The American journal of forensic medicine and pathology
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Am J Forensic Med Pathol · Mar 2004
ReviewOccupational deaths due to penetrating chest injuries from sledgehammer fragments: two case reports and review of the literature.
Occupational deaths due to projectiles from hand tools are rare. We report 2 unusual cases of individuals killed by metallic projectiles produced by the fragmentation of the head of a sledgehammer. At initial examination, these wounds appear similar to atypical gunshot or stab wounds. Proper evaluation requires radiographic examination, scene correlation, and, when possible, comparison of metallic fragments retrieved at autopsy and tools from the scene.
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Am J Forensic Med Pathol · Dec 2003
Case ReportsDeath during transforaminal epidural steroid nerve root block (C7) due to perforation of the left vertebral artery.
Treatment for individuals suffering from migraines and pain due to an inflammation or impingement of a nerve range from noninvasive methods such as massage, physical therapy, and medications to invasive methods such as epidural steroid injections and surgery. Each method of treatment has an associated level of risk. ⋯ We report the first cited case of a death associated with the pain management procedure called nerve root block, also referred to as a transforaminal epidural steroid injection. We present the medical history and autopsy findings of a 44-year-old white female who died of massive cerebral edema secondary to the dissection of the left vertebral artery and subsequent thrombosis due to the perforation of that artery by a 25-gauge spinal needle during a C-7 nerve root block.
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Am J Forensic Med Pathol · Dec 2003
Deaths among criminal suspects, law enforcement officers, civilians, and prison inmates: a coroner-based study.
During the interaction between a criminal suspect and a law enforcement officer, the risk of death to the suspect, police, or civilians is increased. Unfortunately, very little information is available on the death risks arising from this interaction. This study provides an assessment of the risk of death to law enforcement officers, suspects, and bystanders by separating the interactions into the following 4 phases: (1) events prior to and during arrest; (2) police pursuits or chases; (3) transport of the suspects; and (4) during incarceration. ⋯ The majority of cases (98.7%) were males, blacks (63.6%), and single (50.6%). The respective risks of death by phase were prearrest/arrest, 6.5 per 100,000 arrests; transport, 0.93 deaths per 100,000 arrests; and incarceration, 268 deaths per 100,000 inmates. Study showed the following: (1) risk of death to offenders was greatest during police pursuits; (2) the risks during arrests are not insignificant and involved an officer being threatened with a weapon in one-third of the events; and (3) deaths among inmates were primarily due to natural causes.
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Positional asphyxia, a fatal condition arising because of the adoption of particular body positions, causing mechanical interference with pulmonary ventilation, can occur in various circumstances that are likely to come under the observation of the specialist in legal medicine (work, car accidents, torture, kidnapping, etc.). It is difficult to diagnose the cause of death in such cases because they generally present with an aspecific anatomopathologic picture. ⋯ The diagnosis of positional asphyxia is essentially based on 3 criteria: the body position must obstruct normal gas exchange, it must be impossible to move to another position, and other causes of natural or violent death must be excluded. To illustrate the main physiopathologic and diagnostic causes of positional asphyxia, the authors report 2 cases taken from the records of events that came under the observation of the Medico-Legal Sector of Bari University Hospital throughout the last 10 years.