Challenges to recruitment and retention of Black forensic pathologists.

BACKGROUND: Informal estimates place the number of practicing Black forensic pathologists (BFPs) in the United States (US) at somewhere between 35 and 45 which is less than 10% the estimated total of 600. The legacy of medical and institutional racism means that BFPs in the US encounter particular challenges to training and career development that their White peers do not have to contend with. METHODS: A survey developed on SurveyMonkey in English, was distributed through social media networks and by direct email to known BFPs. Their responses to questions about the challenges they faced in training and as qualified specialists and factors that eased or facilitated their progress were collected and analyzed. FINDINGS: BFPs report challenges to recruitment and retention that are like those faced by Black peers in other medical specialties. INTERPRETATION: While personal determination is an essential ingredient to career success as a BFP, there are certain structural barriers that must be eliminated to increase the total number of BFPs. The pipeline that produces BFPs must be nurtured, reimagined, and reinvigorated.

Clinicopathological Aspects of Death due to Wild Mushroom Poisoning: An Autopsy Report.

Mushrooms are widely cultivated and used as a source of diet and commerce; however, unfortunately, some wild mushrooms are highly toxic to humans. Although the poisonous mushrooms have a characteristic physical appearance, sometimes it is difficult to differentiate between the poisonous and nonpoisonous variety even by the experts. We report a case of a 23-year-old married female who mistakenly harvested and consumed wild mushrooms along with her family members and subsequently died on the 5th-day postingestion. Due to the medicolegal implications, a forensic autopsy was conducted in this case. Here, we discuss clinical findings along with detailed autopsy findings of this case, including histopathology examination.

Forensic radiography services: The experiences of radiographers and forensic pathologists in Nigeria.

INTRODUCTION: Radiographers can play an essential role within forensic teams and contribute by producing high quality images. There are several aspects of forensic imaging, these commonly include but are not limited to imaging as part of post-mortem investigations, evaluation of non-accidental injuries and the identification of the presence of illicit drugs. In some countries radiographers perform post-mortem imaging before conventional autopsy, a practice that needs to be advanced in less developed countries. In this study, we explored experiences, attitudes and knowledge of radiographers' and forensic pathologists' in delivering forensic radiography services in Nigeria. METHOD: A qualitative exploratory descriptive study was undertaken. Three focus group interviews were conducted with 14 radiographers and five forensic pathologists. Participants were recruited through purposive sampling from two government owned tertiary hospitals in Lagos-State, Nigeria. Focus groups were audio recorded and lasted approximately 1 h. Data were thematically analysed and managed using the Atlas Ti computer software. RESULTS: Forensic pathologists and radiographers perceived forensic radiography differently. Radiographers reported a reluctance to take images of deceased people and were generally not aware of medicolegal issues involved in performing forensic examinations. Three themes emerged in the study, namely participants' experiences in forensic radiography, participants' knowledge of forensic radiography principles and guidelines, and participants' attitude towards forensic radiography services. CONCLUSION: Improving forensic radiography services is likely to require development of postgraduate curricula in forensic radiography and a fellowship curriculum in radiography for forensic pathologists. IMPLICATION FOR PRACTICE: This paper argues that, for radiographers to produce high quality diagnostic images that can assist the forensic team in medico-legal investigations subspecialisation in the field of forensic radiography would be advantageous.

A social media primer for reluctant forensic pathologists.

Forensic pathologists are not as inclined as their peers in medicine and in the subspecialties of pathology, to use social media for professional reasons. Their reservations generally stem from concerns about respecting their rightful obligations to protect both the decedent's privacy and the integrity of judicial processes. While these are legitimate concerns, they should by no means be considered absolute barriers to participation on social media. The purpose of this paper is to provide clear guidelines on how forensic pathologists should navigate social media and how they could interact with colleagues and members of the public on social media platforms without comprising their integrity, decedent confidentiality or judicial processes.

Death Scene Investigation and Autopsy Practices in Sudden Unexpected Infant Deaths.

