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Shot gun injuries: Fatal massive haemothorax following traumatic haemoperitoneum and trans-diaphragmatic blood migration. 枪伤：创伤性腹膜出血和横膈膜血液迁移后的致命性大量血胸。
Medico-Legal Journal Pub Date : 2026-09-01 Epub Date: 2026-07-10 DOI: 10.1177/00258172261448062
Paranavidana Roshel Claude Wijenayaka, Ajith Rathnaweera
{"title":"Shot gun injuries: Fatal massive haemothorax following traumatic haemoperitoneum and trans-diaphragmatic blood migration.","authors":"Paranavidana Roshel Claude Wijenayaka, Ajith Rathnaweera","doi":"10.1177/00258172261448062","DOIUrl":"10.1177/00258172261448062","url":null,"abstract":"<p><p>Shotgun injuries provide a unique challenge to both forensic pathology and acute clinical care due to their complex internal ballistic behaviour and variable injury patterns. This report describes a case of a 33-year-old man who initially presented with apparent haemodynamic compensation following a mid-range abdominal shotgun injury; subsequently, he developed rapid respiratory deterioration and died. Post-mortem examination revealed a massive left-sided haemothorax caused not by direct thoracic injury, but by trans-diaphragmatic migration of blood from the abdominal cavity through multiple perforations of the left hemidiaphragm. This case highlights the forensic and clinical importance of the thoraco-abdominal transitional region, illustrating how seemingly localised abdominal trauma may cause fatal thoracic compromise. It further emphasises the potential for delayed and unexpected deterioration, as well as the medico-legal implications in interpreting such cases.</p>","PeriodicalId":35529,"journal":{"name":"Medico-Legal Journal","volume":" ","pages":"212-215"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148424884","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Editorial: Part 3: Consumer demand, regulatory gaps and medical harm, past and present: By Eleanor Jane Turner and Diana Brahams. 编辑：第3部分：消费者需求，监管缺口和医疗危害，过去和现在：埃莉诺·简·特纳和戴安娜·布拉姆斯。
Medico-Legal Journal Pub Date : 2026-09-01 Epub Date: 2026-10-07 DOI: 10.1177/00258172261478623
Eleanor Jane Turner, Diana Brahams
{"title":"Editorial: Part 3: Consumer demand, regulatory gaps and medical harm, past and present: By Eleanor Jane Turner and Diana Brahams.","authors":"Eleanor Jane Turner, Diana Brahams","doi":"10.1177/00258172261478623","DOIUrl":"https://doi.org/10.1177/00258172261478623","url":null,"abstract":"","PeriodicalId":35529,"journal":{"name":"Medico-Legal Journal","volume":"94 3","pages":"135-137"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149128719","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Acute traumatic spinal cord injury. Consent is a new cause of action. 急性创伤性脊髓损伤。同意是一种新的诉因。
Medico-Legal Journal Pub Date : 2026-08-18 DOI: 10.1177/00258172261455440
Nicholas Todd
{"title":"Acute traumatic spinal cord injury. Consent is a new cause of action.","authors":"Nicholas Todd","doi":"10.1177/00258172261455440","DOIUrl":"https://doi.org/10.1177/00258172261455440","url":null,"abstract":"<p><p>There are two management strategies for the early management of acute traumatic spinal cord injury (SCI); 10-12 weeks bed-rest or rapid mobilisation (typically following surgery to stabilise an unstable spinal column injury). A recent review has demonstrated poor outcomes with rapid mobilisation with up to 13.2% deteriorating neurologically (0% in one of the conservative series) and 24%-33% of cases failing to improve to walking (compared with the conservative cases). The Montgomery and McCulloch SC judgements mandate that the benefits, risks and alternatives to any proposed treatment are discussed with patients. Previously there was no duty of care to explain the risks and alternatives to rapid mobilisation. There is no decided case but in the light of current knowledge the inferiority of rapid mobilisation, and the alternative of conservative treatment with better outcomes should be explained to patients. A failure to do so could be negligent in respect of consent for treatment.</p>","PeriodicalId":35529,"journal":{"name":"Medico-Legal Journal","volume":" ","pages":"258172261455440"},"PeriodicalIF":0.0,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148798837","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
