Journal of forensic and legal medicine最新文献

{"title":"Common errors In medico-legal reporting by the first responders at A tertiary trauma unit In North India","authors":"Jhansi Lakshmi Mylapalli ,&nbsp;Govinda Balmuchu ,&nbsp;Vidhu Prabhakar ,&nbsp;Piyush Ranjan Sandhu ,&nbsp;Deki Palmo Bodh ,&nbsp;Nirupam Madan ,&nbsp;Sanjeev Lalwani","doi":"10.1016/j.jflm.2025.102859","DOIUrl":"10.1016/j.jflm.2025.102859","url":null,"abstract":"<div><h3>Background</h3><div>The Trauma unit deals with wide variety of medico-legal cases such as assaults, road traffic accidents, injuries due of self-harm, sexual violence, etc. The primary duty of first responders (attending physician/registered medical practitioner) is saving lives, besides recording the medico-legal report (MLR).</div></div><div><h3>Objectives</h3><div>To identify the frequently-encountered errors in medico-legal reporting by emergency physicians and also to signify the importance of efficient documentation of MLRs.</div></div><div><h3>Methodology</h3><div>Data acquisition done retrospectively from previous records after excluding the referral cases associated with outside hospital Medico-legal cases. A total of 400 MLRs were analyzed and score allotted based on the presence or absence of adequate documentation in MLRs. The minimum score is 1, while the maximum score is 5. Grading is done based on the cumulative score for each entity as Above average, average and below average.</div></div><div><h3>Results</h3><div>The treating emergency physicians documented injury in 343 out of 400 MLRs. A total of 309 were graded as \"Above average\" and injury-related description was deficient in 14.2 % (n = 57) cases. Size or dimensions of injury was not mentioned in 80.17 % (n = 186), age and colour of injury was described in none.</div></div><div><h3>Discussion</h3><div>Various factors lead of certain common errors while preparing such medico-legal reports. These errors lead to unnecessary courtroom visits and questioning of the medical fraternity during legal proceedings. Lack of standardization of uniform guidelines while writing an MLR across the nation leads to significant number of errors while documenting MLRs. We implemented a mandatory induction for all the first responders of each batch once in six weeks and observed mitigation of errors in documentation.</div></div><div><h3>Conclusion</h3><div>It is highly recommended to conduct fortnight training or induction of the first responders in preparing the MLRs and effectively enlighten doctors on the importance of medico-legal documentation. This would avoid unnecessary courtroom visits and questioning of the medical fraternity during legal proceedings.</div></div>","PeriodicalId":16098,"journal":{"name":"Journal of forensic and legal medicine","volume":"112 ","pages":"Article 102859"},"PeriodicalIF":1.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143859700","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neurodegenerative disease findings in Finnish neuropathologically examined medico-legal autopsy cases with acute head injuries","authors":"Essi Laakko ,&nbsp;Petteri Oura","doi":"10.1016/j.jflm.2025.102866","DOIUrl":"10.1016/j.jflm.2025.102866","url":null,"abstract":"<div><div>Neurodegenerative diseases present diagnostic challenges due to their diverse clinical presentations, which emphasizes the importance of postmortem neuropathological examination. As neurodegenerative diseases become more common with age, they contribute to a higher risk of falls, accidents and head injuries. Our aims were to, first, report the prevalence of neurodegenerative disease findings in Finnish neuropathologically examined medico-legal autopsy cases with acute head injuries and, second, report the prevalence, injury circumstances, and types of specific brain injuries in the most common disease entities. We analyzed cases from the Helsinki office of the Forensic Medicine Unit, Finnish Institute for Health and Welfare, over the period 2016–2022. Cases were included if they had a suspected or confirmed head injury, and underwent a full neuropathological examination with neurodegenerative immunohistochemistry. Data on background characteristics, neurodegenerative immunostains and diagnoses, and head injuries were collected from cause-of-death investigation documents and neuropathology reports. Prevalences of neurodegenerative diagnoses were calculated, and head injury findings were