Eponyms in forensic pathology

Forensic Pathologist Testimony, Part 1: Common Questions and Considerations

Introduction

Forensic pathologists are the only medical specialists who routinely testify in courts of law as part of their occupation. As such, one element of their training involves learning how to testify responsibly and competently. Individuals qualified as experts are permitted to offer opinions in order to assist the triers of fact.

Results

We review the forensic pathologist's primary role as an expert witness which is to lay out concepts clearly, methodically, and objectively, in medicine, pathophysiology, toxicology, and injury, to convey these concepts with understandable, plain language, and to explain how certain evidence, physical, medical, and historical, supports their conclusions and/or presents limitations.

Discussion

We discuss various components about testifying in court, some common expert questions posed to the forensic pathologist, and what concepts and facts they might consider when answering them. We do not offer a prescription as to how one should answer these questions specifically, but rather we provide a single resource that summarizes some of the key issues that may arise in court for the forensic pathologist.

Forensic identification of a fatal snakebite from Bungarus multicinctus (Chinese krait) by pathological and toxicological findings: a case report

Bungarus multicinctus (B. multicinctus) is one of the top ten venomous snakes in China, ranking first in lethality at 26.9-33.3%. However, to our knowledge, no forensic autopsy-related cases of death from B. multicinctus bite poisoning have been reported. There are surprisingly few reported cases of death from poisoning by other species of neurotoxic snakes. Neurotoxic snake venom is often highly toxic, and death can quickly occur when bitten in the wild if victims are not taken to a doctor in time. We presented a case of an adult female in Fujian Province of China who was bitten by a poisonous snake while digging for bamboo shoots in the mountains and died from the bite of B. multicinctus confirmed by enzyme-linked immunosorbent assays (ELISA) results. The autopsy's results, histopathological findings, and ELISA results reported here can be helpful for future forensic practice in B. multicinctus venom poisoning; we also briefly review the pathological changes of neurotoxin poisoning, which may be useful in other types of neurotoxin snake venom poisoning.

An autopsy case of the decomposed body with kronlein's shot and the importance of skull reconstruction

In forensic medicine, firearm-related fatalities are regular. The range and velocity of the bullet, the characteristics of the wounds, and the probability of recovery are vital components of forensic analyses. While examining gunshot wounds to the skull, focus on the critical difference between bullet entry and exit points and the distance between the muzzle and the bullet entrance is vital. Determining bullet injury in cases of extreme decay has been a difficult challenge. The police send a corpse in the later stages of decomposition for re-postmortem examination, with a history of severe blunt force injuries to the head in our case report. Following the reconstruction of the skull, it is determined that some regions are bone deficient. A bullet entry wound is present on the left side's upper border of the defect, formed like an arc (representing the upper 1/3^rd of a circle), and a corresponding exit wound was discovered on the right side's lower border of the defect, shaped like an arc (representing the lower 1/3^rd of a circle). The bullet passed left to right backward and downward. It is noteworthy that in cases of advanced decomposition, where identifying the characteristics of a bullet wound is nearly impossible, fully skeletonizing the body and reconstructing it will provide critical hints to establishing the cause of death.

Simon's hemorrhages in a case of a fatal construction site accident as the result of body hyperextension in the upside-down position - a possible reconstruction of the injury mechanism

An accident occurred at a construction site and a 27-year-old worker was fatally injured. Equipped with personal protective equipment (helmet and a safety belt), he was standing on an 8-meter-high platform holding a large hose that was attached to a pipe connected to a concrete pump truck. Whilst in use the pipe broke and the hose sent the man flying with force, knocking down the platform railing. Autopsy examination showed that man fell to the ground landing on his head. Prominent Simon's hemorrhages were noted on the L5-S1 and L4-L5 intervertebral discs. When the hose threw the man from the platform, for one brief moment he was suspended in the air, with the safety belt tied firmly to his waist. Simon's hemorrhages most probably emerged at that moment, due to forceful hyperextension and traction of the body in the upside-down position. A relatively unexpected appearance of Simon's hemorrhages contributed to the reconstruction of the injury mechanism.

Detection of chlorine and bromine in free liquid from the sphenoid sinus as an indicator of seawater drowning

We have investigated the usefulness of elemental analysis by energy-dispersive X-ray spectroscopy (EDX) in the examination of free liquid from the sphenoid sinus of drowning victims. We detected both chlorine and bromine in liquid taken from the sphenoid sinus of seawater drowning victims. Because these elements were below the quantification limit in freshwater cases, we could easily distinguish seawater from freshwater drowning cases. Detection of these elements from the liquid in the sphenoid sinuses of drowning victims may be useful as a supportive measure for seawater drowning.

Svechnikov's sign as an indicator of drowning in immersed bodies changed by decomposition: an autopsy study

PURPOSE

Bodies recovered from water often present as a difficult problem in forensic pathology. The aim of this study was to examine the presence and amount of free liquid in the sphenoid sinus in cases of freshwater drowning, and to compare this to the amount found in putrefied bodies recovered from freshwater, as well as in putrefied bodies found in an indoor environment.

METHODS

Free liquid from the sphenoid sinuses was aspirated using a syringe and a needle, after piercing the hypophyseal fossa. Non-putrefied drowning cases were also examined for hemolytic staining of the intima of the aortic root.

RESULTS

In 29 non-putrefied cases of freshwater drowning there was 1.36 ± 1.48 ml in the sphenoid sinuses, with 21 of them having hemolytic staining of aortic intima. In putrefied bodies recovered from freshwater (22 cases) there was 1.26 ± 1.40 ml within the sphenoid sinuses, and in putrefied bodies found in an indoor environment (52 cases), there was significantly less-0.57 ± 0.92 ml.

CONCLUSIONS

Free liquid in the sphenoid sinuses (Svechnikov's sign) may be considered a vital reaction in drowning non-putrefied cases. Hemolytic staining of the aortic intima could be a significant sign of freshwater drowning. In putrefied bodies recovered from water, an amount of 0.55 ml of free liquid in the sphenoid sinuses may imply that the victim was alive upon their contact with the water, but the presence of free liquid in the sphenoid sinuses does not necessarily indicate that drowning had been the cause of death.