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Animal-inflicted injuries to humans are a major public health problem around the world resulting in great morbidity, money loss, and mortality. They are related to wild and domestic animals alike. Animals can cause injuries by various mechanisms-biting, stinging, crushing, goring, stomping, butting, kicking, pecking, etc. We present a case of a ram's attack with fatal consequences. A 4-year-old, 120 kg jezersko-solčava breed ram with prior history of aggressive behavior inflicted multiple injuries to his 83-year-old owner, who died in the hospital a few hours later due to severe blunt force injuries sustained in the attack. The autopsy revealed the cause of death to be multiple injuries of the thorax and the head. Sheep, even though they are not considered aggressive or large farm animals such as cattle and horses, can inflict serious injuries with devastating results. © 2015 American Academy of Forensic Sciences.
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M.D.; Nikica
Ph.D.; and Antun Kosteli
Fatal Injury Caused by a Ram (Ovis Aries)
ABSTRACT: Animal-inflicted injuries to humans are a major public health problem around the world resulting in great morbidity, money
loss, and mortality. They are related to wild and domestic animals alike. Animals can cause injuries by various mechanismsbiting, stinging,
crushing, goring, stomping, butting, kicking, pecking, etc. We present a case of a rams attack with fatal consequences. A 4-year-old, 120 kg
cava breed ram with prior history of aggressive behavior inflicted multiple injuries to his 83-year-old owner, who died in the hospi-
tal a few hours later due to severe blunt force injuries sustained in the attack. The autopsy revealed the cause of death to be multiple injuries of
the thorax and the head. Sheep, even though they are not considered aggressive or large farm animals such as cattle and horses, can inflict seri-
ous injuries with devastating results.
KEYWORDS: forensic science, forensic medicine, animal injuries, blunt injuries, autopsy, sheep, trauma
Animal-inflicted injuries to humans are a major public health
problem around the world resulting in great morbidity, money
loss, and even mortality. They are related to wild and domestic
animals alike. Numerous cases of domestic animal attacks occur
each year, mostly in farming and agricultural parts of the world
(1). Animals can cause injuries by various mechanisms that
include biting, stinging, crushing, goring, stomping, butting,
kicking, pecking, etc. A wide range of blunt and sharp force
injuries may be inflicted to humans by animals, some of which
may be lethal (2). Kicks to the head and chest result in more
immediately fatal outcomes, most likely due to the effects of
direct trauma to the brain, heart, and lungs (3). Of all injuries in
the agricultural industry, 38% are related to livestock, and they
most commonly arise from cattle and horses (4). During the per-
iod from 2001 to 2004, there were 22 on-farm deaths in Austra-
lia of persons over the age of 15 years caused by farm animals,
which constituted 7% of all on-farm deaths in Australia for that
age group in the observed time period. Of those 22 deaths, sheep
were responsible for two deaths (9.1%), and the rest were caused
by horses (11 deaths or 50%), cattle (6 deaths or 27.3%), insects
(2 deaths or 9.1%), and mammals (not horse or dog, 1 death or
4.5%) (5). Langley and Hunter (6) concluded that animals are
responsible for approximately 1% of occupational fatalities in
the United States and that males and the elderly have a higher
risk of fatal injuries from animal-inflicted trauma. They have
also identified high risk occupations for traumatic animal injuries
or a zoonotic infection as farmers and farm workers, veterinari-
ans, cowboys and rodeo riders, animal caretakers, hunters and
trappers, pet store operators, farriers and even researchers. Large
animals can inflict injuries to a number of regions of the body
that may result in a prolonged hospital stay and even death (7).
Here, we present a case of blunt force injuries from a rams
attack that led to a fatal outcome.
Case Report
An 83-year-old man was attacked by his ram in the afternoon,
about 50 meters away from his home. As he approached the
sheep herd that was grazing nearby, he was attacked by the ram.
