A 42-year-old man was found dead after repeated exposure to 1,1-difluoroethane (DFE, Freon 152a), a propellant found in CRC Duster, a product intended for the removal of dust and lint. Toxicologic analysis detected DFE in femoral blood 136.3 mg/L, brain 117.5 mg/kg, liver 87.6 mg/kg, lung 60.3 mg/kg, adipose 235.7 mg/kg, and vitreous fluid 25.1 mg/L. The cause of death was determined to be a fatal cardiac arrhythmia due to intoxication with 1,1-difluoroethane. After comparison to previously published cases involving DFE, we suggest that analysis of adipose tissue for DFE and similar compounds, along with blood and other tissues, may be useful in distinguishing between acute versus chronic exposure. Adipose may also be a valuable alternate specimen for detection in cases where loss or elimination from blood is likely to have occurred.
This retrospective case review investigates modifiable risk factors in sudden unexpected infant deaths, including those attributed to sudden infant death syndrome, and examines the impact of cosleeping with adults or siblings. The study examines sudden unexpected infant deaths from 1991 to 2000 in the state of Kentucky, excluding homicides and deaths from identifiable natural causes. Meta-analysis provides a cosleeping prevalence control in normal infants. Based on the findings described herein, we conclude that cosleeping may represent a risk factor in sudden unexpected infant deaths and that a full scene investigation, including whether the infant was cosleeping, should be sought in all cases of sudden infant death.
The blood levels of parent tricyclic antidepressant (TCA) drugs in 11 cases of suicide are reviewed. Values ranged from 0.11 mg% to 2.4 mg% with a mean of 0.80 mg%, which is consistant with the recent literature. The data suggest that in autopsy cases where TCA tissue levels or TCA metabolite concentrations could not be, or were not determined, blood levels of parent TCA drugs exceeding 0.1 mg% may be regarded confidently as the cause of death when no other cause is present.
This retrospective case review examines farm tractor-related deaths in the Commonwealth of Virginia for an 11-year period, from 1997 to 2007. This study compares decedent's demographic information, toxicology results, and medical histories.A vast majority of farm tractor-related deaths were male (98%) and white (91%). The average age was 60 years with most deaths occurring between the ages of 40 and 80 years. Ethanol use was observed in 9% of all cases with 7% of cases being more than 0.08% wt/vol ethanol, which is the legal limit in Virginia to operate a motor vehicle.The more mountainous, Western District Office of the Chief Medical Examiner composed 60% of total cases with 43% of these western cases related to tractor use on a natural slope or incline. The deaths in other districts were all less than 13% natural slope or incline related, reflecting the topography of these areas.These findings confirm much of what observation would suggest; accidents with farming tractors typically involve older white men. Operating a tractor on steep inclines is dangerous as many tractors do not have adequate rollover protection. The use of ethanol is dangerous when using any heavy equipment.This study provides an initial look at tractor-related deaths in Virginia, and more research is needed in this area to improve safety mechanisms on this machinery.
"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.
This report covers the murder of 13 Oriental adults in Seattle, Washington, on February 19, 1983. The victims were patrons of a local gambling club and were murdered systematically during a robbery. This report highlights the management of multiple homicide victims and illustrates interesting features which were developed during the investigation.
This case report describes sudden death in a young boy resulting from an undiagnosed saccular intracranial aneurysm located at the right posterior cerebral artery. It is suggested that the rupture might have been provoked by xylometazolin aerosol, which can increase blood pressure.
The present study is a retrospective analysis of 13 cases of deaths, which resulted from throwing of corrosives over the body. The cases were autopsied at the Department of Forensic Medicine, Maulana Azad Medical College & Associated Hospitals, Delhi, India, during a period of 13 years from July 1998 to June 2011. The cases represented approximately 0.1% of all autopsy cases during the same period. Data were analyzed with regard to the age, sex, place of occurrence, pattern of injury, survival period, and cause of death. Of these cases, 8 (61.54%) were male, and 5 (38.46%) were female. The most common age group of the victim was 21 to 30 years (46.15%). Six of the victims were attacked on the road side. Face and thorax were involved in all cases (100%). The average total body surface area of burn was 56.69%.The mean survival period was 28.2 days. In 53.85% of cases, the cause of death was septicemia.
