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Simonit F, Da Broi U, Giudici F, Sciarappa OE, Innocenti D, Desinan L. Autopsy findings in fire deaths in relation to manner of death: Analysis of autopsy records in Friuli, Italy (1993-2020). Leg Med (Tokyo) 2024; 67:102372. [PMID: 38154314 DOI: 10.1016/j.legalmed.2023.102372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Accepted: 12/20/2023] [Indexed: 12/30/2023]
Abstract
The determination of the cause and manner of death can be particularly difficult in burned and charred bodies and autopsy remains a key element in the investigation. In this study, 39 autopsy records of fire deaths were reviewed in relation to the manner of death (25 accidents, 8 suicides, 3 homicides and 3 instances in which the manner of death remained undetermined). The analysis focused on the study of the burns, the degree to which the bodies were consumed by fire and the evidence of signs of vital exposure to fire and of non-fire-related injuries. Total surface body area (TBSA) was found to be significantly higher (p = 0.02) in suicides than in accidents. Moreover, the degree of destruction according to the Crow-Glassman Scale and the presence of a pugilistic posture tended to be higher in suicides compared to accidental deaths, whereas such parameters were found to be variable in homicides. With regard to the anatomical distribution of burns, in contrast with the literature, the feet were affected by burning in all suicides, with a significantly higher prevalence than in accidents (p < 0.01). Traumatic non-fire related injuries were noted in all homicides (with no signs of vital exposure to fire), 1 complicated suicide, 1 undetermined death and 13 accidents. We found that very few studies have focused on the analysis of burn distribution and extension according to manner of death and that there is currently no standardised anatomical model with which to study these variables for forensic purposes.
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Affiliation(s)
- Francesco Simonit
- Università degli Studi di Udine, Dipartimento di Area Medica, Medicina Legale, Italy.
| | - Ugo Da Broi
- Università degli Studi di Udine, Dipartimento di Area Medica, Medicina Legale, Italy
| | - Fabiola Giudici
- Cancer Epidemiology Unit, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy
| | - Orazio Elia Sciarappa
- Università degli Studi di Udine, Dipartimento di Area Medica, Medicina Legale, Italy
| | - Dario Innocenti
- Università degli Studi di Udine, Dipartimento di Studi Umanistici, Italy
| | - Lorenzo Desinan
- Università degli Studi di Udine, Dipartimento di Area Medica, Medicina Legale, Italy
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2
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Gentilomo A, Tambuzzi S, Boracchi M, Gentile G, Zoja R. Mechanical asphyxia by hanging and gunshot to the head: A series of rare planned complex suicides. Med Leg J 2024; 92:15-19. [PMID: 35650711 DOI: 10.1177/00258172221102755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
A suicide where the deceased has employed more than one means of ending his or her life is defined as a complex suicide (CS). Forensic practitioners may face difficulties caused by the articulated mechanisms underlying this event. Among CS, the combination of hanging and gunshots is unusual. In this study, we present three unique cases of such planned complex suicides (PCS) that we have encountered in our 28 years of activity at the Bureau of Legal Medicine of Milan. Careful inspection of the death scene, precise analysis of the anamnestic-circumstantial data, and accurate medico-legal autopsy examination were the starting points for a better understanding of the causes and manner of death. In particular, the presence of vital reactions of tissues involved in the two different means used, the coherence of the areas involved with a self-inflicted wound, and the absence of signs of third party intervention allowed us to classify these events as suicides. As for the chronology of events, the lethality of the cerebral lesions caused by the gunshots in all cases, in accordance with the cervical lesions caused by hanging, led us to conclude that we were dealing with PCS and catalogue these three cases as unusually planned complex suicides avoiding incorrect and superficial classification.
