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Am J Forensic Med Pathol 2022 Jun 14. Epub 2022 Jun 14.

From the Department of Pathology, Western Michigan University Homer Stryker School of Medicine, Kalamazoo, MI.

Abstract: Urushiol, the active antigen in poison ivy (Toxicodendron radicans), is frequently associated with type I and type III hypersensitivity reactions. These reactions most often result in cutaneous symptoms that vary in severity and may at times require medical interventions. Injuries involving other body systems associated with urushiol exposure are far less common. Read More

Am J Forensic Med Pathol 2022 Jun 14. Epub 2022 Jun 14.

From the Laboratorio di Istopatologia Forense e Microbiologia Medico Legale-Sezione di Medicina Legale e delle Assicurazioni-Dipartimento di Scienze Biomediche per la Salute-Università degli Studi di Milano Milano, Italy.

Abstract: Severe fungal infections caused by highly invasive fungi such as Aspergillus are not easy to diagnose and often have a poor prognosis. In these cases, the nonspecific symptoms may make clinical diagnosis challenging, and consequently, the autopsy and postmortem histological investigations acquire a crucial role. We report the case of a young man in good health who died of septic shock 3 weeks after having had a tongue piercing. Read More

Am J Forensic Med Pathol 2022 Jun 9. Epub 2022 Jun 9.

Department of Health Care Management and Economics, National Research University Higher School of Economics, Moscow, Russia.

Background: Russia suffers from high alcohol-related mortality. Most forensic autopsies in Russia include blood alcohol tests, but a systematic analysis of these data has never been conducted for children's deaths.

Methods: We performed an analysis of juvenile mortality using autopsy reports from the Moscow Region Bureau of Forensic Medical Examination from January 1, 2009, to December 31, 2018. Read More

Am J Forensic Med Pathol 2022 May 30. Epub 2022 May 30.

From the Department of Forensic Medicine, Charles Nicolle University Hospital, Rouen, France.

Introduction: Falls from height are a major cause of unintentional injury death, resulting in high disability and mortality. We investigated the characteristics of fatal falls and their relationship with intentionality, injury patterns, and death on impact.

Materials And Methods: In this retrospective study, we examined 545 cases of fatal falls from height that underwent autopsy in the forensic department of the Charles Nicolle hospital of Tunis (Tunisia) between January 2008 and December 2020. Read More

Am J Forensic Med Pathol 2022 May 30. Epub 2022 May 30.

Maricopa County Medical Examiner's Office, Phoenix, AZ.

Abstract: Relapsing polychondritis (RP) is a rare inflammatory disease process that affects cartilaginous tissues throughout the body. Although the pathogenesis remains unknown, RP is thought to be an autoimmune disorder in which host immune cells are conditioned to attack the body's cartilage, such as the ears, nose, eyes, joints, and airways, resulting in inflammation and destruction of otherwise healthy tissues. In rare and unusual cases, neurological involvement has been described. Read More

Am J Forensic Med Pathol 2022 May 30. Epub 2022 May 30.

Preclinical Education, Lake Erie College of Osteopathic Medicine, Erie, PA.

Abstract: Fractal wood burning is a new technique of pyrography that passes an electrical current through a piece of wood resulting in decorative electrical burns. This practice has become increasingly popular with many walk-through tutorials of the process found online. This includes videos of how to build homemade devices fashioned from disassembled microwave oven transformers. Read More

Am J Forensic Med Pathol 2022 May 31. Epub 2022 May 31.

From the Division of Legal Medicine, Department of Social Medicine, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan.

Abstract: We report a rare case of fatal exsanguination by a wakizashi, a Japanese short sword (shinken). A man in his 60s was found lying on his back on his bed. He was in cardiopulmonary arrest when the ambulance crew arrived and was pronounced dead on arrival at the hospital. Read More

Am J Forensic Med Pathol 2022 May 30. Epub 2022 May 30.

From the Department of Pathology, Wake Forest School of Medicine, Winston-Salem, NC.

Abstract: Sudden unexplained death in epilepsy (SUDEP) is the most common cause of death in children and young adults with epilepsy with epileptic patients harboring a 27 times increased risk of death from SUDEP. Structural brain lesions are encountered in up to 50% of autopsy cases. In this case series, we report 3 previously undiagnosed structural causes of SUDEP discovered at autopsy at our institution including schizencephaly, ganglioglioma, and focal cortical dysplasia. Read More

Am J Forensic Med Pathol 2022 May 30. Epub 2022 May 30.

From the Department of Pathology, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba.

Am J Forensic Med Pathol 2022 May 19. Epub 2022 May 19.

From the Forensic and Analytical Science Service, NSW Health Pathology, New South Wales, Lidcombe, Australia.

Abstract: Starvation is a rare cause of death in developed countries and is a complex multifaceted pathological process. To complicate the forensic investigation of starvation further, many medical conditions independent of starvation may cause wasting. This article provides one of the first comprehensive guides to the postmortem investigation of starvation in adults, with reference tables on organ-specific macroscopic and microscopic features, as well as features for excluding alternative causes of wasting. Read More

Am J Forensic Med Pathol 2022 May 19. Epub 2022 May 19.