This study examines the consistency of investigative procedures used by the Office of the Chief Medical Examiner, law enforcement, and child protective services, when investigating the violent, sudden, unexpected, or unnatural deaths of children. The study also assessed the status of communication and cooperation among the investigating agencies, to determine whether improvements in the level of cooperation and communication among the systems recommended by prior legislative studies had been achieved. The subjects of this study were children from birth through age 12 who died a sudden, unexpected, or unnatural death in Virginia in 1996. The findings from this research provide both justification to celebrate the progress that has been made and the stimulus to improve the investigation into the sudden, unexpected, or unnatural deaths of children in Virginia. Data suggested that the level of cooperation and communication among child protective services workers, medical examiners, and law enforcement personnel in Virginia had increased between 1986 and 1996. The results demonstrated that some investigative procedures were consistent, especially within regional boundaries. However, the results also showed that inconsistencies exist in the way some deaths are investigated, and that room for improvement exists.
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.
On September 8, 1997 (day 0), an express train in Aquitaine, France, crashed into a petrol tanker, which immediately burst into flames and set the first carriage of the train on fire. We describe the dental technique and methodology which led (day 2) to the positive identification of 92% of these very heavily carbonized remains. In only 1 case, and only to be totally certain, did the investigators have recourse to use molecular biologic techniques. The use of this specific odontostomatologic technique (craniomandibular disarticulation with bone samples) and excellent collaboration with the Identification Unit for Mass Disasters Victims (CIVC) precluded recourse to any reconstructive identification.
This is a series reviewing 14 cases of giant saccular aneurysms diagnosed at the Office of the Chief Medical Examiner of New York City collected over an 11-year period. Data collected on all 14 cases included neuropathological findings, comorbidities, and toxicological findings. Of these 14 cases, 8 were in women, and the ages ranged from 3 to 79 years, with a mean and a median of 50 years. Women were overrepresented in the sixth through eighth decades. Of the 14 cases described, 11 presented with a subarachnoid hemorrhage; 3, no hemorrhage; 2, subdural hemorrhage; 8, intraventricular hemorrhage; 2, intracerebral hemorrhage; and 8, more than 1 hemorrhage type. Location of the aneurysms varied with 6 in the left side of the brain, 6 present in the right side of the brain, and 2 at the midline. We described the clinical, pathological, and toxicological findings associated with these giant aneurysms.
In the 14-year period from 1976 to 1989, there have been 174 homicide victims in the Auckland colonial area. Data accessed from autopsy and police reports show that victims of marital conflict, family dispute, and arguments developing between nonmarried couples made up the largest proportion of homicide cases. Stabbing and assault with a blunt weapon were the most common causes of death. The data also show that homicide is relatively uncommon in Auckland in comparison with other cities of similar size.
The Working Group on Human Asphyxia has analyzed 14 filmed hangings: 9 autoerotic accidents, 4 suicides, and 1 homicide. The following sequence of agonal responses was observed: rapid loss of consciousness in 10 ± 3 seconds, mild generalized convulsions in 14 ± 3 seconds, decerebrate rigidity in 19 ± 5 seconds, beginning of deep rhythmic abdominal respiratory movements in 19 ± 5 seconds, decorticate rigidity in 38 ± 15 seconds, loss of muscle tone in 1 minute 17 seconds ± 25 seconds, end of deep abdominal respiratory movements in 1 minute 51 seconds ± 30 seconds, and last muscle movement in 4 minutes 12 seconds ± 2 minutes 29 seconds. The type of suspension and ethanol intoxication does not seem to influence the timing of the agonal responses, whereas ischemic habituation in autoerotic practitioner might decelerate the late responses to hanging.
The diagnosis of drowning relies primarily on critical examination of the subject's individual characteristics, circumstances, and postmortem macropathologic changes. In this retrospective study, based on 1590 consecutive cases of bodies found in water and undergoing autopsy at the Department of Forensic Medicine, University of Helsinki, from 1976 to 1998, the frequency of circumstantial data and macropathologic changes crucial for the diagnosis of drowning were determined. The fatal events were eyewitnessed in 403 cases (25.3%), and suicide notes were found in 83 cases (5.2%). External foam, frothy fluid in airways, and overlap of the anterior margins of lungs were found in 275 (17.3%), 739 (46.5%), and 669 (42.1%) of the cases, respectively, but no one of these changes, tested against dry-land controls, were specific for drowning. The association of external foam and overlap of the lung margins was exclusive of drowning but was observed in only 176 cases (11.1%). After cross-analysis, 964 (60.6%) of the cases had no circumstantial data or macromorphologic pathologic findings that allowed a definite diagnosis of drowning. The diagnostic problems in putative drowning cases, based on this study sample, have not been overrated. Studies to investigate and improve the reliability of complementary methods for the diagnosis of drowning are warranted.
