigation and solution also remain models of scientific crime detection.

Therapeutic misadventure. An 11-year study from a metropolitan coroner's office.

"Therapeutic misadventure" and its alternative forms is a controversial, though necessary, manner of ruling deaths that result from unexpected complications of medical procedures. Such cases must be brought to the attention of the medical-legal office so that they are thoroughly investigated and documented, and so that appropriate and consistent rulings are made. While it is not generally agreed that a ruling of therapeutic misadventure implies medical negligence, a number of such cases do become the bases for litigation. During an 11-year period in a metropolitan coroner's office that examines about 2,000 cases yearly, 44 cases were ruled therapeutic misadventure, an incidence of 0.46%. A recent increase in such cases is probably the result of improved case finding and investigation. The largest category was that of surgical complications, followed, in order, by complications of anesthesia and of therapeutic and diagnostic procedures, and by drug reaction. No case occurred in ambulatory surgery. There apparently has been a low incidence of attendant lawsuits. The study of cases of therapeutic misadventure is potentially of great value in identifying outcomes and trends, and for the prevention of such cases in the future.

"A brilliant ball of fire." The sabotage of United Airlines Flight 629.

Among the known causes of aircraft disasters, sabotage is perhaps the most terrifying and difficult to comprehend. Bombs have been exploded in at least 34 commercial aircraft, with the resultant loss of more than 300 lives. Motives for these acts include profit, the deaths of certain persons, and politics. On November 1, 1955, United Airlines Flight 629, bound to Denver-Portland, exploded and burned in flight near Longmont, Colorado, a few minutes after takeoff, with the loss of all 44 on board. Investigation revealed that the plane had been destroyed by the explosion of a bomb that had been placed in the rear luggage hold in Denver. Twelve days after the disaster, John Gilbert Graham, the son of one of the female passengers, was arrested and charged with murder. He reportedly admitted placing a time bomb on board the aircraft, apparently in order to collect $37,500.00 in life insurance that he had taken on his mother's life. Though he soon recanted, he was convicted of murder and was executed. The potential for additional such crimes remains.

Murders for profit. The case of John Donald Merrett.

Forensic cases may be of historical interest because of their rarity, unique characteristics and conclusions, and potential for educating forensic scientists. The case of John Donald Merrett, who committed multiple murders for profit in Great Britain in 1926 and in 1954, is a notable example of a case in which both police and forensic scientists made serious errors, these errors leading to Merrett's acquittal when he was tried in 1927 for the shooting death of his mother. Imprisoned for forgery, Merrett was released only to resume a life of crime culminating in 1954 in the brutal murders of his wife and mother-in-law. Pursued by the police, he committed suicide. The Merrett case was of great benefit to forensic medicine in emphasizing the necessity for close teamwork among police and forensic scientists and in furthering the development of forensic ballistics.

A single fatal penetrating chest wound from shattered wind-blown glass.

The great majority of penetrating wounds of the thorax result from firearms and bladed weapons. Penetrating wounds of the heart and of the great vessels still have a high immediate mortality. While penetrating chest wounds occasionally result from fragments of glass; most severe and fatal wounds from glass result from one's falling into or through architectural (plate) glass, sustaining wounds of abdomen or extremities, or both. A single, fatal penetrating chest wound resulting from a wind-blown fragment of glass is distinctly uncommon. The unique case of this type reported herein is that of a 12-year-old youth who was struck in his home in the left anterior chest by a single, sharp, slender fragment of glass blown from a window which shattered in a thunderstorm. This resulted in a rapidly fatal penetrating wound involving thoracic viscera. The forensic pathologist must thoroughly investigate and document such accidental deaths, modifying his/her autopsy procedure as necessary for these purposes and to avoid accidental injury at the autopsy table.

Death in the desert. The sabotage-derailment of "The City of San Francisco".

The completion of the transcontinental railroad in 1869 was a milestone in American history. Seventy years later in August 1939, the westbound, new Southern Pacific Railroad streamlined passenger train "City of San Francisco," was intentionally derailed at high speed in northern Nevada by saboteurs who had moved a rail out of alignment. This resulted in a spectacular wreck, claiming the lives of 24 passengers and crew. Despite the finding of physical and trace evidence; and lengthy, exhaustive investigations by railroad police, the FBI, and forensic scientists, the perpetrators were never brought to justice. Deaths resulting from vandalism and sabotage are among the least common of railroad-related deaths; however, acts of vandalism and violence including train derailment are increasingly frequent in this country. Law enforcement officers and forensic scientists must be able to place these incidents in their proper perspective and to successfully investigate and solve them by employing all means at their disposal.

Gunshot wound of the chest with five intrathoracic foreign bodies.

When a firearm projectile strikes an intermediate target before entering a body, foreign material from that target may be carried into the body with the projectile. This material should be sought and recovered at autopsy, for it may prove to be valuable evidence in subsequent legal proceedings. The unusual case reported here is that of a 12-year-old boy who was sitting on a couch in front of his living room window and there sustained a .45 caliber gunshot wound of the left anterior chest from a gunshot fired at another person in the street outside. First passing through the back of the couch, the bullet carried with it into the body four pieces of cloth and a metal spring, thereby causing an unusual cutaneous entrance wound, and laceration of the right cardiac ventricle and fatal cardiac tamponade within an intact pericardial sac. The assailant was convicted of first-degree murder, a verdict which he appealed.