From the Departments of Pathology.

Abstract: In laymen's terms, it can be difficult to communicate how much force is needed to create a stab wound into a person's chest. Previous work has determined the force to puncture the skin, rib cartilage, or bone but without putting the results in terms that are easy to understand.The purpose of this study was to determine the force needed to puncture 3 types of fruit using 3 different types of knives, namely, a steak knife, a butcher's knife, and a lock-blade knife, to help put these previous results in perspective. Read More

Am J Forensic Med Pathol 2022 May 12. Epub 2022 May 12.

Forensic Medicine and Clinical Toxicology Department, Faculty of Medicine, Cairo University.

Objective: The purpose of this study was to find a mathematical relation that would be able to determine the existence of brain edema with a certain degree of accuracy, away from the subjective impressions of each examiner.

Patients And Methods: The analyzed study sample consists of 100 brains that underwent forensic autopsy in the Egyptian Forensic Medicine Authority, Zagazig department, from January 2017 to June 2018. Measurements of morphometric parameters of the skull were used to determine the volume and diameters of the cranial cavity. Read More

Am J Forensic Med Pathol 2022 May 12. Epub 2022 May 12.

From the Office of Chief Medical Examiner, City of New York, New York, NY.

Abstract: Acute and chronic alcohol use is associated with injury, and autopsies may be performed to ascertain injury deaths in persons with acute or chronic alcohol use. This study sought to determine how many decedents with a history of acute or chronic alcohol use had an internal physical injury diagnosed only at autopsy that caused or contributed to the death. The study reviewed medicolegal investigation and autopsy reports at the New York City Office of Chief Medical Examiner between January 1 and October 11, 2018, to identify 1000 consecutive persons with suspected acute or chronic alcohol use who were autopsied to ascertain whether internal physical injury caused or contributed to the death. Read More

Am J Forensic Med Pathol 2022 Apr 14. Epub 2022 Apr 14.

Department of Pathology, Western Michigan University Homer Stryker MD School of Medicine, Kalamazoo, MI.

Abstract: While routine medical procedures often impose some level of risk for the patient, death after routine urologic care is rare. In this series, we present 2 cases in which a relatively healthy patient ultimately died after complications, one from a prostate biopsy and one from a total nephrectomy. In case 1, a 58-year-old male died due to a 1500-mL to 2000-mL left retroperitoneal hemorrhage that occurred during insertion of a central line for sepsis treatment that resulted from an infection after a transrectal prostate biopsy. Read More

Am J Forensic Med Pathol 2022 Mar 29. Epub 2022 Mar 29.

Abstract: Although there are multiple therapeutic uses for colchicine, it is particularly dangerous in the setting of overdose due to an irreversible mechanism of action combined with a narrow therapeutic window. Colchicine is an antimitotic agent that binds tubulin and inhibits microtubule polymerization. This produces a predictable sequence of toxicity beginning with gastrointestinal effects with progression to multiorgan system dysfunction. Read More

Am J Forensic Med Pathol 2022 Mar 29. Epub 2022 Mar 29.

District of Columbia Office of the Chief Medical Examiner, Washington, DC.

Abstract: Dark skin may obscure injuries. This is reflected in the illustrations in textbooks, which generally depict blunt force injuries in victims with light skin tones. We explored whether forensic pathologists can reliably recognize blunt force injuries in dark-toned skin by comparing the average number of contusions and abrasions of motor vehicle accident victims with dark- and light-toned skin. Read More

Am J Forensic Med Pathol 2022 Mar 28. Epub 2022 Mar 28.

School of Electrical and Information Engineering, University of the Witwatersrand, Johannesburg, South Africa.

Am J Forensic Med Pathol 2022 Mar 21. Epub 2022 Mar 21.

From the Department of Pathology and Laboratory Services, Madigan Army Medical Center, Tacoma, WA Hennepin County Medical Examiner's Office, Minneapolis, MN Armed Forces Medical Examiner System, Dover Air Force Base, DE.

Abstract: Autoerotic death is defined as an accidental death that occurs when some type of apparatus is used to enhance sexual stimulation and causes an unintended death. We present the case of an atypical autoerotic death of a 23-year-old man found deceased in a bathroom. An electrical cord with a standard wall plug on one end and exposed wires twisted into loops on the other end was on the floor near his body. Read More

Am J Forensic Med Pathol 2022 Mar 21. Epub 2022 Mar 21.

From the Department of Forensic Medicine, University of Pretoria Forensic Medicine, University of Pretoria School of Medicine, Pretoria, South Africa.

Am J Forensic Med Pathol 2022 Mar 4. Epub 2022 Mar 4.

From the Department of Pathology, Harris County Institute of Forensic Sciences Baylor Scott and White Health, Dallas, TX.

