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Bases of Forensic Pathology Expert Testimony With Emphasis on Iowa v Tyler. 以爱荷华诉泰勒案为重点的法医病理学专家证词基础。
Q4 Medicine Pub Date : 2021-12-01 Epub Date: 2021-12-07 DOI: 10.1177/19253621211060961
Victor W Weedn

Judicial scrutiny of the forensic sciences is increasing. This scrutiny targets the bases for expert opinions. Forensic pathologists must understand that when they express an opinion it must have an articulable underlying basis. Iowa v Tyler provides a cautionary tale where testimony from a forensic pathologist on the cause and manner of death based exclusively on police reports and audio and video recordings of police interviews of the suspect rather than on medical evidence were held to be inadmissible. Tyler has an odd and distinguishable set of facts, but has been widely cited as an example of problematic forensic pathology testimony.

对法医学的司法审查正在增加。这种审查的目标是专家意见的基础。法医病理学家必须明白,当他们表达意见时,它必须有一个清晰的基础。爱荷华诉泰勒案提供了一个警示性的故事,即法医病理学家仅根据警方报告和警方对嫌疑人面谈的录音和录像提供的关于死亡原因和方式的证词,而不是根据医学证据提供的证词,被认为是不可接受的。泰勒有一组奇怪的、可区分的事实,但被广泛引用为有问题的法医病理学证词的一个例子。
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引用次数: 1
The "Magnificent Seven Errors" in Forensic Autopsy Practice: The Italian Context. 法医尸检实践中的“七大错误”:意大利语境。
Q4 Medicine Pub Date : 2021-12-01 Epub Date: 2021-11-09 DOI: 10.1177/19253621211056191
Roberto Scendoni, Piergiorgio Fedeli, Nunzia Cannovo, Mariano Cingolani

According to the Italian legal system, forensic autopsies are performed by a medical doctor specialized in legal medicine, otherwise known as a medicolegal expert (MLE), who has a range of very complex responsibilities. Indeed, the quality of forensic autopsy activity is always questioned in courts of law; incorrect assessments are dangerous because they can jeopardize the validity of a criminal investigation and thus affect the outcome so that a real culprit may be acquitted or an innocent person convicted. Nonconformities also discredit the professionalism of the specialist who performs the autopsy. The work of a MLE implies a series of assignments and duties that should be given constant consideration, but when certain aspects of this activity are underestimated or overlooked, this can lead the expert to make mistakes with irreparable consequences for the judicial investigation. In this article, for the first time, we present a summary of seven known errors related to autopsy activity following death by unnatural causes, with the purpose of alerting MLEs who work under the Italian judicial system to the potential dangers of such errors. These relate to: oversights in autopsy technique, incorrect collection of photographic and video material, unauthorized attendance at the autopsy, missing/mistaken reporting at any stage of the forensic activity, failure to notify the party forensic consultant, using histological or toxicological nonaccredited laboratories for forensic activities, and lack of observance of the chain of custody.

根据意大利法律制度,法医尸检由专门从事法律医学的医生进行,也称为法医专家(MLE),他有一系列非常复杂的职责。的确,法庭上法医解剖活动的质量总是受到质疑;错误的评估是危险的,因为它可能危及刑事调查的有效性,从而影响结果,使真正的罪犯可能被无罪释放,或使无辜的人被定罪。不符合也使进行尸检的专家的专业精神受到怀疑。MLE的工作意味着一系列的任务和职责,这些任务和职责应该得到不断的考虑,但是当这项活动的某些方面被低估或忽视时,这可能导致专家犯错误,对司法调查造成不可弥补的后果。在本文中,我们首次总结了与非自然原因死亡后尸检活动有关的七个已知错误,目的是提醒在意大利司法系统下工作的mle注意此类错误的潜在危险。这些问题涉及:尸检技术上的疏忽,不正确收集照片和视频材料,未经授权出席尸检,在法医活动的任何阶段缺少/错误报告,未通知法医顾问,使用未经认可的组织学或毒理学实验室进行法医活动,以及缺乏对监管链的遵守。
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引用次数: 2
Neck Injuries Caused by Delivery Modes? Late Questions to the Matshes et al. 分娩方式导致颈部损伤?数学的后期问题等。
Q4 Medicine Pub Date : 2021-12-01 Epub Date: 2021-11-25 DOI: 10.1177/19253621211062043
Niels Lynøe, Anders Eriksson
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引用次数: 0
Organ Retention Litigation 器官保留诉讼
Q4 Medicine Pub Date : 2021-09-01 DOI: 10.1177/19253621211032498
V. Weedn
The common practice of retaining organs and tissues after the autopsy dissection is a potential legal liability for forensic pathologists and the offices they work for. In 1988, a coroner and the coroner’s office were successfully sued for corneal procurements without the consent of the next of kin. That led to later lawsuits of forensic pathologists and medical examiner offices over the retention of brains for formalin fixation and neuropathologic examination without consent, although the autopsies were not consent based. National Association of Medical Examiners became involved in this ligation and filed numerous amicus briefs. These later lawsuits were not successful. After caselaw on the subject, such lawsuits have largely abated. Nonetheless, the threat of such lawsuits remains, and statutory language can be promulgated to mitigate the risk.