The 4-year-old, 120 kg ram was a jezersko-sol
cava breed
(a medium-sized, hornless breed originally from Slovenia). He
had shown aggressive behavior before, but it always ended with-
out any injuries to the people around him. According to the son
of the deceased, who was also the first to come to his fathers
aid, he heard his father yelling and moaning loudly and immedi-
ately ran to him to find the ram was still attacking him. He man-
aged to control the ram, which in the meantime started to attack
him too, and dragged him to the fold and tied him there. He
then alerted the neighbors to call the emergency services. The
rams behavior was explained, aside from his obvious inborn
aggressiveness (multiple prior aggressive incidents, and attacks
on humans), by the common increase of aggression in rams dur-
ing the mating season that had just begun. A couple of minutes
later, when the son returned to his injured father, he was still
lying on the ground, unable to move, and moaning in pain. The
victim was emergently transported to the hospital.
At the moment of admittance, he had a GCS score of 10 and
was tachycardic, hypotensive (80/60 mmHg) with visible contu-
sions of the head and thorax. The blood saturation of O
88% and hemoglobin 13.3 g/dL. Imaging studies showed a left-
Department of Forensic Medicine and Criminology, School of Medicine,
University of Zagreb,
Salata 11, 10000 Zagreb, Croatia.
Faculty of Agriculture, Department of Fisheries, Beekeeping Game
Management and Special Zoology, University of Zagreb, Sveto
cesta 25, 10000 Zagreb, Croatia.
Faculty of Agriculture, Department of Animal Science, University of
Zagreb, Sveto
simunska cesta 25, 10000 Zagreb, Croatia.
Received 7 June 2014; and in revised form 28 Aug. 2014; accepted 29
Aug. 2014.
1©2015 American Academy of Forensic Sciences
J Forensic Sci,2015
doi: 10.1111/1556-4029.12813
Available online at:
sided temporo-occipital subdural hematoma, blood in the ventri-
cles of the brain, emphysema in the soft tissue of the right side
of the neck and thoracic wall, right-sided pneumohemothorax,
multiple bilateral rib fractures, multiple sternal fractures, and
fractures of the left transverse processes of the L1 to L4 verte-
brae. He was transferred to the intensive care unit with right-
sided chest tube, central venous catheter, urinary catheter, as
well as pain relief medication; he was also started on mechanical
ventilation. Laboratory findings showed acidosis (pH 7.21) and
hemoglobin level decrease (96 g/L). He was then given colloid
and crystalloid infusions with a noncontinuous noradrenaline
infusion that was later converted to continuous after developing
signs of hemodynamic instability. Ongoing laboratory studies
showed progression of acidosis and further blood loss. Repeat
imaging showed extensive air inside the right thorax, fluid
(blood) in the thorax more pronounced on the right side, medias-
tinal shift toward the left side, the tip of the chest tube inside the
fourth right intercostal space, and also a large active bleeding on
the back side of the right liver lobe, blood collection in the right
frontal pararenal space and extravasation of the contrast into the
tissue of the right kidney. The patient went into cardiopulmonary
arrest and despite ongoing fluid and blood product resuscitation,
the victim died the evening of admission.
Autopsy Findings
External examination was notable for multiple cutaneous blunt
force injuries of the face, scalp, chest, and upper extremities
(Fig. 1).
Internal examination demonstrated slight subarachnoid hemor-
rhage over the occipital lobes of the brain and around the cere-
bellum as well as a very thin lamellar left-sided temporo-
occipital subdural hematoma. The ventricles of the brain were
filled with cerebrospinal fluid mixed with blood. Multiple bilat-
eral (anterior, lateral, and posterior) rib fractures were present,
associated with left (600 mL) and right (500 mL) hemothoraces,
lung contusions, and lung lacerations. The sternum had multiple
fractures. There were also fractures of the vertebral column
between the T2-T3 and T6-T7 vertebrae, and fractures to the left
transverse processes of the L1 L4 vertebrae. The peritoneal
cavity contained 600 mL of liquid blood associated with a
593 cm hepatic hematoma and laceration. The blood alcohol
analysis came back negative.
The autopsy report concluded that multiple blunt force injuries
were the cause of death.
Animal-related injuries and fatalities are relatively rare in
Croatia, but certain population subgroups are at a higher risk
such as hunters for injuries inflicted by wild animals (8) and
farmers and agricultural workers by domestic animals (1,4,5).