Abstract: Cavernous sinus thrombosis is a rare and often fatal condition, usually associated with infections in the head and neck region. Clinical presentation includes fever, headache, and periorbital swelling. Mortality can be high; however, prompt treatment can reduce the probability of death. Read More

Am J Forensic Med Pathol 2022 Jun 23;43(2):121-125. Epub 2022 Feb 23.

From the Department of Legal Medicine, Taher Sfar Teaching Hospital.

Abstract: In Tunisia, hydatid cyst is an endemic parasitic disease. The cyst may remain asymptomatic, discovered accidentally, or in case of a complication, the most serious of which is sudden death. We propose, in this article, to analyze the degree of involvement of the cyst in the mechanism of death, through the review of 25 cases. Read More

Am J Forensic Med Pathol 2022 Feb 23. Epub 2022 Feb 23.

From the Eastern Montana Crime Lab, Billings, MT Department of Pathology, University of North Dakota School of Medicine and Health Sciences, Grand Forks, ND.

Am J Forensic Med Pathol 2022 Feb 7. Epub 2022 Feb 7.

From the Class of 2023 Uniformed Services University, Bethesda, MD San Antonio Uniformed Services Health Education Consortium, San Antonio, TX Forensic Pathology Investigations, AFMES, Dover, DE Defense POW/MIA Accounting Agency (DPAA), Dover, DE.

Abstract: In a sudden death investigation of a service member with sickle cell trait (SCT), evidence of sickle cell crisis further complicated by coexisting, undiagnosed diabetic ketoacidosis called into question the synergistic effects of diabetic ketoacidosis on red blood cell sickling. Sickle cell trait affects more than 4 million people in the United States (US) with the highest prevalence in non-Hispanic Blacks (7%-9%; Mil Med 2017;182(3):e1819-e1824). The heterozygous state of sickled hemoglobin was previously considered a benign condition causing sickling during hypoxic, high-stress conditions such as exercise and high altitude (Am Assoc Clin Chem 2017). Read More

Am J Forensic Med Pathol 2022 Jun 4;43(2):101-104. Epub 2022 Feb 4.

Jack, Joseph and Morton Mandel School of Applied Social Sciences, Begun Center for Violence Prevention Research and Education, Case Western Reserve University, Cleveland, OH.

Abstract: The public health role of a medical examiner office (MEO) in a pandemic is largely undefined; however, death data may be useful in strategic planning. Deaths reportable to MEO are defined in statute, with discretion as to the assumption of jurisdiction. We analyzed the daily reported death numbers (DRDNs) in our jurisdiction from March 1, 2020, to March 31, 2021, and compared them with hospital admission and COVID-19 fatality data over the same period. Read More

Am J Forensic Med Pathol 2022 Mar;43(1):98-100

Office of the State Forensic Pathologist, Royal Hobart Hospital, Hobart, Tasmania, Australia.

Abstract: Bed poles are held in place by a frame that is inserted underneath a bed mattress and are designed to assist in moving an incumbent from a lying to an upright sitting position, or to help with turning, repositioning, or transferring. Two cases demonstrate, however, that lethal entrapment may be caused by such devices-a 76-year-old man and an 84-year-old woman were both found beside their beds hanging by their necks from bed poles. Gaps between bed poles and mattress/bed sides may provide potentially lethal confined spaces. Read More

Am J Forensic Med Pathol 2022 Mar;43(1):73-75

Institute of Legal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.

Abstract: Myocarditis can focally or diffusely involve the myocardium and is associated with arrhythmia, cardiac failure, and sudden death. The majority of cases of myocarditis are lymphocytic in etiology, and neutrophilic myocarditis is relatively uncommon. Although reported in lymphocytic myocarditis, isolated/focal neutrophilic myocarditis of the atrium causing death is not reported in the postmortem literature, and its postmortem computed tomography correlation is not documented. Read More

Am J Forensic Med Pathol 2022 Jun 28;43(2):105-109. Epub 2022 Jan 28.

From the Departments of Forensic Medicine.

Abstract: Polymerase chain reaction (PCR) is indispensable for diagnosing coronavirus disease 2019 (COVID-19) in autopsy cases. In this study, we performed comprehensive reverse transcription quantitative PCR (RT-qPCR) and rapid antigen tests for COVID-19 on forensic postmortem specimens, regardless of the antemortem symptoms and causes of death. Immediately before forensic external examination and autopsy, a wiping solution was collected from the nasopharynx with a dry swab, and rapid antigen testing and RT-qPCR were performed. Read More

Am J Forensic Med Pathol 2022 Jan 28. Epub 2022 Jan 28.

From the Maryland Office of the Chief Medical Examiner, Baltimore, MD.

Abstract: A 1989 state law in Maryland allows family members to contest cause and manner of death determinations of medical examiners. A previous article described the experience with this law involving 12 appeals over a 3-year period (2012-2015). We now update the experience with the law involving 10 appeals that occurred over a subsequent period (2015 to September 2021) and a resultant change in the law. Read More