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Affiliation(s)
- Andrea Gentilomo
- Dipartimento di Scienza Giuridiche "Cesare Beccaria" - Università degli Studi di Milano, Via festa del Perdono, 7 - 20122 Milano, Italy
| | - Stefano Tambuzzi
- Dipartimento di Scienza Giuridiche "Cesare Beccaria" - Università degli Studi di Milano, Via festa del Perdono, 7 - 20122 Milano, Italy
| | - Michele Boracchi
- Dipartimento di Scienza Giuridiche "Cesare Beccaria" - Università degli Studi di Milano, Via festa del Perdono, 7 - 20122 Milano, Italy
| | - Guendalina Gentile
- Dipartimento di Scienza Giuridiche "Cesare Beccaria" - Università degli Studi di Milano, Via festa del Perdono, 7 - 20122 Milano, Italy
| | - Riccardo Zoja
- Dipartimento di Scienza Giuridiche "Cesare Beccaria" - Università degli Studi di Milano, Via festa del Perdono, 7 - 20122 Milano, Italy
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3
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Harding MJ, Márquez-Grant N, Williams M. Examining thermally induced movement of the fatal fire victim. Forensic Sci Int 2024; 355:111942. [PMID: 38266427 DOI: 10.1016/j.forsciint.2024.111942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2023] [Revised: 11/02/2023] [Accepted: 01/14/2024] [Indexed: 01/26/2024]
Abstract
Investigating a fatal fire scene comprises analysis not only of the fire's development to identify the point of fire origin and ignition source, but analysis of a victim's position and their relationship within the scene. This work presents both qualitative and quantitative results from experimentation investigating the effect of a real fire environment on the human body, and how the position of a victim at the post burn investigation stage may be significantly different to the position at fire ignition. Qualitative observations were undertaken on the burning of 39 compartment and vehicle scenes from ignition through to suppression, each containing a human cadaver. The results of analysis question the validity of previous work based on cremation observations. Quantitative results were produced by recording 13 points on the body on the X, Y and Z axis, both pre and post burn on a smaller dataset of ten compartment burns. Results have enabled a more robust assessment of thermally induced movement of the body within the scene along each axis, evidencing that pugilism is not the universal reaction of the fatal victim to thermal exposure, with extension of the upper limbs far more common than has been previously reported.
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Affiliation(s)
- Mary-Jane Harding
- Cranfield Forensic Institute, Cranfield University, Bedford, United Kingdom.
| | | | - Mike Williams
- Cranfield Forensic Institute, Cranfield University, Bedford, United Kingdom
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Simonit F, Da Broi U, Angeli F, Innocenti D, Desinan L. A charred body inside a burning car with a garden hose connected to the exhaust pipe: Post-mortem self-immolation, a complex or a complicated suicide after the ingestion of alcohol? The importance of an interdisciplinary approach. J Forensic Sci 2024; 69:341-345. [PMID: 37787181 DOI: 10.1111/1556-4029.15383] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 09/01/2023] [Accepted: 09/12/2023] [Indexed: 10/04/2023]
Abstract
The analysis of charred bodies represents a serious challenge for forensic pathologists, and an interdisciplinary approach is often the only way to determine the cause and manner of death. We present an unusual case in which the charred body of a 61-year-old man was found inside his burning vehicle. In order to determine cause and manner of death, an interdisciplinary team was employed, with experts in forensic pathology, forensic radiology, toxicology and fire investigations. Post-mortem computed tomography, autopsy and toxicology ruled out the presence of trauma injury and detected signs of vital exposure to fire and blood alcohol levels. On the other hand, according to fire investigations, the fire started inside the car and partially burned fragments of a garden hose were found along the right side of the car. A suicide could therefore be hypothesized, with the man having attempted to poison himself with the car's exhaust fumes and having set the car on fire. The death was consistent with a complicated suicide in which the victim, in a state of reduced capability, accidentally set his car on fire and was unable to escape. The hypothesis of a complex suicide, with the car having been set deliberately on fire, could not, however, be ruled out.