presented for the most common disease entities. During the study period, there were a total of 128 neuropathologically examined cases with suspected or confirmed acute head injuries. Neurodegenerative immunohistochemistry was performed in 57 of them, and a neurodegenerative diagnosis was established in 47 cases. The most prevalent diagnoses were Alzheimer's disease neuropathologic change (ADNPC) (n = 34), cerebrovascular disease (CVD) (n = 34) and Lewy body disease (LBD) (n = 9). Old head injuries were common among cases with any neurodegenerative diagnosis (36.2 %). Of specific findings, subdural haemorrhage and hypoxic-ischaemic neuronal injury had the highest absolute prevalence in cases with ADNPC, although there were no major differences between ADNPC, CVD and LBD. In conclusion, the most prevalent neurodegenerative disease entities in this dataset were ADNPC, CVD and LBD. A history of head injuries was common regardless of the neurodegenerative entity.</div></div>","PeriodicalId":16098,"journal":{"name":"Journal of forensic and legal medicine","volume":"112 ","pages":"Article 102866"},"PeriodicalIF":1.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143799695","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intimate partner violence in southernouthern Tunisia: A retrospective study of the sociodemographic and medicolegal clinical profile","authors":"Nihel Feki,&nbsp;Rakia Soiniya,&nbsp;Marwa Ouni,&nbsp;Hela Siala,&nbsp;Narjes Karray,&nbsp;Sami Bardaa,&nbsp;Zouhair Hammami,&nbsp;Wiem Ben Amar,&nbsp;Malek Zribi","doi":"10.1016/j.jflm.2025.102855","DOIUrl":"10.1016/j.jflm.2025.102855","url":null,"abstract":"<div><h3>Background</h3><div>Intimate partner violence (IPV) is a significant public health issue that severely affects women's health and well-being in Tunisia. Understanding the socio-epidemiological profiles of IPV victims and perpetrators, along with the medico-legal implications, is essential for developing effective prevention measures.</div></div><div><h3>Methods</h3><div>This was a cross-sectional, retrospective study that analyzed victims of intimate partner violence (IPV) in the Governorate of Sfax, Tunisia, from June 2022 to June 2023. Participants were interviewed face-to-face, and data were collected from medico-legal reports and police records based on the victims' complaints.</div></div><div><h3>Results</h3><div>Our study included 374 suspected IPV victims, 96 % of whom were women with a mean age of 36. Most alleged perpetrators were male, with a significant proportion having a history of alcohol abuse and criminal activity. Physical assault combined with verbal abuse was the predominant form of IPV, often triggered by financial difficulties. The average duration of temporary total disability was 6 days, with 6.9 % of victims at risk for partial permanent disability.</div></div><div><h3>Conclusion</h3><div>This study provides insights into the socio-epidemiological profiles of IPV victims and perpetrators in southern Tunisia. While the findings may underestimate the true prevalence due to underreporting, the adoption of domestic violence legislation represents a significant step forward. By understanding these dynamics, we can develop effective strategies to mitigate the risk of IPV and promote healthier relationships.</div></div>","PeriodicalId":16098,"journal":{"name":"Journal of forensic and legal medicine","volume":"112 ","pages":"Article 102855"},"PeriodicalIF":1.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143807996","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unidentified: Simulation-based education in forensic odontology","authors":"Ranya Al Ghazi ,&nbsp;Scott McGregor ,&nbsp;Scheila Mânica","doi":"10.1016/j.jflm.2025.102865","DOIUrl":"10.1016/j.jflm.2025.102865","url":null,"abstract":"<div><div>We report on a prototype computer-simulated training programme in dental autopsy entitled <em>Unidentified</em>. This was developed to offer a simulated real-world experience of conducting dental identification procedures as a forensic odontologist. Unidentified is a tool developed as a proof of concept for a single case from an air crash disaster with a running time of 40 min to an hour. Standards of a disaster victim identification (DVI) guide and forms were followed. The game development platform ‘Unreal Engine’ was used by collaborators from a gaming enterprise and academic contributors from a leading institution in game development. Accessibility, practicality, and affordability are advantages of the training. Further developments will make ante-mortem and reconciliation phases available and expand the exercise to mass casualty incidents.