Biomedical subjects

B Madea

Publications and source records attributed to B Madea.

At least 127 records · Page 7Linked to original sources

PubMedDate not supplied

[Sudden death after release from police detention].

3 fatalities shortly after discharge from police custody are reported. Case 1: A 55-year old alcoholic was discharged from police custody after taking a blood sample under violent conditions and found dead in his flat 2 days later. Cause of death: arrhythmia due to acute coronary insufficiency or alcoholic cardiomyopathy. Case 2: A 27-year-old alcoholic was met highly intoxicated twice in the course of one day, was put in the family's care and was found dead the next morning. Cause of death: alcohol/drug intoxication with agonal aspiration. Case 3: A 32-year-old man known to be prone to seizures and to become aggressive under the influence of alcohol was left by the police in medical care confined to a litter in a "hog-tied" fashion with the help of 3 belts. Cause of death: cerebral hypoxia after respiratory and cardiac arrest of unknown reason. A causal relationship with positional restraint is discussed. The cases reported underline the duty of the police to examine prior to discharge from custody with the appropriate lot of care whether the person held in custody has recovered from the helpless state due to disease, injury or intoxication or if medical treatment is required.

Adult↗

PubMedDate not supplied

[Fatal child neglect in West Germany 1 January 1985 to 2 October 1990. Results of a multicenter study].

UNLABELLED: Up to now reliable data were available on cases of lethal child neglect in the area of the Federal Republic of Germany prior to reunification (the former West Germany). In a multicenter study we therefore examined the police and court records for such cases occurring in the period from 1 January 1985 to 2 October 1990 in nearly the entire area of Federal Republic of Germany. RESULTS: The study center received information on 19 cases of lethal child neglect. Extrapolated to all institutes of legal medicine, this corresponds to 20 cases and thus 3.5 cases a year in the whole of West Germany in the period studied. There is to be added a dark-field which cannot be limited more precisely. However, the cases of fatal child neglect might have occurred much more seldom than fatal child abuse caused by use of physical violence. Slightly more than half the victims were younger than 1 year, the oldest one was 7 10/12 years old. Most frequently the children died of starvation and thirst. Mostly the mothers/nursing mothers killed the child alone or together with the victim's father/stepfather. In the majority of the cases there was not a close affection between parents and child. Nearly 30% female/male perpetrators suffered from chronic alcohol abuse. Only 15 (= 56%) of 27 female/male perpetrators were sentenced to imprisonment (period between 7 months on probation and 10 years). Mitigation circumstances existed for nearly half the persons sentenced to imprisonment. It is true that child neglect is a rarer crime, but the experts of legal medicine always have to indicate errors made during the external inspection of the corpse (among others failures to see indications of neglect).

Cause of Death↗

PubMedDate not supplied

[Toxicologic findings in suicide with doxepin and paroxetine].

A young nurse was found dead in her flat. In chemical-toxicological analysis the following femoral blood drug concentrations were determined: paroxetine 0.176 mg/l, doxepine 82.12 mg/l, desmethyldoxepine 0.34 mg/l. Additionally the drug concentrations were determined in various body fluids and organs. The results of the described fatality are discussed. For interpretation of toxicologic results in antidepressant fatalities ratios of parent drug to metabolite and postmortem drug redistribution should be taken into account.

Adult↗

PubMedDate not supplied

[Victim-related aspects of homicide of elderly persons in the catchment area of the Bonn Forensic Medicine Institute].

The present study examines the circumstances of 19 homicides involving 10 males and 9 females 60 years of age or older, which were submitted to the Bonn Institute of Forensic Medicine for autopsy. The incidence of these homicides sharply decreased by age. The causes of death were blunt force injuries alone or in combination in 8 cases and strangulation in 5 cases, thus reflecting the importance of the direct physical assault. Defense wounds were found in only 6 cases. The deceased unexceptionally suffered from diseases of the cardiovascular or respiratory system. Robbery or family/partner conflicts accounted for the vast majority of motives. Both, the most common location for homicide being in the victim's own residence and the high proportion of neighbours, acquaintances and relatives among the assailants underline that violence in the close social context endanger the elderly more than conventional violent street crimes. In the victims of homicide the elderly were represented in a smaller proportion than their percentage in the population at large. Over the 8 years of the present study there was no increasing tendency in the homicide rate in the elderly population.

Aged↗

PubMedDate not supplied

[Occupation-related aspects of homicidal acts].

