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Vester MEM, Nolte KB, Hatch GM, Gerrard CY, Stoel RD, van Rijn RR. Postmortem Computed Tomography in Firearm Homicides: A Retrospective Case Series. J Forensic Sci 2020; 65:1568-1573. [PMID: 32402110 PMCID: PMC7496672 DOI: 10.1111/1556-4029.14453] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2020] [Revised: 04/16/2020] [Accepted: 04/17/2020] [Indexed: 11/30/2022]
Abstract
Postmortem computed tomography (PMCT) is integrated into the evaluation of decedents in several American medical examiner offices and medicolegal death investigative centers in many other countries. We retrospectively investigated the value of PMCT in a series of firearm homicide cases from a statewide centralized medical examiner’s office that occurred during 2016. Autopsies were performed or supervised by board‐certified forensic pathologists who reviewed the PMCT scans prior to autopsy. PMCT scans were re‐evaluated by a forensic radiologist blinded to the autopsy findings and scored by body region (head–neck, thoracoabdominal, and extremities). Injury discrepancies were scored using a modified Goldman classification and analyzed with McNemar’s test. We included 60 males and 20 females (median age 31 years, range 3–73). Based on PMCT, 56 (79.1%) cases had injuries relevant to the cause of death in a single body region (24 head–neck region, 32 thoracoabdominal region). Out of these 56 cases, 9 had a missed major diagnosis by PMCT outside that region, including 6 extremity injuries visible during standard external examination. Yet all had evident lethal firearm injury. We showed that PMCT identifies major firearm injuries in homicide victims and excludes injuries related to the cause of death in other regions when a single body region is injured. Although PMCT has a known limited sensitivity for soft tissue and vascular pathology, it can be combined with external examination to potentially reduce or focus dissections in some of these cases depending on the circumstances and medicolegal needs.
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Affiliation(s)
- Marloes E M Vester
- Department of Forensic Medicine, Netherlands Forensic Institute, Laan van Ypenburg 6, 2497 GB, The Hague, The Netherlands.,Department of Radiology and Nuclear Medicine, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
| | - Kurt B Nolte
- Office of the Medical Investigator, University of New Mexico School of Medicine, 1101 Camino de Salud, Albuquerque, NM, 87102
| | - Gary M Hatch
- Office of the Medical Investigator, University of New Mexico School of Medicine, 1101 Camino de Salud, Albuquerque, NM, 87102
| | - Chandra Y Gerrard
- Office of the Medical Investigator, University of New Mexico School of Medicine, 1101 Camino de Salud, Albuquerque, NM, 87102
| | - Reinoud D Stoel
- Department of Forensic Medicine, Netherlands Forensic Institute, Laan van Ypenburg 6, 2497 GB, The Hague, The Netherlands
| | - Rick R van Rijn
- Department of Forensic Medicine, Netherlands Forensic Institute, Laan van Ypenburg 6, 2497 GB, The Hague, The Netherlands.,Department of Radiology and Nuclear Medicine, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
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He M, Fang YX, Lin JY, Ma KJ, Li BX. Unnatural deaths in Shanghai from 2000 to 2009: a retrospective study of forensic autopsy cases at the Shanghai Public Security Bureau. PLoS One 2015; 10:e0131309. [PMID: 26110435 PMCID: PMC4481348 DOI: 10.1371/journal.pone.0131309] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2014] [Accepted: 06/01/2015] [Indexed: 11/19/2022] Open
Abstract
Shanghai is the most developed city in China and has a soaring population. This study uses forensic epidemiology to determine the relationship between unnatural deaths and the development in Shanghai, based on recently released forensic autopsy cases from the 2000s at the Shanghai Public Security Bureau (SPSB). There were 5425 accidental deaths, 2696 homicides, 429 suicides, 186 natural deaths, and 1399 deaths of undetermined cause. There was a male-to-female ratio of 2.02:1, and the average age was 40.9±18.7 years. Traffic accidents (84.2%) were the number one cause of accidental deaths, which decreased during the study period. Sharp force injury (50.6%) was the leading cause of homicides, different from Western countries, where firearms are the leading cause. Hanging (24.5%) was the leading cause of suicides, whereas drug and chemical intoxication was the leading cause in the previous decade; pesticide ingestion decreased in the 2000s. In addition to traffic accidents, manual strangulation was the leading cause of death in childhood fatalities. Children under age 2 were vulnerable to homicides. In the 2000s, there were a large number of drug overdoses, and illegal medical practices and subway-related deaths first appeared in Shanghai. A new type of terrorist attack that involved injecting people with syringes in public places was reflected in the SPSB archives. The forensic epidemiology and changes in unnatural deaths in this decade reflected their relationship with the law, policy and changes in Shanghai. Illegal medical practices, subway-related deaths and terrorist attacks were closely related to the development in Shanghai. Identifying the risks of unnatural deaths will improve public health.
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Affiliation(s)
- Meng He
- Department of Forensic Medicine, School of Basic Medical Sciences, Fudan University, Shanghai 200032, P. R. China
| | - You-Xin Fang
- Department of Neurology, Huashan Hospital, Fudan University, Shanghai 200040, P. R. China
| | - Jun-Yi Lin
- Department of Forensic Medicine, School of Basic Medical Sciences, Fudan University, Shanghai 200032, P. R. China
| | - Kai-Jun Ma
- Shanghai Key Laboratory of Crime Scene Evidence, Institute of Forensic Science, Shanghai Public Security Bureau, Shanghai 200083, P. R. China
| | - Bei-Xu Li
- Department of Forensic Medicine, School of Basic Medical Sciences, Fudan University, Shanghai 200032, P. R. China
- * E-mail:
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