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Affiliation(s)
- Francesco Simonit
- Dipartimento di Area Medica, Medicina Legale, Università degli Studi di Udine, Udine, Italy
| | - Ugo Da Broi
- Dipartimento di Area Medica, Medicina Legale, Università degli Studi di Udine, Udine, Italy
| | | | - Dario Innocenti
- Dipartimento di Studi Umanistici DIUM, Università degli Studi di Udine, ne, Udine, Italy
| | - Lorenzo Desinan
- Dipartimento di Area Medica, Medicina Legale, Università degli Studi di Udine, Udine, Italy
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D'Antonio G, Serinelli S, Albore M, Bolino G. Medico-legal scene investigation in the case of burned bodies - a systematic review. Med Leg J 2023; 91:226-230. [PMID: 37793642 DOI: 10.1177/00258172231191214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/06/2023]
Abstract
A judicial on-site examination is essential for the correct analysis of a forensic case, particularly when there has been a fatal fire, as heat-related changes to bodies make identification by the forensic pathologist and other specialists difficult along with estimating the post-mortem interval and determining the precise cause and manner of death. We systematically reviewed all relevant articles dating from 2003 to 2022 in the PubMed database with a view to updating recommendations on how best to proceed. Our recommendations highlight the importance of a multidisciplinary team approach involving various forensic specialists.
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Affiliation(s)
- Gianpiero D'Antonio
- Department of Anatomic, Histologic, Medico-Legal Sciences and of Locomotor System, Rome University Sapienza, Italy
| | - Serenella Serinelli
- Direzione Regionale Lazio - Istituto Nazionale della Previdenza Sociale, Italy
| | - Marco Albore
- Department of Anatomic, Histologic, Medico-Legal Sciences and of Locomotor System, Rome University Sapienza, Italy
| | - Giorgio Bolino
- Department of Anatomic, Histologic, Medico-Legal Sciences and of Locomotor System, Rome University Sapienza, Italy
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6
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O'Donovan S, van den Heuvel C, Baldock M, Byard RW. An overview of suicides related to motor vehicles. MEDICINE, SCIENCE, AND THE LAW 2023; 63:151-158. [PMID: 36000305 DOI: 10.1177/00258024221122187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Although vehicles may be used in a wide variety of suicides, this has not been a focus in the forensic literature. Thus, an analysis of coronial autopsy reports at Forensic Science SA, Adelaide, South Australia over a 16-year period from January 2005 to December 2020 was undertaken to provide an overview of cases in which it was considered that a vehicle had been integral to the successful completion of a suicide. De-identified details were collected from all cases in which a vehicle had facilitated or been used as a method of suicide. A number of different types of vehicle-related suicide methods were identified, including cases where vehicles had been used as secure places for suicide or where the vehicle had been used to cause significant blunt force trauma or to enter a lethal environment such as water. Specific examples were taken from the following categories: (1) inhalation of gas, (2) drug toxicity, (3) hanging or ligature strangulation, (4) self-immolation, (5) drowning, (6) vehicle collision, (7) driving off a cliff, (8) jumping or lying in front of a vehicle and (9) the use of more than one method (i.e. complex). This report is not intended to provide an epidemiological analysis of car-related suicides. Instead, the details of selected cases have been used to illustrate the spectrum of methods that may be used in vehicle-assisted suicides.