Even with species that are considered docile and nonaggressive,
such as sheep, people should get to know individual animals and
their behavioral patterns and apply precautions in order to mini-
mize risk and avoid potential injuries.
Sheep (Ovis aries) are one of the first domesticated animal
species, their domestication occurring approximately
11,000 years ago in the Fertile Crescent (9). Their inborn
aggression has been greatly diminished, almost completely lost,
by selective breeding; therefore, sheep are extremely friendly
and docile animals. Incidents of humans being attacked by sheep
are rare. While sheep (female) are generally very docile, nonag-
gressive animals, this may not always be the case with rams
(male), especially before and during the mating season, that is,
when they are introduced into a herd with females or a group of
rams. Rams can be very aggressive and have been known to
cause serious injuries, even death, to humans (6,10).
Rams and sheep, like other livestock, have a so-called flight
zone, which represents the animals personal space where it feels
comfortable and unthreatened. When a person is outside of the
animals flight zone, the animals will turn and face him. If a per-
son enters the flight zone slowly, the animal will back away;
however, if the person enters the flight zone suddenly, the
animal behavior can be unpredictable and dangerous (11). Spe-
cial precautions should be undertaken by farm workers in breed-
ing planning, taking into account many individual characteristics
like aggressiveness to provide more docile animals in the future
and thus minimize risk for attacks on humans and other animals.
Sheeps (especially rams) attack pattern, in those rare
instances when they attack humans, is generally headbutting in
full sprint, so they will take a running start and hit the target with
their head causing severe blunt force injuries to the victims
abdomen and/or thorax if in upright position or potentially to any
part of the body depending on the position and height relations
of the victim and animal. After the initial attack, sheep will, in
accordance with their level of aggression, either cease from fur-
ther attacks or continue attacking the victim. When the victim is
knocked down (often immediately after the initial attack if it was
of average force developed by a medium to large animal), sheep
are known to headbutt repeatedly with occasional kicking with
their legs. The greatest force is developed in the initial attack (the
running headbutt) and is of high intensity, but forces in the sub-
sequent follow-up attacks are also of medium to high intensity
and can also cause severe and even fatal injuries. Kosteli
c (12)
states that rams are equally dangerous to people if they have
horns or are hornless. The body mass of rams in Croatia varies
according to breed and age and can be between 50 and 170 kg.
Heavy breed rams hit a person in the body, while the lighter
breeds can jump and then hit a person in the head when in the
upright position. It is especially dangerous to kneel in the vicinity
of a ram because that makes it easier for them to headbutt the
vital parts of the body such as the thorax and the head. Smith
and Sherman (13) state that a buck goat rears up on its hind legs
FIG. 1–– External examination photographs. (A) Multiple blunt force inju-
ries of the head, probably sustained in the secondary attacks while the victim
was on the ground. (B) Abrasion with surrounding hematoma on the right
front side of the thorax (probably initial injuryrunning headbutt) with visi-
ble surgical incisions on the right thoracic wall.
and comes down forcefully to headbutt, while a ram will back up
to take a running start and headbutt or hit anywhere on the body.
Murphy et al. (14) concluded in their research that patients
admitted to the hospital after sustaining injuries from cattle, par-
ticularly those injured by headbutting or trampling, should be
treated as high-velocity trauma. Although sheep are significantly
smaller in size than cattle, they can develop high speeds in run-
ning attacks and, coupled with a sufficient body weight, can pro-
duce high kinetic energies causing major damage to human body
with potentially lethal outcome. Sheep should be considered
among the group of domestic animals that can produce life-
threatening blunt force injury in their attacks.
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Additional information and reprint requests:
c Petar, M.D.
Department of Forensic Medicine and Criminology
School of Medicine
University of Zagreb
Salata 11, 10000 Zagreb
... Human injuries due to animal attacks are a major public health problem around the world causing morbidity and even mortality [1,2]. They may be caused by wild and domestic animals alike. ...
... Domestic animal attacks occur mainly in farming and agricultural countries. They can cause injuries by various mechanisms that include biting [2]. The animals that are most frequently associated with these assaults are dogs [1,3]. ...
