1
|
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.
Collapse
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
| |
Collapse
|
2
|
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.
Collapse
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
| |
Collapse
|
3
|
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]
|
4
|
Alexandri M, Tsellou M, Antoniou A, Koukoulis AN, Papadodima S. A rare case of complicated suicide: Self-immolation and subsequent stab heart injury due to fall into a glass door. Med Leg J 2022; 90:163-165. [PMID: 35695246 DOI: 10.1177/00258172221086674] [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: 06/15/2023]
Abstract
Complicated suicides can be defined as incidents where death is caused by a subsequent trauma rather than the primary injury. Deaths which occur as a complication of the suicidal act are very rare with few reports in the literature. We present the case of a 60-year-old man who was found at his home while still alive. His body was burning and he was lying on his back impaled by shards of glass that had come from a broken glass door. An ambulance was called but the man died before arrival at hospital. The autopsy showed stab heart and lung injuries in thorax and an abdominal stab trauma which resulted in the protrusion of the small intestine. Homicide was excluded and the sequence of events was reconstructed to reveal a complicated suicide intended to result from self-immolation but which resulted in a fall against a glass door which in turn resulted in shards of glass piercing his body and a fatal stab wound to the heart.
Collapse
Affiliation(s)
- Maria Alexandri
- Department of Forensic Medicine and Toxicology, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Maria Tsellou
- Department of Forensic Medicine and Toxicology, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Anastasia Antoniou
- 2nd Department of Psychiatry, "Attikon" University General Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | | | - Stavroula Papadodima
- Department of Forensic Medicine and Toxicology, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| |
Collapse
|
5
|
Maiese A, Ciallella C, dell’Aquila M, De Matteis A, Toni C, Scatena A, La Russa R, Mezzetti E, Di Paolo M, Turillazzi E, Frati P, Fineschi V. Cause of Death in Charred Bodies: Reflections and Operational Insights Based on a Large Cases Study. Diagnostics (Basel) 2022; 12:1986. [PMID: 36010336 PMCID: PMC9407296 DOI: 10.3390/diagnostics12081986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 07/26/2022] [Accepted: 08/14/2022] [Indexed: 11/17/2022] Open
Abstract
Our study aims to demonstrate the experience of analyzing fully or partially charred corpses to offer a proper implementation protocol for determining the cause of death. In this study, we present a total of 103 cases obtained from the University of Rome La Sapienza and the University of Pisa archives. All cases were classified based on the extent and severity of burns using a visual method. We divided all cases into two groups. The first group included grade I-II burns (21 cases) without the need for identification. The second group (82 cases) included injuries worse than grade burns II, so all cases were analyzed using an analytical method. For each case, we have documented which of the following analyses have been used and the corresponding findings: inspection, autopsy examination, imaging examination, genetic and toxicological examinations, and histological examination. The results describe the main diagnostic findings and show that only the application of all the above systematic analyses can provide greater accuracy and reliability in describing the causes of death or solving problems, such as identification. In conclusion, we propose an available protocol that defines the main steps of a complete diagnostic pathway that pathologists should follow daily in studying charred bodies.