Resuscitation attempts have been hypothecated to explain retinal hemorrhages in infants who are suspected victims of child abuse. This study was undertaken to test that hypothesis by postmortem ocular examinations following unsuccessful resuscitation attempts on a sample of 169 children selected by 19 prosectors willing to contribute to the study. Cardiopulmonary resuscitation had been attempted for a minimum of 30 min in 131 of the children, whereas 38 controls did not have such protracted attempts; 70 children with prolonged resuscitation attempts had no retinal hemorrhages, including eight children whose fatal blunt force injuries of the trunk represented extremes of the forces used in resuscitation attempts. Children who died of asphyxia, respiratory illnesses, sudden infant death syndrome, and various other causes had no hemorrhages; neither did 21 children who died of head injury or central nervous system (CNS) diseases, nor did 29 controls. Retinal hemorrhages were present in 70 children, 61 with prolonged resuscitation attempts and nine controls. Among those with attempted resuscitation, 56 had head injuries, and four had CNS diseases and sepsis, all recognized causes of retinal hemorrhages. The other death that involved a resuscitation attempt and retinal hemorrhages was an officially "undetermined" death. The child had come from a household with two prior child deaths and documented abuse. No case is found in this study to support the hypothesis that retinal hemorrhages are caused by resuscitation attempts.
After being condemned and imprisoned in Lisbon by the Portuguese Inquisition, Luis Mendes de Franca exiled himself in late 1683 to France, where his descendants adopted the family name Mendes France. In 1695, at the age of 55 years, Luis Mendes committed suicide in Bordeaux by a pistol shot that decapitated him. The inquest conducted at that time concluded that Luis Mendes was insane and thus not guilty of the crime of suicide. We hypothesize that he used a flint stone-type pistol loaded with an extraordinarily large quantity of black gunpowder. Using available information on historic firearms, ammunition, and powder, coupled with the preserved testimony of historic figures, we propose a reconstruction of this drama and a diagnostic approach to the psychiatric aspects of the suicide.
In the 15th and 16th centuries, the Renaissance was accompanied by a real cultural revolution in Europe and France. Montaigne, the Bordeaux humanist and writer, was highly involved in this movement, particularly by his thinking on medicine, physicians, and illness. The 2 forensic reports presented are the oldest known testimonies of forensic medical activity in Bordeaux in the 16th century. They concern a visit to prison in 1556 and the solemn transfer of the body of a man hanged in 1579. The authors also describe how necropsies were performed before 1573 in Bordeaux, the year in which medical studies were reformed. However, the first official teaching of forensic medicine in Bordeaux (Ecole Royale de Médecine) began only in 1814.
The nervous system has increased susceptibility for methanol intoxication. The aim of this study is to investigate various central nervous system lesions of methanol intoxication in 17 cases autopsied in the mortuary department of the Council of Forensic Medicine in Istanbul, Turkey. The reasons of methanol intoxication in the cases was likely the unwitting ingestion of methanol while drinking illegal alcohol. Survival times ranged from several hours to days. In 8 cases (47%), cerebral edema and in 9 cases (53%) at occipital, temporal and parietal cortex, basal ganglia and pons, petechial bleeding was observed. In addition to these findings, hemorrhagic necrosis were observed in thalamus, putamen, and globus pallidus in 5 cases (29.4%) and, in cerebral cortex in another 3 cases (17.6%). In 3 of the cases (17.6%) in which cerebral edema was found, herniation findings accompanied to the situation and in 2 cases (11.7%), pons bleeding was observed. Around the basal ganglia, in 2 of the cases with hemorrhagic necrosis, the situation ended with a ventricular compression. In 7 cases (41%), the associated findings of chronic ischemic changes in cortical neurons, lacunae formation, degeneration of granular cell layer of the cerebellum, and reactive gliosis were considered as the results of chronic alcoholism.
The limited disruption produced in tissue simulant by the rifle and bullets used in the Stockton, California, schoolyard shooting is entirely consistent with the autopsy reports on the five children who died of their wounds. It is also entirely consistent with well-documented battlefield studies and with previous tissue-simulant studies from many laboratories. It is inconsistent with many exaggerated accounts of assault-rifle wounding effects described by the media in the aftermath of this incident. This information should be documented for the historical record. However, the critical reason for correcting the misconceptions produced by media reaction to this incident is to prevent inappropriate gunshot-wound treatment.