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Affiliation(s)
- Siobhan O'Donovan
- The School of Biomedicine, 1066The University of Adelaide, Adelaide, SA, Australia
- Forensic Science SA, Adelaide, SA, Australia
| | | | - Matthew Baldock
- Centre for Automotive Safety Research, 1066The University of Adelaide, Adelaide, SA, Australia
| | - Roger W Byard
- The School of Biomedicine, 1066The University of Adelaide, Adelaide, SA, Australia
- Forensic Science SA, Adelaide, SA, Australia
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7
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Interpol review of fire debris analysis and fire investigation 2019-2022. Forensic Sci Int Synerg 2022; 6:100310. [PMID: 36578979 PMCID: PMC9791831 DOI: 10.1016/j.fsisyn.2022.100310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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8
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Alexandri M, Koukoulis AN, Tsellou M, Papadodima S. A burned body with a shotgun head injury found on an "altar" made of banknotes: A case report from Greece and brief review of the literature. Leg Med (Tokyo) 2021; 51:101882. [PMID: 33873015 DOI: 10.1016/j.legalmed.2021.101882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Revised: 04/04/2021] [Accepted: 04/06/2021] [Indexed: 10/21/2022]
Abstract
We describe an unusual case of a burnt body with a shotgun head injury found on a "bed" made of wooden boards on a pile of banknotes, resembling an altar. The body belonged to a 64-year-old man, of Greek nationality, with cancer who set his house (including the room in which he was found) and vehicle on fire before shooting himself, planning this way his postmortem burning. The combination of fire with the use of an "altar" and the destruction of body and possessions creates a unique death scene that implies a suicide with a ritual character.
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Affiliation(s)
- Maria Alexandri
- Department of Forensic Medicine and Toxicology, School of Medicine, National and Kapodistrian University of Athens, Greece
| | | | - Maria Tsellou
- Department of Forensic Medicine and Toxicology, School of Medicine, National and Kapodistrian University of Athens, Greece
| | - Stavroula Papadodima
- Department of Forensic Medicine and Toxicology, School of Medicine, National and Kapodistrian University of Athens, Greece.
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Byard RW, Heath KJ. Delayed familial self-immolation: A rare memorial event. Leg Med (Tokyo) 2021; 50:101865. [PMID: 33640835 DOI: 10.1016/j.legalmed.2021.101865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Revised: 02/01/2021] [Accepted: 02/15/2021] [Indexed: 10/22/2022]
Abstract
Self-immolation suicides refer to lethal situations where a victim has intentionally set themselves on fire using an accelerant, or has deliberately stepped into a fire. These are rare events in Western countries accounting for only 0.6-1% of suicides. Two cases are described of familial self-immolation with features of an anniversary/memorial event: Case 1: The charred body of a 66-year-old woman was found beside a suburban waterway with evidence of self-immolation using methylated spirits. Death was attributed to incineration; Case 2: Twenty five years later the charred body of another 66-year-old woman was found on the banks of a nearby suburban river. Analysis of clothing revealed ethanol, a major component of methylated spirits. Death was due to the combined effects of inhalation of products of combustion and incineration. Review of the history revealed that the decedent in case 2 was the daughter of the victim in case 1. This, therefore, represents an extremely rare event, that of familial self-immolation suicides with the daughter choosing the same method that had been used by her mother, at an identical age and in a similar location. These cases add to the potential complexities of familial suicides.
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Affiliation(s)
- Roger W Byard
- Forensic Science SA and Adelaide Medical School, The University of Adelaide, Frome Road, Adelaide, South Australia 5005, Australia.
| | - Karen J Heath
- Forensic Science SA and Adelaide Medical School, The University of Adelaide, Frome Road, Adelaide, South Australia 5005, Australia
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10
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Gentile G, Galante N, Tambuzzi S, Zoja R. A forensic analysis on 53 cases of complex suicides and one complicated assessed at the Bureau of Legal Medicine of Milan (Italy). Forensic Sci Int 2020; 319:110662. [PMID: 33401231 DOI: 10.1016/j.forsciint.2020.110662] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Revised: 12/15/2020] [Accepted: 12/17/2020] [Indexed: 10/22/2022]
Abstract
Complex suicides are highly uncommon suicides in which multiple detrimental methods are used simultaneously or in chronological succession. We retrospectively analyzed through our database the 25512 autopsy reports registered at the Bureau of Legal Medicine of Milan in the last 27 years from 1993 until 2019, where 4498 suicides were documented. We assessed 53 cases of complex suicides and only one case of complicated suicide: for all of them we analyzed both data collected during the on-site investigation and the autopsy. In our case series, we identified a total number of 113 methods chosen and variably combined by the victims, which were classified into 17 categories. On the whole the most frequent association of suicide methods resulted in the combination of the plastic bag suffocation with inert gas inhalation (13 out of 53 complex suicides; 24.5%). We also analyzed our cases of simple suicides (1993-2019), to compare them with the complex suicides. In this study, we present a complete analysis regarding our cases of complex suicides, discussing the challenges and the interpretative issues which a forensic pathologist might deal with. A thorough on-site judicial inspection and a careful autopsy examination are crucial in such cases. Moreover, the clinical history of the victims and laboratory findings are supplemental elements to be necessarily considered to establish the actual manner of death and avoid any misinterpretations.