Collapse
Affiliation(s)
- Aniello Maiese
- Department of Surgical Pathology, Medical, Molecular and Critical Area, Institute of Legal Medicine, University of Pisa, 56126 Pisa, Italy
| | - Costantino Ciallella
- Department of Anatomical, Histological, Forensic and Orthopedical Sciences, Sapienza University of Rome, Viale Regina Elena 336, 00161 Rome, Italy
| | - Massimiliano dell’Aquila
- Department of Anatomical, Histological, Forensic and Orthopedical Sciences, Sapienza University of Rome, Viale Regina Elena 336, 00161 Rome, Italy
| | - Alessandra De Matteis
- Department of Anatomical, Histological, Forensic and Orthopedical Sciences, Sapienza University of Rome, Viale Regina Elena 336, 00161 Rome, Italy
| | - Chiara Toni
- Department of Surgical Pathology, Medical, Molecular and Critical Area, Institute of Legal Medicine, University of Pisa, 56126 Pisa, Italy
| | - Andrea Scatena
- Department of Surgical Pathology, Medical, Molecular and Critical Area, Institute of Legal Medicine, University of Pisa, 56126 Pisa, Italy
| | - Raffaele La Russa
- Section of Legal Medicine, Department of Clinical and Experimental Medicine, University of Foggia, 71122 Foggia, Italy
| | - Eleonora Mezzetti
- Department of Surgical Pathology, Medical, Molecular and Critical Area, Institute of Legal Medicine, University of Pisa, 56126 Pisa, Italy
| | - Marco Di Paolo
- Department of Surgical Pathology, Medical, Molecular and Critical Area, Institute of Legal Medicine, University of Pisa, 56126 Pisa, Italy
| | - Emanuela Turillazzi
- Department of Surgical Pathology, Medical, Molecular and Critical Area, Institute of Legal Medicine, University of Pisa, 56126 Pisa, Italy
| | - Paola Frati
- Department of Anatomical, Histological, Forensic and Orthopedical Sciences, Sapienza University of Rome, Viale Regina Elena 336, 00161 Rome, Italy
| | - Vittorio Fineschi
- Department of Anatomical, Histological, Forensic and Orthopedical Sciences, Sapienza University of Rome, Viale Regina Elena 336, 00161 Rome, Italy
| |
Collapse
|
6
|
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.
Collapse
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.
| |
Collapse
|
7
|
Simonit F, Sciarappa OE, Bassan F, Scorretti C, Giudici F, Desinan L. Complex and complicated suicides in Friuli (1993-2017). MEDICINE, SCIENCE, AND THE LAW 2021; 61:14-24. [PMID: 33591875 DOI: 10.1177/0025802420934661] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Complex suicides involve more than one suicide method. According to the intention of the victim, they are classified as 'planned' when the use of more than one suicide technique has been previously devised by the victim and 'unplanned' when the first method turns out to be too painful or insufficient to cause death, and the individual then resorts to other means of suicide. Complicated suicide, on the other hand, is a term that was introduced by Töro and Pollak, in which a failed act of suicide is followed by traumatisation, which has a fatal outcome. This type of death must be distinguished from complex suicides. From a sample of 1160 fatalities (837 males) between 1993 and 2017, we identified 20 (1.72%) cases of complex suicide and three (0.26%) cases of complicated suicide. We considered age, sex, psychiatric history, previous suicide attempts, suicide methods and eventual secondary traumatisation. We also compared planned and unplanned complex suicides. The results show a higher number of planned complex suicides (16 vs. 4), a prevalence of males (n = 17) and adults (median age = 48 years, range 21-74 range). Plastic bag suffocation and gas inhalation (n = 8) were the most commonly used methods. Firearms (n = 4) were used exclusively by males in planned complex suicides. Wrist and forearm cuts (n = 5) were found in four unplanned and one planned complex suicides, and all of the cases with known previous suicidal attempts (n = 3) involved planned complex suicides. Complicated suicides concerned three male victims in two failed attempts of hanging and an unforeseen carbon monoxide intoxication following a non-fatal gunshot to the mouth, confirming the rarity of these fatalities.
Collapse
Affiliation(s)
- Francesco Simonit
- Department of Medicine, Surgery and Health Sciences, University of Trieste, Legal Medicine, Italy
| | - Orazio Elia Sciarappa
- Dipartimento di Area Medica, Medicina Legale, Università degli Studi di Udine, Italy
| | - Fabio Bassan
- Department of Medicine, Surgery and Health Sciences, University of Trieste, Legal Medicine, Italy
| | - Carlo Scorretti
- Department of Medicine, Surgery and Health Sciences, University of Trieste, Legal Medicine, Italy
| | - Fabiola Giudici
- Biostatistic Unit, Department of Medicine, Surgery and Health Sciences, University of Trieste, Italy
| | - Lorenzo Desinan
- Dipartimento di Area Medica, Medicina Legale, Università degli Studi di Udine, Italy
| |
Collapse
|