In this article, we present a case of sudden death of a 17-year-old boy, in which diagnosis of Williams syndrome was firstly suspected after medicolegal autopsy, on the basis of typical macroscopical changes (facial appearance, dental status, supravalvular aortic stenosis with mild enlargement of the heart and significant thickening of the left ventricular myocardium) as well as heteroanamnestic data (slight mental retardation and nervousness). All other causes of sudden death were excluded. The definite diagnosis of this syndrome could not be corroborated as specific genetic analysis (fluorescent in situ hybridization test) could not be performed because of the lack of appropriate technical facilities.
A case of a harness racing accident in which the driver died of head injuries is presented. To evaluate the victim's head injury and corresponding helmet damage, a videotape of the race was reviewed and analyzed. Based on calculations of a simplified trajectory analysis and testing of the helmet, it was determined that the helmet design did not provide adequate protection for the victim. The standards for harness helmet design are being re-evaluated by the harness racing industry to ensure the safety of the drivers. A review of 178 harness racing injuries and deaths, current harness helmet research, and recommendations for safer helmets are discussed. A protocol for the forensic investigation of sports-related injuries and/or deaths is also presented to assist medical examiners in fulfilling their roles as practitioners of preventive medicine.
Injuries from animals are very common, but fortunately deaths are rare. Few studies, however, have evaluated human deaths due to both venomous and nonvenomous animals. Utilizing the Medical Examiner's Data Base, this study examines deaths due to venomous and nonvenomous wild and domestic animals in North Carolina. During 1972-1989, there were 92 deaths reported. Seven categories of "type of animal" involved in the attack were developed. Deaths were most likely to occur from June through November. Victims ranged in age from 1 to 93 (average, 46.1) years and 75% were male. Injuries occurred at the worksite in 18 cases, and 10 victims had detectable alcohol levels. Most deaths were due to insect stings, and several victims had a previous history of insect allergy. The majority of victims were injured at their residence. Although rare, many deaths were potentially preventable. Methods to decrease the number of injuries resulting from animals are discussed.
The incidence of morphologic variations (MVs) was investigated in 180 infants who died unexpectedly and suddenly and in 180 age-matched nonsuddenly deceased infants. The same person (G.M.) performed a full postmortem and histologic examination on all of the infants, none of whom had significant malformations. The test group (TG) consisted of 146 infants whose death was unexplained, whereas group 3 (G3) consisted of 34 infants with adequately determined causes of death. The principal findings in the control group were prematurity, inflammatory and metabolic diseases, tumors, and traumatic lesions. MVs were present in 62% of the TG infants, in 47% of the G3 children, and in 22% of the controls. The differences between the TG and G3 on the one hand and the controls on the other are statistically significant (p < 0.001 and 0.05, respectively). In the TG, anomalies were twice, dysplasias three times, and dysmorphisms four times as common as in controls; in G3, four times as many dysplasias and dystropics were found as in controls. In the TG, 23% of the MVs were multiple as compared with 9% in G3 and 5% in controls. The pattern of distribution was not confined to certain organs. Among the relative high percentage of dysplasias, the large number of neuroblastomas is striking.
American forensic medicine is forever indebted to pioneers like George Magrath of Boston, Milton Helpern of New York, LeMoyne Snyder of Michigan, and others, but the organizing of forensic medicine in the formal sense is due to the efforts of Charles Norris (Figure 1) and his successor Thomas A. Gonzales (Figure 2). These men were instrumental in developing the subspecialty as an extension of clinical medicine in which information derived from study of the dead was applied to benefit the living. Their combined efforts between 1918 and 1954 represent the epitome of the application of scientific expertise to medicolegal investigation of deaths in America. Their collaboration from 1918 to 1935 was particularly fruitful. The support of Dr. Alexander Gettler and, in 1938, the addition of Dr. Wiener to the Office of the Chief Medical Examiner made this period a golden era for forensic medicine.