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Affiliation(s)
- Guendalina Gentile
- Laboratorio di Istopatologia Forense e Microbiologia Medico Legale, Sezione di Medicina Legale e delle Assicurazioni, Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Via Luigi Mangiagalli, 37, 20133 Milano, Italy
| | - Nicola Galante
- Laboratorio di Istopatologia Forense e Microbiologia Medico Legale, Sezione di Medicina Legale e delle Assicurazioni, Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Via Luigi Mangiagalli, 37, 20133 Milano, Italy
| | - Stefano Tambuzzi
- Laboratorio di Istopatologia Forense e Microbiologia Medico Legale, Sezione di Medicina Legale e delle Assicurazioni, Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Via Luigi Mangiagalli, 37, 20133 Milano, Italy
| | - Riccardo Zoja
- Laboratorio di Istopatologia Forense e Microbiologia Medico Legale, Sezione di Medicina Legale e delle Assicurazioni, Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Via Luigi Mangiagalli, 37, 20133 Milano, Italy.
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11
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Simonit F, Da Broi U, Furioso C, Desinan L. A burned body with a gunshot wound in the mouth and a suicide note: A complex or complicated suicide? J Forensic Leg Med 2020; 72:101958. [PMID: 32452448 DOI: 10.1016/j.jflm.2020.101958] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Revised: 03/30/2020] [Accepted: 04/06/2020] [Indexed: 11/26/2022]
Abstract
The body of a 53-year-old man was found in a burning car. The ignition key was in start position and the accelerator pedal was held down by his right foot. Autopsy revealed a gunshot entrance wound in the hard palate, a bullet track through the anterior cranial fossa and a projectile lodged in the left frontal lobe. The brain stem was free of lesions and any signs of secondary brain injury, such as brain oedema and intracranial haemorrhage, were not significant. Soot deposits and thermal injury to the mucosa were observed in the airways below the glottis and carboxyhaemoglobin (COHb) saturation was 40%. A single bullet case and a handgun were recovered next to the driver's seat. Fire investigators identified the motor as the beginning of the burning: therefore, the conclusion was that the car had caught fire due to overheating of the engine. Differential diagnosis between complex and complicated suicide was essential. The cause of death was identified as carbon monoxide intoxication, and the injuries to the brain were not felt to be immediately fatal. The case has been classified as a complicated suicide. There are no other published cases of a complicated suicide involving exposure to fire or the use of firearms.
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Affiliation(s)
- Francesco Simonit
- Dipartimento di Area Medica, Medicina Legale, Università degli Studi di Udine, p. le S. Maria della Misericordia 15, 33100, Udine, Italy.
| | - Ugo Da Broi
- Dipartimento di Area Medica, Medicina Legale, Università degli Studi di Udine, p. le S. Maria della Misericordia 15, 33100, Udine, Italy.
| | - Cristina Furioso
- Azienda Sanitaria Universitaria Giuliano Isontina (ASUGI), Dipartimento di Prevenzione, Servizi di Medicina Legale, via del Farneto 3, 34142, Trieste, Italy.
| | - Lorenzo Desinan
- Dipartimento di Area Medica, Medicina Legale, Università degli Studi di Udine, p. le S. Maria della Misericordia 15, 33100, Udine, Italy.
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