When the 'dead' are still alive: Systemic failures in assessing neonates in Nepal. 当“死者”还活着：尼泊尔评估新生儿的系统性失败。
Medico-Legal Journal Pub Date : 2026-07-10 DOI: 10.1177/00258172261442702
Samata Nepal, Alok Atreya, Layasha Tuladhar, Ritesh G Menezes, Sharmila Gurung
{"title":"When the 'dead' are still alive: Systemic failures in assessing neonates in Nepal.","authors":"Samata Nepal, Alok Atreya, Layasha Tuladhar, Ritesh G Menezes, Sharmila Gurung","doi":"10.1177/00258172261442702","DOIUrl":"https://doi.org/10.1177/00258172261442702","url":null,"abstract":"<p><p>Wrongful declaration of death in premature newborns continues in Nepal notwithstanding modern medical advances. We describe four cases of neonates who were wrongly declared dead and later found to be alive. This report aims to analyse the systemic failures that contributed to these outcomes which were identified over 6 years (2019-2025) through 'grey' literature. All these premature neonates were found alive hours later, some when enroute to cremation or burial. These cases highlight minimal or absent vital signs assessment before declaration of death was wrongly made and was shockingly negligent and a breach of the duty of care owed to the baby. In one case, death was declared by a nurse rather than a doctor in breach of minimum WHO standards and raises profound ethical and legal issues.</p>","PeriodicalId":35529,"journal":{"name":"Medico-Legal Journal","volume":" ","pages":"258172261442702"},"PeriodicalIF":0.0,"publicationDate":"2026-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148424811","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Absconding from hospital by mental patients. 精神病人从医院潜逃。
Medico-Legal Journal Pub Date : 2026-06-01 Epub Date: 2026-02-28 DOI: 10.1177/00258172251414244
Benjamin Andoh
{"title":"Absconding from hospital by mental patients.","authors":"Benjamin Andoh","doi":"10.1177/00258172251414244","DOIUrl":"10.1177/00258172251414244","url":null,"abstract":"<p><p>This paper reviews and comments on the recent case of Ellame Ford-Dunn, who caused her own death after being allowed to abscond from hospital. It then discusses some important issues relating to the case and makes some helpful suggestions that will help prevent or reduce the incidence of absconding from hospitals, especially, where compulsorily detained patients are concerned. This paper shows the need for effective measures to be taken to prevent mental patients from absconding from hospital because absconding can result in serious consequences for the absconder, etc. The paper has the following parts: (a) facts and decision, (b) the meaning of absconding, (c) consequences of absconding from hospital, (d) the civil law ramifications of the University Hospitals Sussex NHS Trust's defective policy regarding absconders and consequent breach of duty under the Health and Social Care Act 2008 and (e) recommendations.</p>","PeriodicalId":35529,"journal":{"name":"Medico-Legal Journal","volume":" ","pages":"81-83"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147322339","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Acute subdural haematoma in sudden infant death: diagnostic challenges in a low-resource setting; non-accidental injury, post-mortem or resuscitation artefact? 婴儿猝死的急性硬膜下血肿：低资源环境下的诊断挑战非意外伤害，死后还是复苏的人工制品？
Medico-Legal Journal Pub Date : 2026-06-01 Epub Date: 2025-12-26 DOI: 10.1177/00258172251401694
Paranavidana Roshel Claude Wijenayaka, Usliyanage Clifford Priyantha Perera, Pradeep Rohan Ruwanpura