尸检后保留器官和组织的常见做法对法医病理学家及其工作办公室来说是一种潜在的法律责任。1988年,一名验尸官和验尸官办公室在未经其近亲同意的情况下被成功起诉购买角膜。这导致后来法医病理学家和法医办公室就未经同意保留大脑进行福尔马林固定和神经病理学检查提起诉讼,尽管尸检并非基于同意。美国国家法医协会参与了这项结扎手术,并提交了许多法庭之友案情摘要。后来的这些诉讼都没有成功。在这个问题上的判例法之后,这类诉讼在很大程度上减少了。尽管如此,此类诉讼的威胁仍然存在,可以颁布法定语言来减轻风险。
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引用次数: 0
Study on Evaluation of Knowledge, Attitude, and Practice of Sri Lankan Traffic Police Officers Related to Examination of Drunk Drivers, in Two Most Populated Districts of Sri Lanka 斯里兰卡两个人口最多地区对斯里兰卡交警酒后驾驶考试相关知识、态度和实践的评估研究
Q4 Medicine Pub Date : 2021-09-01 DOI: 10.1177/19253621211032502
Y. Thivaharan, I. Kitulwatte, T. Muthulingam, Maleesha Jayasundara, N. Borukgama, Udaya Prageeth, Dumith Senevirathna, D. Kulathunga, Sandamini Aththanayaka
Introduction: Driving under the influence (DUI) of alcohol is one of the substantial predisposing factors for mishaps among road users. A traffic police officer will be the first authoritative personnel a drunk driver encounters in the legal system. The absence of accurate skills and knowledge of these officers impedes the structuring of legal procedures and may lead to miscarriage of justice. Objective: To assess the knowledge, attitude and practice of Sri Lankan traffic police in handling and managing an alleged case of driving under influence of alcohol. Methods: This was a descriptive cross sectional study carried on a sample of 384 traffic police officers attached to the districts of Colombo and Gampaha, through a questionnaire. Results: Out of 384, only 75 of police officers knew the correct preliminaries to perform before administering a breathalyzer test. 79.7% knew the correct instructions for using a breathalyzer, but only 3.4% knew the colour changes of the breathalyzer. Significantly poor attitude was observed among the police officers, regarding the importance of producing a drunk driver for medico-legal examination (P = 0.001) Only 222 (57.8%) answered correctly that a drunk driver needs to be subjected to a medico-legal examination as early as possible. Significantly poor practice and attitude was observed in officers with longer service duration but no significant association was observed between ranks of officers and attitude and practice (P = 0.199). Conclusions: The results of our study demonstrate that the knowledge attitude and practice on efficiently handling a case of DUI among traffic police officers is poor, even though all of them are engaged in DUI duties irrespective of their service duration. The need for continuous professional development programmes was highlighted.
引言:酒后驾驶是道路使用者发生事故的主要诱因之一。交通警察将是醉酒司机在法律体系中遇到的第一个权威人员。这些官员缺乏准确的技能和知识,阻碍了法律程序的构建,并可能导致误判。目的:评估斯里兰卡交通警察在处理和管理一起涉嫌酒后驾驶案件时的知识、态度和做法。方法:这是一项描述性的横断面研究,通过问卷调查,对科伦坡和甘帕哈地区的384名交通警察进行了抽样调查。结果:在384名警察中,只有75名警察知道在进行酒精测试之前要做的正确的准备工作。79.7%的人知道正确的酒精测试仪使用说明,但只有3.4%的人知道酒精测试仪的颜色变化。对于让醉酒司机接受法医检查的重要性,警察的态度明显较差(P=0.001)只有222人(57.8%)正确回答醉酒司机需要尽早接受法医检查。服务时间较长的警察的行为和态度明显较差,但警察级别与态度和行为之间没有显著关联(P=0.199)。结论:我们的研究结果表明,交警在有效处理酒后驾车案件方面的知识态度和行为较差,即使他们所有人都从事酒后驾驶职责,而不管他们的服务期限如何。会上强调了持续的专业发展方案的必要性。
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引用次数: 0
Crocodile Attack Injuries: A Failed Attempt to Conceal Homicide 鳄鱼袭击造成的伤害:掩盖谋杀的失败尝试
Q4 Medicine Pub Date : 2021-09-01 DOI: 10.1177/19253621211033472
Kunasilan Subramaniam, Grace Wong Yi-Li, Vomanasri Krishnan, Iyvonne Chuah Sock Yi, Muhammad Aniq bin Mohd Amran
Crocodile attacks are not uncommon in this region. There have been 92 cases reported since 2015 and 50 cases alone reported in Sarawak. Every year death has been attributed to a crocodile attack. An estimate of 71% of the total cases of crocodile attack ended up dead. However, there are instances where a crocodile attack happened after the death of a person. This is a case of an adult male who was reported missing. His body was found by two local anglers, being mauled by crocodiles. Only partial trunk and lower limbs were found, and the major organs were absent. The postmortem features of the crocodile attacks have been described.