This autopsy study evaluates the possible cumulative effects of cocaine use in HIV-infected adult individuals on cardiovascular tissue. A total of 187 autopsy case reports and available H&E sections of myocardium and coronary arteries were reviewed. Four major study groups were defined: (A) a total of 63 cases positive for cocaine and negative for HIV (COC); (B) 40 cases positive for HIV/AIDS and negative for cocaine (HIV), (C) 23 cases both HIV/AIDS and cocaine (HIV/COC), and (D) a control group of 61 age-, sex- and race-matched, negative for cocaine and for HIV (CONT). The following morphologic and demographic data were analyzed: heart weight, left ventricular hypertrophy, myocardial fibrosis, thickening of the intramyocardial vessels, myocarditis, acute or remote myocardial infarcts (MI), age, sex, and race. Increased frequency of coronary wall and adventitial infiltrates, myocarditis, and thickened intramyocardial vessels present in HIV/COC group (14.5%, 17.4%, and 17.4% vs. 6.5%, 3.3%, and 0% in CONT group) may indicate possible combined and/or cumulative effects of HIV and cocaine on cardiovascular pathology.
In 1870, Ansil L. Robinson was charged with the murder of his mistress, Mary Lunsford, in Mansfield, Ohio, U.S.A. Evidence against Robinson included an attempt to match his teeth to bite marks on the victim's arm. Robinson was acquitted after a 3-week trial despite the evidence linking his teeth to the wounds. This trial represents an early and perhaps the first attempt to admit bite-mark evidence in a court of law in the United States. The acquittal resulted in the obscurity that prevented this case from coming to the awareness of the forensic dental and legal communities sooner.
Richard Spencer Childs, the son of a wealthy businessman, was born in Manchester, Connecticut in 1882. His father, William Hamlin Childs, was founder of the Bon Ami Company. The family moved to Brooklyn in 1892 and Childs lived the rest of his life in the New York area. Childs emerged as an important and influential political reformer during the early years of the 20th century, the so-called Progressive era. His steadfast belief that only major elected offices attracted large electorates and that the long ballot strengthened political machines motivated him to launch the short ballot movement. He remained active for two generations in the drive to democratize the machinery of government. His reform zeal was rooted in the conviction that an inefficient and undemocratic government was caused largely by structural deficiencies. Although the Progressive period in American politics is well-known for the social reformers it produced, Childs became a prime mover of the lesser-known but equally important structural reform movement. The development of the medical examiner system as a replacement for the outmoded and politically marked coroner's system, therefore, was the outcome of this movement. Through his activities in the National Municipal League, his work with Dr. Alan Moritz and Dr. Richard Ford, and the support of Milton Helpern, Childs helped to promote knowledge of the model medical examiner law requirements, which was deveoped by the efforts of Childs and this organization. He was always interested in the progress in America of the advancement and adoption of adequate medicolegal investigative systems. American medicolegal investigation is indebted to the activities and support of Richard Spencer Childs.
A brief profile of Harrison Martland is not enough to judge the totality of his impact on American medicine. His scholarly study of the occupational exposure of the radium watch dial painters is a classic in epidemiological application of the tools of the pathologist to the study of a community problem. It serves as an excellent example of how knowledge derived from study of the dead can be applied to the benefit of the living and present similar problems from occurring.
Forensic medicine in the United Kingdom includes both forensic pathology and clinical forensic medicine on the living. It began at the end of the 18th century, long after its development in Germany, Italy, France, and other countries in Europe. Initial beginnings were in Scotland, where a program began at the University of Edinburgh with the establishment of a chair in Forensic Medicine by Prof. Andrew Duncan Sr. The development in England began in London's Kings College Medical School with a chair held by Prof. William A. Guy. Later chairs in Forensic Medicine were established in Glasgow, Aberdeen, and in London, where Forensic Medicine was taught at St. Mary's Hospital Medical School, Guy's Hospital Medical School, London Hospital Medical School, Charing Cross Hospital Medical School, St. Thomas Hospital Medical School, and St. George's Hospital Medical School. In other cities in England, Wales, and Northern Ireland, departments were founded in Leeds, Manchester, Cardiff, and Belfast. Many textbooks were prepared during this time by professors from these medical schools and by others working in nonacademic areas. The development of coroner activities and those of the police surgeons is also part of the study of forensic medicine.
In this article, we report on 19 autopsy cases in China in which the cause of death was poisoning by toxic plants. The emphasis is on analyses of the target organs or tissues affected by these plants. The mechanism of poisoning and cause of death are approached on the basis of the pathologic changes, and associated problems relating to forensic medicine are discussed.
