A retrospective study of the injury patterns seen in fatal falls downstairs

IF 1.2 4区 医学 Q3 MEDICINE, LEGAL Journal of forensic and legal medicine Pub Date : 2024-10-09 DOI:10.1016/j.jflm.2024.102767
Kate McGoldrick , SallyAnne Collis , Linda Mulligan
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Abstract

Introduction

Fatal falls involving stairs are often associated with advanced age, intoxication, acute natural pathology and less commonly – the involvement of a third-party. The injury patterns seen in these cases are often complex and from a medico-legal standpoint, determining third-party involvement based on pathology alone can prove a significant challenge. Classifying the manner of death in such cases, can become particularly complex when the injury pattern appears inconsistent with a simple fall downstairs, or there is an absence of eye-witness testimony.

Aim

To explore the circumstances and injury patterns seen in cases of fatal falls downstairs which were classified as accidental vs. undetermined by the coroners.

Study design

This retrospective study explored the injury patterns present in all cases of fatal falls downstairs referred to the Office of the State Pathologist (OSP) over a 10-year-period (2012–2022) (n = 51).

Results

Fatal falls downstairs which were classified as undetermined were found to have a greater number of craniofacial fractures, spinal fractures and intracranial injuries when compared to accidental falls. Undetermined staircase deaths also displayed more significant fracturing involving the facial skeleton.

Conclusion

Ultimately, where there is a question of third-party involvement, the Post-Mortem Examination (PME) findings alone cannot determine the manner of death. The pathologist's examination may identify injuries that are inconsistent with a simple fall downstairs, but it is the coroner who must conduct a thorough investigation into the circumstances of the fatal fall and ultimately determine the classification of the death.
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对致命坠楼事故中受伤模式的回顾性研究
导言涉及楼梯的致命跌倒通常与高龄、醉酒、急性自然病理学有关,较少见的是与第三方的参与有关。这些病例中的损伤模式通常很复杂,从医学法律角度来看,仅根据病理学来确定是否涉及第三方是一项重大挑战。研究目的探讨被验尸官归类为意外或未确定的致命坠楼案件中的情况和伤害模式。研究设计这项回顾性研究探讨了10年间(2012-2022年)所有转介至州立病理学家办公室(OSP)的致命坠楼病例(n = 51)的损伤模式。结果与意外坠楼相比,被归类为未确定的致命坠楼病例中颅面骨折、脊柱骨折和颅内损伤的数量更多。结论如果存在第三方参与的问题,仅凭尸检结果并不能确定死亡方式。病理学家的检查可能会发现与单纯坠楼不符的伤痕,但验尸官必须对致命坠楼的情况进行彻底调查,并最终确定死亡类别。
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来源期刊
CiteScore
2.70
自引率
6.70%
发文量
106
审稿时长
57 days
期刊介绍: The Journal of Forensic and Legal Medicine publishes topical articles on aspects of forensic and legal medicine. Specifically the Journal supports research that explores the medical principles of care and forensic assessment of individuals, whether adult or child, in contact with the judicial system. It is a fully peer-review hybrid journal with a broad international perspective. The Journal accepts submissions of original research, review articles, and pertinent case studies, editorials, and commentaries in relevant areas of Forensic and Legal Medicine, Context of Practice, and Education and Training. The Journal adheres to strict publication ethical guidelines, and actively supports a culture of inclusive and representative publication.
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