</div></div>","PeriodicalId":16098,"journal":{"name":"Journal of forensic and legal medicine","volume":"113 ","pages":"Article 102865"},"PeriodicalIF":1.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143908041","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mummification – An historical and cultural overview","authors":"Roger W. Byard","doi":"10.1016/j.jflm.2025.102863","DOIUrl":"10.1016/j.jflm.2025.102863","url":null,"abstract":"<div><div>Review was undertaken of historical mummifications which has shown that this process has occurred accidently and deliberately in many cultures globally for millennia in a wide variety of environments. Although Egypt is considered the major source of mummified material, mummification has occurred in Europe, Africa, Asia, Oceania, Greenland and the Americas. Changes to bodies after mummification, with distortion and loss of tissues and organs, present challenges to contemporary investigators who may have difficulties in determining the time, cause and manner of death. A good example of this was the mistaken assessment that Iron Age sacrifices of bodies found in bogs in Denmark represented present day homicides. Modern investigative tools such as conventional radiography, computed tomography (CT), magnetic resonance imaging (MRI), scanning electron microscopy, infrared spectroscopy, endoscopy and X-ray diffraction analysis have provided more accurate and less destructive ways of examining such remains to enable valid scientific analyses to be achieved.</div></div>","PeriodicalId":16098,"journal":{"name":"Journal of forensic and legal medicine","volume":"112 ","pages":"Article 102863"},"PeriodicalIF":1.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143783678","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unusual autopsy, unusual tissue(s) for DNA, but a useful genetic profile: A case of the DNA profiling from the human tissue of challenged provenance","authors":"Enrica Macorano ,&nbsp;Bianca Beltrame ,&nbsp;Nunzia Ilaria Vacca ,&nbsp;Francesca Vacca ,&nbsp;Giacoma Mongelli ,&nbsp;Gerardo Cazzato ,&nbsp;Aldo Di Fazio ,&nbsp;Francesco Introna","doi":"10.1016/j.jflm.2025.102864","DOIUrl":"10.1016/j.jflm.2025.102864","url":null,"abstract":"<div><div>The autopsy of the non-fresh cadaver is characterized by inherent difficulties in that it requires the adoption of genetic and histological investigation techniques to the specific case. The case that the authors present in this paper concerns the corpse of a young woman who had already been autopsied, then treated with 20 % neutral buffered formaldehyde, a preserving agent, to enable its intercontinental transport, and then autopsied again. At the judge's request, a second judicial autopsy was performed in order to verify the cause of death and to carry out genetic investigations. As fresh tissue was not available to perform the genetic analysis, three different tissue matrices were taken: retina, liver, and iliopsoas muscle. The biological matrices taken were chosen as they were considered less likely to be in contact with formaldehyde and therefore probably less prone to artifacts caused by the action of formalin on the DNA structure. All three biological matrices were used to obtain a genetic profile. In particular, the genetic data obtained from the retina was found to be better than the genetic profile obtained from the iliopsoas muscle. In turn, the genetic profile obtained from the iliopsoas muscle was found to be better than the genetic data obtained from the liver sample.</div></div>","PeriodicalId":16098,"journal":{"name":"Journal of forensic and legal medicine","volume":"112 ","pages":"Article 102864"},"PeriodicalIF":1.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143768222","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"“I can’t breathe” – A study of civil litigated cases on prone restraint deaths","authors":"Alon Steinberg ,&nbsp;Dhilan Patel ,&nbsp;Amanda Frugoli","doi":"10.1016/j.jflm.2025.102862","DOIUrl":"10.1016/j.jflm.2025.102862","url":null,"abstract":"<div><h3>Introduction</h3><div>Prone restraint by law enforcement has come under scrutiny due to its association with in-custody deaths and subsequent civil litigation. The true incidence, risk factors, and physiological mechanisms contributing to these fatalities remain poorly understood. This study aims to assess prone restraint-related death occurrences and identify associated risk factors by analyzing legal case records.