... In fact, donkeys, like other livestock, have a personal space where it feels comfortable and unthreatened, called a 'flight zone'. If a person enters this zone suddenly, the animal's reaction can be unpredictable and dangerous [2,13]. Such aggression may be shown by pets to their human owners [14]. ...
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... In 2015, another fatality by a hornless ram was reported, this time in Croatia. The blunt force injuries, that caused death, were located on the head, thorax, and the upper extremities (8). Finally, a bizarre accidental death involving sheep shearing was reported in Australia, when a sheep kicked the shear out of the hand of a 29-year-old man, causing him a lethal incision wound on the neck (9). ...
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... Injuries caused by animals are a worldwide public health problem, that keeps rising (O'Brien et al., 2015) with important economic losses, high morbidity and mortality (Skavic et al., 2015). Both wildlife and domestic animals may cause these injuries (Skavic et al.). ...
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... Interaction and coexistence with animals may result not only in traumatic injuries, but may also have fatal consequences for humans [54][55][56][57]. The types of cases regarding a variety of exotic and wild animals as well as livestock or pets span a wide range from sharp force trauma to poisoning [58][59][60][61][62][63]. Animal attacks on humans occasionally may turn into lethal accidents, but usually the deaths resulted from unwitnessed attacks [63,64] require medico-legal investigations. ...
... The most significant injuries involve the head and face, and then the upper torso. Pigs may cause significant injuries with their tusks, or from biting, and sheep have been known to cause lethal blunt force injuries from charging handlers [11,13]. An unusual death caused by a sheep was severing of the major neck vessels by electric clippers that had been knocked out of the shearers hand [14]. ...
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Authoritative yet easy to read, Sheep and Goat Medicine, 2nd Edition covers all the latest advances in sheep and goat medicine, including medical treatment, surgery, theriogenology, and nutrition. Full-color photographs and clear instructions provide the answers you need, guiding you through common procedures and techniques such as restraint for examination, administration of drugs, blood collection, and grooming; these descriptions are often accompanied by explanatory diagrams and charts. With diseases, surgeries, and treatments organized by body system, information is always easy to find. New to this edition are chapters on parasite control, nutritional requirements, and performing a necropsy. Developed by Dr. D.G. Pugh, a world-renowned expert on the medical care of sheep and goats, this reference is unmatched for its comprehensive coverage of herd health, physical examination, anesthesia, and multisystem diseases. Clear writing style makes the book useful and easy to understand, even for sheep and/or goat owners who are not veterinarians. Both surgery and medicine are covered in each body systems chapter, so it's easier to choose between treatment options for specific disorders. Superbly illustrated surgical procedures clearly demonstrate the steps to follow in performing surgical procedures. An explanation of the differences in normal behavior between sheep and goats shows how they are not the same, and require different methods of treatment. A consistent, logical format in each body systems chapter makes information easy to find by beginning with physical examination and diagnostic procedures, followed by discussions of common diseases that involve the system. Consistent headings include pathogenesis, clinical signs, diagnosis, treatment, and prevention. A comprehensive nutrition chapter covers diet evaluation, method of balancing rations, total parenteral nutrition, and examples of nutritious diets. Practical formulas are included for making sodium sulfite for testing passive transfer, and Sheather's solution for fecal flotation. Useful appendixes summarize essential information on drugs and drug dosages, fluid therapy, and normal values and conversions. A diverse, authoritative panel of contributors provides current information on the care of valuable breeding stock as well as pets. Full-color photographs and graphics accurately depict conditions and procedures. New Fluid Therapy and Nutritional Support chapter covers emergency and critical care essential to the care of sheep and goats. New Gastrointestinal Parasitism chapter covers treatments for parasites, key to the successful management of all flocks. New Necropsy chapter helps you prevent disease outbreaks in a flock by determining the cause of death.