鳄鱼袭击在这个地区并不罕见。自2015年以来,共报告了92例病例,仅砂拉越就报告了50例。每年的死亡都被归咎于鳄鱼袭击。据估计,鳄鱼袭击事件中有71%最终死亡。然而,也有鳄鱼在人死后袭击的例子。这是一起报告失踪的成年男性案件。他的尸体被两名当地垂钓者发现,他们被鳄鱼咬伤。仅发现部分躯干和下肢,主要器官缺失。已经描述了鳄鱼袭击的尸检特征。
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引用次数: 1
Fatal Necrotizing Fasciitis as a Consequence of Blunt Trauma: A Case Report 钝性创伤致致命坏死性筋膜炎1例报告
Q4 Medicine Pub Date : 2021-09-01 DOI: 10.1177/19253621211038108
Chandrakanth Hv, H. Rg, S. Rani
Necrotizing fasciitis is an uncommon lethal bacterial infection that involves the subcutaneous tissue and fascia. It can be mono or polymicrobial infection. The diagnosis is mainly dependent on clinical signs and symptoms. Trauma is the commonest cause for it. The early signs and symptoms may mimic cellulitis. We present a case of necrotizing fasciitis following an assault. The patient was received in a state of shock. Despite all measures, the patient could not be saved. Early debridement and antibiotic therapy have a key role in the prognosis of the disease. Medicolegal issues can arise when the disease develops post-assault because of the vague and unpredictable nature of the disease and its challenging prognosis.
坏死性筋膜炎是一种罕见的致命细菌感染,涉及皮下组织和筋膜。它可以是单一或多种微生物感染。诊断主要取决于临床体征和症状。创伤是最常见的病因。早期体征和症状可能类似蜂窝组织炎。我们报告一例攻击后坏死性筋膜炎。病人在休克状态下接受治疗。尽管采取了各种措施,病人还是没能得救。早期清创和抗生素治疗对疾病的预后起着关键作用。当疾病在袭击后发展时,由于疾病的模糊性和不可预测性及其具有挑战性的预后,可能会出现法医学问题。
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引用次数: 0
Aortoesophageal Fistula Secondary to Esophageal Diverticulum Resulting in Sudden Unexpected Death 食管分流器继发主动脉食管瘘致猝死
Q4 Medicine Pub Date : 2021-09-01 DOI: 10.1177/19253621211038122
R. Ndikumana, A. Lal, J. Herath
Aortoesophageal fistula (AEF) is a rarely encountered clinical outcome that is often fatal. It is most commonly a postoperative complication of vascular surgery (secondary AEF). Reported primary causes of AEF include aortic aneurysm, atherosclerosis, infection, foreign objects, achalasia with megaesophagus, gastrointestinal malignancy, and radiotherapy. Aortoesophageal fistula is often not a top diagnostic consideration for clinicians or pathologists and has the potential to be overlooked. This report describes a rare case of AEF secondary to an esophageal traction diverticulum and associated abscess that resulted in the sudden unexpected death of a 78-year-old male. Aortoesophageal fistula is an important consideration for pathologists and requires careful consideration in the postmortem setting.