</div></div><div><h3>Methods</h3><div>This retrospective study examined United States legal records from the National Legal Database, LexisNexis, covering 2010 to 2019. Cases were identified using the MeSH term “prone restraint cardiac arrest.” Data extracted included demographic and case-specific variables such as age, gender, body mass index (BMI), duration of prone restraint, application of additional body weight, race, use of a conducted electrical weapon (CEW), presence of body camera footage, reports of excited delirium, drug intoxication, settlement amounts, and documented statements of “I can't breathe.\"</div></div><div><h3>Results</h3><div>A total of 229 cases met the inclusion criteria for analysis. The majority of subjects (98 %) were male, with an average age at death of 37 years. Among cases with available data, 38 % were African American, 33 % had obesity, and 64 % involved recreational stimulant drug use. In 58 % of cases, death occurred after one to 5 min of prone restraint. Additional body weight was applied in 80 % of cases, while CEWs were used in 39 %. Excited delirium was reported in 31 % of cases. More than 20 % of individuals were recorded saying, “I can't breathe.” The average reported settlement in resolved cases was $2.5 million.</div></div><div><h3>Conclusion</h3><div>This study represents the largest case series of 229 reported prone restraint-related deaths to be reported in the medical literature, yet the true incidence remains uncertain. Further research is essential to better understand the prevalence, contributing risk factors, and potential mitigation strategies. Collaboration among the medical and forensic communities, law enforcement agencies, and policymakers is critical to accurately assess the scope of this issue and implement measures to reduce fatalities associated with prone restraint.</div></div>","PeriodicalId":16098,"journal":{"name":"Journal of forensic and legal medicine","volume":"112 ","pages":"Article 102862"},"PeriodicalIF":1.2,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143859702","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epidemiology of stray bullet injuries in Karachi- A three-year study","authors":"Qudsia Hassan ,&nbsp;Muhammad Ikram Ali ,&nbsp;Muhammad Taha Sohail ,&nbsp;Summaiya Syed Tariq ,&nbsp;Muhammad Muaz Abbasi ,&nbsp;Mirza Altamish Mohammad Baig","doi":"10.1016/j.jflm.2025.102857","DOIUrl":"10.1016/j.jflm.2025.102857","url":null,"abstract":"","PeriodicalId":16098,"journal":{"name":"Journal of forensic and legal medicine","volume":"112 ","pages":"Article 102857"},"PeriodicalIF":1.2,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143760463","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A retrospective cross-sectional analysis of community deaths in County St. Patrick Trinidad over a one-year period from January to December 2022","authors":"Sara Archee ,&nbsp;Cherisse Ratiram ,&nbsp;Nalini D. Maharaj","doi":"10.1016/j.jflm.2025.102850","DOIUrl":"10.1016/j.jflm.2025.102850","url":null,"abstract":"<div><h3>Objective</h3><div>To analyse the trends in community deaths in County St. Patrick in South-West Trinidad for a period of one year from January 1, 2022–December 31, 2022.</div></div><div><h3>Methods</h3><div>The community deaths were obtained from the County St. Patrick Community Mortality Registry and analysed for a period of one year from January to December 2022 to examine trends in demographic characteristics, manner of death and prevalence of communicable and non-communicable diseases.</div></div><div><h3>Results</h3><div>There were 597 community deaths recorded for the period January to December 2022 in County St. Patrick Trinidad. The age and sex distribution of community deaths followed a similar distribution to national mortality data with more deaths occurring in males (59.1 %) and persons aged 60 years and older (77.2 %). Post-mortem examinations were requested in 30.5 % of community deaths which is comparable to previous regional post-mortem rates. The majority (91.5 %) of community deaths were classified by manner of death as natural. The proportion of unnatural deaths (8.5 %) was consistent with previous national mortality data. The trend of the prevalence of communicable diseases followed the national mortality trend of COVID-19 related deaths in Trinidad and Tobago, with the highest number of deaths occurring in January 2022 and decreased as the year progressed. There was an increased prevalence of non-communicable diseases particularly hypertension (44.4 %) and diabetes (32.5 %) in community deaths when compared to the national prevalence of 25.8 % and 11.7 % respectively.