Fully revised and expanded, Goat Medicine, Second Edition includes discussions on new diseases ranging from bovine spongiform encephalopathy to floppy kid disease as well as major updates on important diseases such as scrapie, mycoplasmosis, paratuberculosis, and urolithiasis. Information has also been added on management of transgenic goats and organic goat production. The text begins by outlining fundamentals of goat practice and moves on to sytems-based coverage of the goat. Each chapter provides clinical anatomy and physiology of every system alongside information on relevant clinical signs, differential diagnosis, and system-specific disease.
Hunter and game animal conflicts are occasionally reported from various parts of the country. This case series comprises all 7 game animal attacks on hunters reported to the Croatian Hunting Association over a period of 13 years (1999–2011), covering the entire Croatian territorial area. Seasonally, attacks occurred most frequently in the winter time, when the hunting season is at its peak. The most common attacking animal, representing 5 of 7 cases (71.4%), was the wild boar, and the majority of the attacks happened in the morning. All of our victims were male, with an average age of 51 years (range, 26 to 69 years). Six victims sustain ed a bite wound or wounds and one was rammed by the animal. Most all of our patients (5 of 7,with one unknown) recovered completely and without significant complications.
Animals may be responsible for an array of potentially lethal injuries. Blunt force injuries characteristically involve larger animals such as cattle or horses that may kick, crush, or trample a victim causing head and facial injuries. Farm workers in particular are at high risk of lethal injuries involving the head and torso. Significant blunt trauma may be found in vehicle occupants after collisions with large animals such as camels or moose. Rarely, zookeepers may be crushed by particularly massive animals such as elephants. Sharp force injuries usually involve carnivore bites, most often from dogs with a "hole and tear" pattern of wounding. Injuries from animals such as alligators and sharks may have a significant component of crushing. Incised wounds may result in death from exsanguination and air embolism. On occasion, blunt or sharp trauma from animal activity may be confused with postmortem damage or with inflicted injury from an assault.
Bovine-related injuries to farmers are common in rural communities. Many injuries are significant requiring hospital admission and surgery. We reviewed all cattle-related injuries admitted to a regional trauma centre over 10 years and detail the nature of the injuries. A retrospective review was undertaken, using hospital inpatient coding system (HIPE) to identify patients admitted following cow-related trauma for the last 10 years. From retrieved charts mechanism of injury was identified, demographics recorded and Injury Severity Score (ISS) and Trauma Injury Severity Score (TRISS) calculated based on the injuries sustained. 47 patients were identified, with a median age of 53 years. 4 injuries occurred in children, and 12 in patients over 65 years old. Three-quarters of those injured were male. Kicking was the most common mechanism of injury (n=21), but charge/head-butt injuries and trampling injuries were associated with more serious injury scores. 72% of patients were admitted under Orthopaedics as their primary care team, 25% under General Surgeons, with one patient admitted medically. Mean ISS score was 6.9 (range 1-50). 41 operative interventions were performed on 30 patients during their admission. 6.3% of patients required admission to Intensive Care with a mean length of stay of 12.3 days (range 2-21 days). There was no mortality. Cow-related trauma is a common among farming communities and is a potentially serious mechanism of injury that appears to be under-reported in a hospital context. Bovine-related head-butt and trampling injuries should be considered akin to high-velocity trauma.
This study examined injuries among farmers and farm family treated at two rural Vermont hospitals. Most involved dairy farming and woodlot activities. Livestock accounted for 38% of injuries among dairy farmers. Other injuries involved a variety of events, including equipment repair and use, haying, chemicals and biologicals, falls, and contacts with fixed objects. Half of woodlot injuries involved chainsaws. On average, livestock-related injuries resulted in 21.5 days of disability for work during the first 6 months after injury, whereas those not involving livestock averaged 16.2 days of disability. On dairy farms 14% of farming injuries were to family members, and at least a third of all injuries to farm family members were work related. Insurance coverage for medical care was sparse for all rural persons treated for injury, especially for woodlot operators.
Fatal multiple injuries may be caused by a vehicular accident, a fall from a height or by repeated heavy blows. In this unusual case the victim, a farmer, was found in a field away from any farm vehicles or buildings. It was only after consideration of the circumstances in which the deceased was found, the pattern of injuries and the statements of many people, including the local molecatcher, that the assailant was identified: a 16 stone Suffolk ram (Figure 1).