Several homicides characterized by peculiarities related to the occupation of the perpetrator are reported and compared with observations from literature. Common characteristics of the cases are determined by the following factors: availability of the equipment (i.e. drugs, poisons, tools) and application of special knowledge, skills or techniques provided by professional education (i.e. pharmacology, injection and dissection techniques in physicians and related professions, use of extraordinary, self-constructed weapons by technicians). Remarkable features of some cases are the long period of meticulous preparation and professional attempts to abolish or disguise suspicious findings. Thus, these homicides often present with uncommon modes of commitment and unusual forensic findings which are difficult to recognize and assess. Supplementing own experience by the cases reported in literature is an indispensable prerequisite to examine these cases properly and to provide professional and competent expert opinion for the police authorities.

Adult↗

PubMedDate not supplied

[An unusual case of self-harm with petroleum distillate].

After surgical treatment of an inguinal hernia, a 26-year-old male was discharged from hospital with a well healing surgical wound. Four weeks later he was admitted again with a major localized painful swelling of the soft tissues, whereas the clinical examination revealed no further local or systemic signs of inflammation. The immediate operation disclosed no abscess formation, but a large colliquation necrosis of the subcutaneous tissue with an outstanding petroleum-like odour. On toxicological examination of the necrotic tissue, a respective petroleum distillate was found. The patient was confronted with the suspicion of having injected the petroleum preparation himself to prolong the wound healing and finally admitted the self-mutilating behaviour. The pathophysiology, clinical history and morphological findings are discussed in comparison with case reports of chemically induced self-mutilation.

Adult↗

PubMedDate not supplied

[Cadaver dismemberment by chain saw].

It is reported about the dismembering of a 57-years-old man by means of a chain saw, allegedly without participation in the very assault. The victim died after heavy violence to this throat and bleeding from stab wounds. Afterwards his trunk was divided horizontally, his thorax, skull and upper arm were sewn into without cutting through. The closer circumstances of the crime and localization of the saw injuries lead to the assumption of a participation in the assault. Technical details of chain saws and typical findings as to injuries are described.

Alcoholism↗

PubMedDate not supplied

[Differentiation between self-inflicted and homicidal stab wounds to the neck].

39 autopsy cases with throat incision examined in the Bonn Institute of Legal Medicine in the years 1990 through 1998 were evaluated with respect to the query whether the morphological criteria generally established for the differentiation between homicide and suicide are also suitable for the assessment in this special localization. Integrative consideration of localization, direction of incision, hesitative resp. tentative injuries, defence injuries, concomitant injuries and capability to act allowed for a discrimination on grounds of legal medical findings in 84 per cent of the cases.

Adolescent↗

PubMedDate not supplied

[Forensic medicine experiences in cremation autopsy in Bonn].

2016 coroner's crematorial inquests of the Bonn Institute of Legal Medicine over a 3 years' period were evaluated and the statements in the death certificates were compared to those ones of the Statistical Country Office of Northrhine-Westphalia. No significant differences were found with respect to age, gender and reason of death. However, the number of insufficiently classified deaths with respect to the reason of death were overrepresented especially in cases of older women, while the number of unnatural deaths was generally underrepresented. According to legal medical criteria 2 1/4 per cent of the deaths were falsely classified as natural. Only in 2 cases an autopsy was accomplished. Other author's statements on the validity of death certificates were confirmed.

Adult↗

PubMedDate not supplied

[Homicide by burning].

Compared to the total number of deaths by heat (burning, scalding), homicides by the direct effect of thermal energy (setting the victim on fire, pouring hot liquids over them) are rare; accordingly this subject is seldom dealt with in forensic and criminological literature. From our own autopsy material three cases are presented describing some peculiarities of homicide by heat. Sometimes additional findings (e.g., residual traces of gagging or tying) primarily point in the direction of homicide.

Adult↗

PubMedDate not supplied

[Unusual carbon monoxide poisoning].

Despite of indicative death scenes or characteristic findings of the external examination, about 40% of the accidental fatal intoxications due to carbon monoxide are not recognized before the performance of the autopsy. Six cases are reported which illustrate possible reasons for the delayed establishment of the diagnosis: unusual circumstances of the intoxication or sources of carbon monoxide, only subtle degree or lack of external signs of the intoxication or a competing cause of death at autopsy.--Cases 1 and 2: 53, respectively 54-year-old couple, found dead in a caravan, extreme putrefaction of the bodies, spectrophotometric detection of the fatal carboxyhaemoglobin level in oedema fluid of the scalp.--Case 3: 23-year-old lorry driver, found dead in the tightly closed cab of his lorry, operation of a source of electricity with "environmentally friendly" fuel, carboxyhaemoglobin level 83%.--Case 4: 19-year-old man, found dead in the flat of friends, removal of the CO-source before alerting the police forces, lack of the bright pink coloration of livor mortis, haemopericardium due to atrial rupture at postmortem examination, carboxyhaemoglobin level 65%.--Case 5: 27-year-old man, found dead in his flat, advanced decomposition of the body, residues of a charcoal fire in a metal bucket in the sink, carboxyhaemoglobin level 80%.--Case 6: 42-year-old woman, lying dead in the garage beside her car, engine switched-off, ignition key next to the body on the floor under the car, carboxyhaemoglobin level 46%.