</div></div><div><h3>Conclusion</h3><div>The community deaths in County St. Patrick over a one-year period from January to December 2022 followed similar national and global trends such as age and gender. However, our results revealed the impact of the increasing homicide rate in Trinidad and Tobago, increased prevalence of NCDs specifically hypertension and diabetes, and decreasing trend in COVID-19 deaths. Recommendations include to improve the reporting of community deaths, strengthen end of life/palliative care services in the public health care system and improving the prevention and control of NCDs.</div></div>","PeriodicalId":16098,"journal":{"name":"Journal of forensic and legal medicine","volume":"112 ","pages":"Article 102850"},"PeriodicalIF":1.2,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143859701","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Determinant factors in the identification of unknown cadavers in a forensic medical institute","authors":"Aldeir José da Silva ,&nbsp;Polyanna Helena Coelho Bordoni ,&nbsp;Luiz Sérgio Silva ,&nbsp;Giulia Maciel Nery ,&nbsp;Paulo Márcio Campos de Oliveira","doi":"10.1016/j.jflm.2025.102853","DOIUrl":"10.1016/j.jflm.2025.102853","url":null,"abstract":"<div><h3>Introduction</h3><div>Globally, efforts are being made to locate and identify as many missing people as possible, due to the social and legal importance of this process. Brazilian law 13.812/2019 established the National Policy for the Search for Missing Persons, prioritizing the search and identification of missing persons by public security agencies.</div></div><div><h3>Objective</h3><div>To evaluate factors related to the identification of unknown bodies that arrived at a Brazilian Medical Examiner's Institute.</div></div><div><h3>Method</h3><div>This was an epidemiological, cross-sectional study aiming to describe the characteristics of unidentified individuals in 2021 and factors related to their identification. A descriptive analysis, Pearson's Chi-square test with Monte Carlo simulation, and prevalence ratios obtained through Poisson regression were conducted.</div></div><div><h3>Results</h3><div>A total of 3649 individuals were examined, with a higher prevalence of male individuals and adults, whose cause of death was undetermined. Among them, 1046 arrived at the institute unidentified, while the rest were identified upon admission. Proportionally, there were more men and young people among the unidentified compared to those already identified upon arrival at the Institute. Of the 1046 unidentified individuals, most were recognized by family members, with 30 % identified technically, predominantly through fingerprint analysis. There were proportionally more unidentified individuals who were still unidentified and lacked information on sex, age, and cause of death compared to those who were identified. Fingerprint collection and the issuance of comparative anthropological/odontological reports were statistically significant for the identification process, and there was a higher chance of identification among unidentified females or individuals up to 17 years old, who represented a smaller number of cases, which improved the targeting of direct comparison between antemortem and postmortem data.</div></div><div><h3>Conclusions</h3><div>Fingerprint collection is especially important for the identification process. Defining or predicting the biological profile of the unidentified is crucial for the direct comparison of cases, making forensic anthropology services essential for critical cases involving cadaveric transformation, especially when there is the possibility of issuing comparative reports.</div></div>","PeriodicalId":16098,"journal":{"name":"Journal of forensic and legal medicine","volume":"111 ","pages":"Article 102853"},"PeriodicalIF":1.2,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143682733","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}