Biomedical subjects

B Brinkmann

Publications and source records attributed to B Brinkmann.

366 records · Page 21Linked to original sources

PubMedDate not supplied

[Homicides without clues in children].

From 1990 to 1995, 274 deaths of infants (age range 7 days-6 years) were investigated in Münster, where there were no indications of suspicious circumstances. In 167 cases a legal autopsy was carried out and revealed 5 homicides. In 107 cases where an autopsy was not ordered by the prosecutor 3 homicides were discovered. A similar frequency of homicides in both groups indicates that the criteria used to form the basis of a decision by the prosecutor to release the body are insufficient. On average one out of 30 cases was found to be a homicide as the result of the autopsy where the initial assumption was death from natural causes.

Autopsy↗

PubMedDate not supplied

[Errors in autopsy in Germany. Results of a multicenter study (II)].

In the result of a workshop held in Münster on 1st May 1993, 23 institutes of legal medicine in Germany reported death cases where the primary supposition was natural death or a death without legal relevance, but where the autopsies by chance revealed an unnatural death or a death with legal relevance. In the institutes participating in the study 13,000 autopsies were performed during the period of the reports, i.e. 75% of all legal autopsies performed in one year in Germany. A total of 92 "discoveries by chance" were reported where a natural death was given on the death certificate after the external examination of the corpse among them 49 accidents, 10 homicides, and 19 deaths by medical implications. In 717 deaths the manner of death was certified as "unclear" on the death certificate, but the autopsy revealed an unnatural manner of death. Some of these cases are also "discoveries by chance" after serious medical errors during the examination of corpses. Among these 717 cases were 35 homicides. It seems remarkable, that the prosecutors did not order a toxicological examination in several cases of fatal intoxications. Furthermore the results show that doctors often overlooked signs of carbon monoxide poisoning during the external examination of corpses. From errors made during the external examination another group of cases resulted which were initial classified as unnatural death without legal relevance, but the autopsy surprisingly revealed relevant facts. Finally in 29 autopsies carried out after exhumation evidence of homicide was found in 3 cases. On the basis of this multicentre study it can be estimated that there are at least 1200 homicide cases or 11,000 cases of unnatural death per year which do not appear in the official statistics and have been classified as natural death. The considerable grey area of fatal cases in connection with medical intervention resulting from the study (n > 2000) is also alarming. In addition at least 100 undiscovered homicides are certainly included in the group of death cases certified as unclear during the external examination and where no autopsy was performed. Sources of the grey area are essentially errors made during the external examination of corpses and to a lesser degree incorrect decisions to release the corpse, mistakes were seldom made also by doctors performing the autopsy. The study shows a considerable grey area of unnatural death cases, which exists within the modern society of Germany. In face of this emphasis must placed on the historical demands of criminologists and forensic pathologists: reinforced education and further education of medical students and doctors in the field of the external examination of corpses. Introduction of a specialized medical external examination of corpses Adherence to the 3 classical classifications of the manner of death: natural, unnatural and unclear on the death certificate. Increased number of autopsies.

Accidents↗

PubMedDate not supplied

[Retained capacity for action in brain gunshot injury. Case report and systematic examination].

A case of physical activity following a suicidal gunshot to the head including perforation of the left frontal lobe from a .22 rimfire rifle is reported. Subsequently, the man was able to walk a distance of more than 100 m and to reload manually. The special wound ballistic features of the head leading to increased intracranial projectile effects are discussed and the morphological changes such as cortical contusion zones, intracerebral hemorrhages or indirect skull fractures are explained. The analysis of 38 cases of head shots followed by physical activity reveals that injury to certain CNS-areas or the use of centre fire rifles and large handguns usually excludes a potential for subsequent physical activity. But physical activity is possible if the trajectory is restricted to the frontal brain or one temporal lobe only and if a projectile of low wounding potential has been used for this gunshot.

Brain↗

PubMedDate not supplied

[White blood stains?].

Following to bullet wounds of the upper maxillary region and of the lungs great quantities of blood were expectorated by the victim soiling the clothes of the perpetrator. (These cloth consisted of a mixture of wool and synthetic fibers producing a rough surface.) The suit was washed out in cold water and dried. The only macroscopic findings were intensively stained white to grey spots missing any brown or red color portion. These were identified to consist of fibrin. Extensive examination proved the existence of blood spots of group A. Experimental stains applied to the same cloth showed identical changes after washing out.

ABO Blood-Group System↗

PubMedDate not supplied

[Autopsy before cremation--formality without efficacy?].

A multicentre study involving 36 out of 38 German medico-legal Institutes discovered 784 non-natural fatalities among 78,000 external examinations before cremation (1%) in 1995. These included 169 accidents, 16 suicides, 3 homicides and 589 deaths in connection with medical treatment. In the remaining 7 cases, a belated differentiation between homicide and accident was not successful. A linear projection results in 1980 non-natural fatalities among all 197,000 external examinations before cremation. This number includes 8 homicides but due to considerable inhomogeneities, a number of 40 homicides appears to be realistic. Consequently, abolishing the mandatory external examination before cremation would be equivalent to an official renouncement of solving relevant non-natural deaths. In case of a thorough external examination, a total of 18,000 non-natural fatalities including approximately 180 homicides could be detected per year during the first external examinations (n = 885,000).

Autopsy↗

PubMedDate not supplied

[Exhumation and no end. A comparative analysis].

If the order to carry out an autopsy has been neglected, exhumation is the only possibility to obtain findings which allow conclusions on the manner of death, cause of death and chain of events. The quality of findings will however be influenced by advanced states of putrifaction. In spite of identical legislature the number of exhumations carried out at the institutes of legal medicine in München and Münster differs considerably, as demonstrated by a comparison of the data from the years 1993-1996. As previously described by other authors, there is a reciprocal correlation between the number of autopsies and the exhumation rate. The frequency of autopsies which are ordered can be explained by the varying application of the statutory framework by the investigation procedure. In some cases where an exhumation has been carried out, it was difficult to comprehend why an autopsy was not originally ordered.

Autopsy↗