Accidents↗

PubMedDate not supplied

[Simulation of homicide to hide child's suicide].

A case of pretending a homicide to conceal a child suicide is reported in which characteristic findings of the postmortem examination and conclusions from the analysis of forensic autopsy series provided substantial support for the police investigation. In the late night hours of a spring day the police authorities were informed that a 10-year-old girl had been found dead on a playground near its parents' house. As injuries of the neck were recognized by the police officers a homicide investigation was initiated. The post mortem examination showed a furrow symmetrically slanting from the front to the nape of the neck, discrete punctate haemorrhages of the skin of the face and numerous 'tram-line' bruises of the back, buttocks and extremities. These findings indicated as cause and manner of death suicidal hanging following corporal punishment. Confronted with these conclusions the mother immediately made a corresponding confession.

Autopsy↗

PubMedDate not supplied

[Site of injuries in falls on staircases].

52 autopsy cases in combination with falls on staircases examined in the Bonn Institute of Legal Medicine in 1992 to 2000 were evaluated with respect to the query whether the morphological criteria were valid for reconstruction of the fall, in what way facial injuries were involved and whether isolated trunk injuries caused the death. In 80 per cent of all cases the localization of impact on skull and trunk could be deliminated in regards to heaviness of injuries with fractures and involvement of inner organs. Facial injuries were noticed in 50 per cent and were--as well as arm and leg injuries--caused by strike in fall or after impact. In only two cases in consequence of falls on staircases trauma of the trunk led to death by bleeding.

Accidental Falls↗

PubMedDate not supplied

[Evidence for use of electroshock devices].

The authors tested whether use of an electro shock weapon (stun gun) leaves marks on skin which can be found in an exterior examination. On pig skin such marks could not be produced postmortally. An experiment on one of the authors caused reddish skin marks which persisted for about 2 h. Inability to act as promised by the weapons' manufacturers did not occur in our experiments, exactly as previously described by other authors. Use of an air tester which shoots barbed electrodes ought to produce bleedings if the electrodes actually penetrate the skin.

Animals↗

PubMedDate not supplied

[Forensically relevant unexpected delivery after unrecognized or denied pregnancy].

The authors report on two cases of supposed unknown pregnancy, in which the newborns were found dead in the lavatory by the emergency physician. Besides the classical questions of newborn's autopsies concerning vitality, viability and cause of death, position was to be stated towards the probability of an unexpected birth. In the first case the mother's statement of not having been aware of her pregnancy was plausible considering the general circumstances such as corpulence, continued bleedings and intact family situation; autopsy proved a (rare) twin stillbirth as a result of fetal hypoxaemia caused by grave placental dysfunction and misinsertion of the umbilical cord. Contrary to this, in the second case, a live birth, a denial of pregnancy was more likely to be assumed due to misinterpretation of typical symptoms of pregnancy in combination with professional and private stress.

Autopsy↗

PubMedDate not supplied

[Medical and legal problems of multiple death certificates].

In cases of unnatural death and unclear manner of death the police has according to section 159 StPO to inform the prosecution. The prosecutor has to decide how the case shall be handled. Independent inquiries or even independent handling of the case by the police are not scheduled. For legal purposes it is not possible to induce another doctor to issue another death certificate with the manner of death certified as natural.

Cause of Death↗

PubMedDate not supplied

[Child neglect death of an infant by faulty nutrition].

A 3 month old child was treated in hospital for "toxikosis and prolonged gastroenteritis". The child required a special diet. The parents picked up the child in hospital and brought it home against the device of the doctors. 26 hours later the child had died of severe exsikkosis (loss of 17% of body weight within one day). Using immunological methods (Ouchterlony test) we were able to demonstrate the child was fed with contraindicated food although the doctors had pointed out that the child needs a special diet. The parents were sentenced at court in two instances for manslaughter.

Cause of Death↗

PubMedDate not supplied

[Duration of the fire and degree of charring of a burned cadaver].

A 37-year-old woman was found dead severely charred in the bedroom of her house. The autopsy revealed as cause of death a strangulation of the neck. On the basis of the decomposition of the body the experts were asked for a statement on the duration of burning. There seems to be only little medicolegal experience on the duration of burning to a defined state of decomposition. Based on observations during cremations published in the literature and experimental burnings a burning time of approximately 20 minutes (after temperatures of more than 700 degrees C had been reached) is supposed to be sufficient to produce the present state of the body.

Adult↗