OBJECTIVE: To describe and compare sudden unexpected infant death (SUID) investigations among states participating in the SUID Case Registry from 2010 through 2012. STUDY DESIGN: We analyzed observational data from 770 SUID cases identified and entered into the National Child Death Review Case Reporting System. We examined data on autopsy and death scene investigation (DSI) components, including key information about the infant sleep environment. We calculated the percentage of components that were complete, incomplete, and missing/unknown. RESULTS: Most cases (98%) had a DSI. The DSI components most frequently reported as done were the narrative description of the circumstances (90%; range, 85%-99%), and witness interviews (88%, range, 85%-98%). Critical information about 10 infant sleep environment components was available for 85% of cases for all states combined. All 770 cases had an autopsy performed. The autopsy components most frequently reported as done were histology, microbiology, and other pathology (98%; range, 94%-100%) and toxicology (97%; range, 94%-100%). CONCLUSIONS: This study serves as a baseline to understand the scope of infant death investigations in selected states. Standardized and comprehensive DSI and autopsy practices across jurisdictions and states may increase knowledge about SUID etiology and also lead to an improved understanding of the cause-specific SUID risk and protective factors. Additionally, these results demonstrate practices in the field showing what is feasible in these select states. We encourage pediatricians, forensic pathologists, and other medicolegal experts to use these findings to inform system changes and improvements in DSI and autopsy practices and SUID prevention efforts.

Differences in the Determination of Cause and Manner of 127 Natural Death Cases by Postmortem Inspection and Autopsy / 대한법의학회지

Medico-legal investigations in Korea depend mostly on postmortem inspection without autopsy. Both untrained physicians and experienced forensic pathologists may not be able to determine the cause and manner of death only by postmortem inspection. The aim of our study was to show the limitations of postmortem inspection by evaluating the discrepancy between the results of postmortem inspection and autopsy after natural death. The manner of death by postmortem inspection changed to unnatural death in 9.4% of the cases (12 cases/127 cases) after autopsy. The cause of death in most cases was consumption of alcohol, agricultural chemicals, and antipsychotic intoxication. The cause of death by postmortem inspection changed in 24.3% of the cases (26 cases/107 cases) among cases of confirmed natural death after autopsy. The positive predictive value of cause of death by postmortem inspection was higher for cardiovascular disease (79.0%) and lower for chronic alcoholism and/or chronic liver disease (28.6%). This study shows that forensic pathologists could make considerable errors in determining the cause and manner of death without autopsy and emphasizes the necessity to refine medico-legal investigations in Korea by introducing the limited autopsy with toxicologic study and supportive postmortem imaging.

Inadequacies of Death Certification: The Role of Forensic Pathologist / 대한법의학회지

Death certification is a public health surveillance tool and a valuable source of information at the national and local levels. Among activities that benefit from the availability of cause-of-death statistics obtained from death certificates are the monitoring of the health of populations, the setting of priorities and the targeting of intervention. Such statistics are also the keystone of much epidemiological study. So adequate writing cause-of-death statements for death is very important. The present study was undertaken to evaluate death certification in Seoul and Kyung-in area of Korea. The available 203 death certificates were obtained from the 1026 autopsy files of National Institute of Scientific Investigation(june, 2002-september, 2002). The summary of the results were: 1. Cases that writing the phenomenon such as cardiac or respiratory arrest, heart failure in the box of cause-of-death were 64 cases(31.5%). Cases that writing the immediate cause of death in the second or third line of box were 50 cases(24.6%). Cases that writing two or more immediate cause-of-death in one line of box were 36 cases(17.7%). 2. Cases that the statement of cause-of-death not correlated with the statement of manner-of-death were 18 cases(8.4%). 3. Cases that the immediate cause-of-death and manner-of-death is changed after autopsy were 179 cases(88.2%). The results of this study showed inadequacies of death certification in Seoul, Kyung-in area of Korea. We thought the reasons for this inadequacies of death certification were mainly insufficient education and campaign for physicians about accurate understanding of cause of death, manner of death. The forensic pathologists certified a number of deaths and have responsibility for education about cause of death, manner of death. So we emphasized need for forensic pathologists to be involved in works related with death certification forms and policies.