Academic Forensic Pathology最新文献

Introduction: Vascular Ehlers-Danlos syndrome (vEDS) is an autosomal dominant disorder that results from mutations in the collagen type III gene. It is a risk factor for medium-sized artery aneurysms, dissections, and ruptures. We report a case of hemoperitoneum due to medial dissection and rupture of the superior mesenteric artery related to vEDS. Methods: A full body CT scan and full three cavity autopsy was performed in a 47-year-old man with a history of an intermittent abdominal cramping for one week rand complex past medical history that included a sigmoid bowel perforation at age 20, and previous popliteal artery pseudoaneurysm rupture. Histology and genetic testing were performed. Results: The postmortem computed tomography and autopsy showed a significant hemoperitoneum due to a ruptured dissection of the superior mesenteric artery and branches, and multiple splanchnic artery dissections with renal and small bowel infarctions. Genetic testing revealed a heterozygous COL3A1 gene variant associated with Ehlers-Danlos syndrome. Death was attributed to hemoperitoneum due to medial dissection and rupture of the superior mesenteric artery due to arteriopathy. Discussion: The relatively young age and medical history correlate with the autopsy findings and genetic testing towards the conclusion of an arteriopathy consistent with vEDS.

This article describes two cases of rare surgical complications during functional endoscopic sinus surgery (FESS) and the resulting forensic investigations. The first case involved damage to the skull base and intracerebral artery, leading to a fatal cerebrovascular event, while the second case involved destruction of the medial orbital wall. The clinical and pathological findings are described in detail for each case. In Russia, in cases of disputes regarding medical malpractice, a commission-based expert examination is appointed by the civil court, criminal court, or investigator. This commission includes, in addition to a forensic pathologist, a practicing physician specializing in the field related to the case under consideration. Single-expert examinations for such cases are not provided; the investigation is always conducted jointly by a forensic pathologist and a clinician. It is important to investigate whether the mistake was due to preventable causes or deviations from accepted standards. This can only be done through the joint work of clinicians and forensic pathologists. These two cases are important because they demonstrate how different forensic conclusions can be for patients who undergo the same operation and experience similar severe complications. Despite the similarities, the forensic and legal outcomes were entirely different due to different reasons for the mistakes.

Introduction: The coronavirus disease of 2019 (COVID-19) pandemic has resulted in a great deal of morbidity and mortality worldwide. Since most deaths related to COVID-19 are currently considered natural, and they tend to occur following a clinically recognized illness, many medical examiner/coroner offices within the United States do not take jurisdiction over the majority of COVID-19 deaths.

Methods: In this review, we present the experience of a medium-sized medical examiner's office affiliated with an academic medical school institution, over the first 15 months of the COVID-19 pandemic.

Results: Compared to a 15-month period that immediately preceded the pandemic, our office experienced a significant increase in the total number of reported deaths, scene investigations, full autopsies, natural deaths, accidents, homicides, and drug-related deaths, but a decrease in the number of suicides. Overall, our office performed 5 autopsies during the study period where COVID-19 was considered the primary cause of death, 4 cases where COVID-19 was considered a contributory cause of death, and 28 cases where COVID-19 testing was positive, but COVID-19 was not contributory to death.

Discussion: The COVID-19 pandemic was accompanied by a sizeable increase in work volume within our academic medical examiner's office. Although this increased workload was not related to a large number of COVID-19-related deaths investigated by the office, there were numerous areas of increased workload that were likely secondarily related to the conditions associated with the pandemic.

An explosive is a container that is filled with material that will explode when it is thrown or dropped, or when a device inside it makes it explode. Many materials can be used in making up of a bomb individually or when mixed with some other chemical. The type of explosive that gets misused most commonly are those used in manufacturing and other commercial applications due to their easy accessibility to public. Improper handling and inattentive behavior toward the explosives can lead to disastrous circumstances. Here we report such a case in which a 30-year-old male took rocks of potassium sulphate (called Gandhak Potash in the local vernacular language) and struck them with a metallic pestle, which triggered an explosion. The distal phalanges of both hands were found traumatically amputated. Stippling effect due to unburnt powdered explosive substance were present over the head, face, chest, and anteromedial aspect of legs. He died within few hours after the blast. Different type of mechanical injuries and injuries to the internal organs can be sustained over the body due to effects of explosion as we've seen in our case, that is, abrasion, contusion, lacerations, fractures, burn injury and such pattern of injury, and specific injuries sustained due to pressure effect like blast lung along with circumstantial evidence helps in deciding the manner of death.

Limited case reports have been published regarding serotonin syndrome due to the combined effects of supratherapeutic levels of dextromethorphan and selective serotonin reuptake inhibitor. We report a case of an adolescent with postmortem findings suggestive of a diagnosis of serotonin syndrome-induced psychosis associated with a double homicide and suicide. Postmortem toxicology of the suicide victim was remarkable for elevated serotonergic metabolites of fluoxetine and dextromethorphan in a 14-year-old male.