{"title":"Acute subdural haematoma in sudden infant death: diagnostic challenges in a low-resource setting; non-accidental injury, post-mortem or resuscitation artefact?","authors":"Paranavidana Roshel Claude Wijenayaka, Usliyanage Clifford Priyantha Perera, Pradeep Rohan Ruwanpura","doi":"10.1177/00258172251401694","DOIUrl":"10.1177/00258172251401694","url":null,"abstract":"<p><p>Acute subdural haemorrhage in sudden infant death (SID) presents a forensic challenge, particularly in resource-limited settings, where distinguishing true injury from resuscitation or post-mortem artefacts is difficult. We report a case of a previously healthy 2-month-old male infant found unresponsive shortly after being placed prone following breastfeeding. Despite prolonged resuscitation, the infant died. Autopsy revealed faint anterior chest contusions consistent with resuscitation and bilateral acute subdural haemorrhages without skull fractures, retinal haemorrhages or cerebral oedema. Histology confirmed acute subdural and subarachnoid haemorrhages without chronic changes, and toxicology was negative. Scene investigation identified no risk factors for trauma or accidental suffocation. The findings suggest the haemorrhages probably resulted from peri-mortem hypoxic vascular injury or resuscitation artefacts, emphasising the importance of integrating clinical history, autopsy, histology and scene information to avoid misinterpretation of subdural haemorrhages in cases of SID.</p>","PeriodicalId":35529,"journal":{"name":"Medico-Legal Journal","volume":" ","pages":"124-127"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145834119","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
A hypothalamus centred pathogenesis of heat stroke deaths - A postmortem-based human study. 以下丘脑为中心的中暑死亡发病机制——一项基于尸体的人类研究。
Medico-Legal Journal Pub Date : 2026-06-01 Epub Date: 2026-04-08 DOI: 10.1177/00258172251410688
Ashok Kumar Rastogi, Ashutosh Kumar, Shreekant Bharti, Sanjeev Kumar Paikra, Ashok Kumar Datusalia, Amit Maruti Patil, Rajesh Kumar
{"title":"A hypothalamus centred pathogenesis of heat stroke deaths - A postmortem-based human study.","authors":"Ashok Kumar Rastogi, Ashutosh Kumar, Shreekant Bharti, Sanjeev Kumar Paikra, Ashok Kumar Datusalia, Amit Maruti Patil, Rajesh Kumar","doi":"10.1177/00258172251410688","DOIUrl":"10.1177/00258172251410688","url":null,"abstract":"<p><p>Heat stroke deaths are increasing during the summer in tropical countries but the pathogenesis mechanisms are not well established. Postmortem-based human studies in heat stroke cases are few in the literature, which makes post mortem forensic determination of the cause of death extremely difficult. We consider four cases (three male and one female, age range: 40-60 years) who were brought to the mortuary for forensic determination of the cause of death. Autopsy followed standard protocol and gross observations were made. Visceral tissue samples taken for histological staining and microscopic examination. Our observations indicated that the anterior hypothalamus may have a commanding role in the pathogenesis of heat stroke. Acute haemorrhage in the preoptic area of the anterior hypothalamus associated with microvascular injury and acute necrotic lesions of key organs involved in the hemodynamic circulation and temperature control, primarily the heart, lung, kidney and liver should be considered in the forensic determination of the cause of death in such cases.</p>","PeriodicalId":35529,"journal":{"name":"Medico-Legal Journal","volume":" ","pages":"84-89"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147634566","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Frenular tear as a sign of non-penetrative sexual assault in a male child: Case report with medicolegal implications. 系带撕裂作为男性儿童非插入性侵犯的标志：具有医学法律意义的病例报告。
Medico-Legal Journal Pub Date : 2026-06-01 Epub Date: 2025-11-18 DOI: 10.1177/00258172251362990
Vikas Meshram, Mohammed Akbar, Rahul Saxena, Tanuj Kanchan
{"title":"Frenular tear as a sign of non-penetrative sexual assault in a male child: Case report with medicolegal implications.","authors":"Vikas Meshram, Mohammed Akbar, Rahul Saxena, Tanuj Kanchan","doi":"10.1177/00258172251362990","DOIUrl":"10.1177/00258172251362990","url":null,"abstract":"<p><p>Child sexual abuse (CSA) is a very serious issue. In India, The Protection of Children from Sexual Offences (POCSO) Act 2012 introduced stringent laws and severe punishments to deter such offences. Notwithstanding, child sexual abuse continues, with many cases going unreported due to societal stigma, fear and lack of awareness. Girls are the most common victims, but boys, whose cases are less frequently reported, may also be victims. Social taboos surrounding sexual abuse of boys contributes to its underreporting. This abuse typically comprises