主动脉食管瘘(AEF)是一种罕见的临床结果,往往是致命的。它是最常见的血管手术术后并发症(继发性AEF)。据报道,AEF的主要病因包括主动脉瘤、动脉粥样硬化、感染、异物、食管贲门失弛缓症、胃肠道恶性肿瘤和放疗。主动脉食管瘘通常不是临床医生或病理学家的首要诊断考虑,并有可能被忽视。本报告描述了一例罕见的食管牵引憩室继发急性食管炎并伴有脓肿,导致一名78岁男性突然意外死亡。主动脉食管瘘是病理学家的一个重要考虑因素,需要在死后仔细考虑。
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引用次数: 0
Acute Esophageal Necrosis (Black Esophagus): An Autopsy Case Series 急性食管坏死(黑色食管):尸检病例系列
Q4 Medicine Pub Date : 2021-09-01 DOI: 10.1177/19253621211036305
Lauren R. Crowson-Hindman, Keenen Smith, A. Phillips
Introduction: Acute esophageal necrosis (AEN), also known as black esophagus and acute necrotizing esophagitis, is a rare pathologic finding of unknown etiology. It was first characterized as diffuse, circumferential black discoloration of the esophageal mucosa that affects predominantly the distal esophagus with sharp transition to normal-appearing mucosa at the gastroesophageal junction. Case frequency of AEN remains low and mainly found incidentally, with up to 0.2% in autopsy and endoscopy studies. Men are 4 times more commonly affected and overall mortality is approximately 32%. Methods: Black esophagus was incidentally found during ten forensic autopsy cases. Complete autopsies with photographs, histological examination, and toxicological analysis were performed. Case background information was reviewed. A review of literature was done, with research criteria including previous case reports, diagnosis, and autopsy, endoscopic, and microscopic findings of AEN. Results: Nine of ten deceased were male, with an age range of 26 to 67 years old. The most common preexisting pathological condition was chronic alcohol consumption, seen in six of ten cases, and in eight cases, the death occurred suddenly at home. “Classic” black esophagus was only seen in four cases. Upper gastrointestinal hemorrhage due to acute necrotizing esophagitis was established as the immediate cause of death in six of ten cases. Discussion: This case series demonstrates ten cases of AEN with variation in appearance, yet diagnosis supported by histology, ancillary testing, and case information. The case frequency was higher than previously reported, 0.7%, suggesting that the prevalence of AEN may be underestimated, especially in forensic death investigations.
简介:急性食管坏死(AEN),又称黑色食管和急性坏死性食管炎,是一种罕见的病理发现,病因不明。首先表现为食管黏膜弥漫性、周向性黑色变色,主要累及食管远端,在胃食管交界处迅速过渡到正常粘膜。AEN的病例频率仍然很低,主要是偶然发现的,在尸检和内窥镜检查中高达0.2%。男性的发病率是男性的4倍,总死亡率约为32%。方法:在10例法医尸检中偶然发现食管黑色。进行了完整的尸检,包括照片、组织学检查和毒理学分析。审查了病例背景资料。对文献进行了回顾,研究标准包括以前的病例报告、诊断、尸检、内窥镜和显微镜下发现的AEN。结果:10例死者中有9例为男性,年龄26 ~ 67岁。最常见的先前存在的病理状况是慢性饮酒,10例中有6例出现,其中8例在家中突然死亡。“典型”食管黑色仅见于4例。急性坏死性食管炎引起的上消化道出血被确定为10例中6例的直接死亡原因。讨论:本病例系列展示了10例AEN的外观变化,但诊断支持组织学,辅助检查和病例信息。病例频率高于先前报道的0.7%,这表明AEN的患病率可能被低估了,特别是在法医死亡调查中。
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引用次数: 1
Confronting Forensic Pathologists 直面法医病理学家
Q4 Medicine Pub Date : 2021-09-01 DOI: 10.1177/19253621211032504
V. Weedn
Background: The Sixth Amendment Confrontation Clause gives defendants a right to confront their accusers. Method: U.S. Supreme Court cases that interpreted this right as applied to forensic scientists were reviewed. Results: Melendez-Diaz, Bullcoming, and Williams examined constitutional rights to confront forensic scientists. Lower courts have specifically examined their application to forensic pathology. Whether autopsy reports are considered “testimonial” varies among jurisdictions and has not been definitively settled. Defendants are generally able to compel testimony of forensic pathologists. Where the forensic pathologist is truly unavailable, the surrogate expert should be in a position to render an independent opinion.
背景:《第六修正案对抗条款》赋予被告对抗原告的权利。方法:对美国最高法院将这一权利解释为适用于法医科学家的案件进行审查。结果:Melendez Diaz、Bullcoming和Williams审查了宪法赋予他们对抗法医科学家的权利。下级法院专门审查了它们在法医病理学方面的应用。尸检报告是否被视为“证明”因司法管辖区而异,尚未得到明确解决。被告通常能够强迫法医病理学家作证。如果法医病理学家确实不在,代理专家应该能够发表独立意见。
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引用次数: 0
期刊
Academic Forensic Pathology
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