A review of circumstances surrounding 19 backcountry deaths in Alberta, Canada, between 1980 and 1991 suggests several factors that increase the risk of injury or death. This study provides a descriptive profile of a fatally injured backcountry skier and the circumstances surrounding his or her death. The individual most likely to suffer a fatal injury while participating in a backcountry ski activity is a 36-year-old man. He is typically an experienced backcountry skier who chooses to ski in areas where the avalanche hazard is known to be moderate to extreme. Delineating the personal characteristics of those at risk for backcountry injury and identifying situations that put them at risk will enable better design of education programs. Targeting high-risk groups may also reduce the incidence of death from this activity.
Twenty years after the Second World War the public were made aware of War Crimes committed by the German forensic pathologist, Gerhart Panning (1900-1944). From 1942 till 1944, Panning was professor at the Institute of Forensic Medicine at the University of Bonn. Panning died of tuberculosis on 22 March 1944. After the Second World War, Panning's widow tried to obtain denazification for her husband. There were no particularly serious doubts. In 1965, Konrad Graf von Moltke, the son of Helmuth James Graf von Moltke (1907-1944), presented to the court a private letter from his father to his mother. In this letter, written in 1941, Panning's experiments on Soviet prisoners are described. In the so-called Callsen trial in the court of Darmstadt from 1960 to 1968, the experiments were confirmed by witnesses. In 1941, Panning performed experiments in cooperation with the Sicherheitsstaffel (Nazi special police) in the Ukraine to prove that captured ammunition of the soviet infantry violated international law. For this purpose, different parts of the bodies of living Soviets were used as firing targets. He published the results of these experiments in a scientific journal without any evidence of the origin of these observations. In this article, Panning's life and crimes have been described.
The effectiveness of previously untested disaster plans was demonstrated during the aftermath of the crash of Delta Airlines Flight 191 at D/FW International Airport on Friday, August 2, 1985. These plans, in effect for years and subjected to periodic review, were as yet untried before this first disaster at D/FW International since its opening. This paper outlines the disaster plans, the actual problems encountered, the logistics of a disaster of this kind, and insights gained from the experience.
A review of the activities and beginnings of the U.S. Army Quartermaster Corps Graves Registration Service is presented to broaden existing knowledge of how the remains of military casualties were processed and identified. The focus is on the activities of this service in France after World War I. The processing and other problems faced by this organization are often identical to those experienced by the forensic pathologists or other medicolegal investigators who are confronted with remains of an unidentified person.
A review is given of milestones in commercial aviation in America and a list of the commercial air crashes that have occurred in America or to American carriers overseas. It is not complete, but it is useful as a baseline of information.
This is a history of the science of firearms examination which for the most part originated with the report by Dr. Albert Hall in 1900 about the basic problems of bullet identification. The literature of the early part of the century is reviewed and individual articles apropos to this subject are analyzed. The American experience is reviewed, including the activities of Dr. Goddard up to 1930. He discusses the investigation of the St. Valentine's Day Massacre in Chicago.
A new definition of accidental autoerotic death (AAD) is proposed. A death is an AAD if it is solitary, accidental, and caused by a lethal paraphilia. On the basis of a series of 46 AADs, all occurring among men in the period 1933-1990 in Denmark, the definition cannot be rejected. A paraphilia is regarded as lethal if it is inherently life-threatening. The results of this study have been related to previous reports of similar autoerotic deaths in the literature. It is suggested that the present distinction between asphyxial AAD as typical and nonasphyxial ADD as atypical be replaced with lethal paraphilia with accompanying nonlethal paraphilia or props as typical AAD and lethal paraphilia with no accompanying nonlethal paraphilia or props as atypical AAD.
The occurrence of multiple sclerosis in clustered groups of cases that are often related to others in time and place has been observed on several occasions in the last 50 years. Selected clusters are here reviewed in relation to suspected sources of heavy metal (mercury, lead) poisoning as background for the analysis of the 1983-1985 "outbreak" of 30-40 cases of multiple sclerosis in Key West, Florida. Evidence is presented that the time-place clustering resulted from environmental pollution stemming from a nearby dump pile of rocky debris. The probable mechanism is discussed.
Police shootings, or, when law enforcement officers shoot and kill criminal suspects, have been studied in metropolitan Dade County from 1956 to 1982. A total of 194 cases have been studied and analyzed according to age, race, sex, Spanish surname, alcohol and/or drugs detected at autopsy, and prior criminal arrest record of the victim. The reason(s) for the shooting and any agencies involved have also been noted. Finally, an appendix is included that provides guidelines for the forensic pathologist on how to approach a case.