either penetrative or non-penetrative sex acts, primarily resulting in penile and anal injuries, in addition to other extragenital injuries. We report the case of a 7-year-old boy who was brought to the emergency department with active penile bleeding. Investigation revealed sexual abuse perpetrated by his father's co-worker. Examination revealed a penile frenular tear with haematoma, indicative of inflicted trauma. This case highlights the forensic significance of penile frenular tears in non-penetrative abuse in male children, distinguishing them from self-inflicted or accidental injuries. It underscores the medico-legal challenges, injury patterns, mechanisms and circumstances involved, emphasising the need for prompt evaluation, legal enforcement and awareness to protect children and ensure justice.</p>","PeriodicalId":35529,"journal":{"name":"Medico-Legal Journal","volume":" ","pages":"121-123"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145551204","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Neglected emergency: Autopsy case report on fatal delirium tremens. 被忽视的紧急情况：致死性震颤性谵妄尸检病例报告。
Medico-Legal Journal Pub Date : 2026-06-01 Epub Date: 2026-03-01 DOI: 10.1177/00258172261419305
Shrihari Siddhardhan, Alagarasan Naveen, Sowmiya Punniyakodi, Sanjay Sriram S
{"title":"Neglected emergency: Autopsy case report on fatal delirium tremens.","authors":"Shrihari Siddhardhan, Alagarasan Naveen, Sowmiya Punniyakodi, Sanjay Sriram S","doi":"10.1177/00258172261419305","DOIUrl":"10.1177/00258172261419305","url":null,"abstract":"<p><p>Delirium tremens (DT) is one of the most severe and potentially fatal manifestations of alcohol withdrawal syndrome most often found in individuals with a history of prolonged and heavy alcohol use who suddenly stop. Without prompt intervention, DT may lead to life-threatening complications such as seizures, cardiovascular collapse and autonomic dysfunctions. The importance of understanding DT extends beyond its acute neurological and psychiatric symptoms. From a forensic perspective, autopsy findings can reveal a cascade of underlying physiological derangements. We present an autopsy case report that illustrates the clinical and pathological features of DT, emphasising its rapid progression and the critical need for multidisciplinary intervention.</p>","PeriodicalId":35529,"journal":{"name":"Medico-Legal Journal","volume":" ","pages":"128-132"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147322304","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Histopathological hallmarks of rabies: A case report from the autopsy table. 狂犬病的组织病理学特征：来自尸检台的一例报告。
Medico-Legal Journal Pub Date : 2026-06-01 Epub Date: 2025-11-18 DOI: 10.1177/00258172251365044
V J Jishnu, Harshal R Thube, Manish Shrigiriwar
{"title":"Histopathological hallmarks of rabies: A case report from the autopsy table.","authors":"V J Jishnu, Harshal R Thube, Manish Shrigiriwar","doi":"10.1177/00258172251365044","DOIUrl":"10.1177/00258172251365044","url":null,"abstract":"<p><p>Rabies is a zoonotic disease that affects many mammals, including humans, through bites from infected animals. We report a necropsy of rabies in a male patient from a rural background and the vital role of forensic histopathology in confirming the diagnosis of rabies. A man was admitted with fever, altered sensorium, aggressive behaviour and unconsciousness. Two years earlier he had been scratched on the foot by a stray dog but had received no anti-rabies treatment. He died within 96 hours of symptom onset. Histopathological testing of the brain during necropsy showed the presence of Negri bodies and confirmed the diagnosis of rabies. Although the incubation period of rabies can vary widely, this was not a classic case of rabies infection with a normal incubation period. In rural settings, where molecular testing is difficult, appropriate testing and analysis of samples with histopathology can clarify the diagnosis.</p>","PeriodicalId":35529,"journal":{"name":"Medico-Legal Journal","volume":" ","pages":"117-120"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145551199","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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