Biomedical subjects
Publications and source records attributed to M L Taff.
A conceptual approach is presented herein to assist forensic pathologists in their courtroom explanation of asphyxial deaths due to strangulation. Two-dimensional visual aids have been designed for jurors to understand easily the anatomic structures of the neck, the classic external features of asphyxia, and the directionality of force applied to the neck, as well as internal neck injuries associated with various forces.
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Thousands of barium enemas are performed in the United States each year without incident. Occasionally complications arise, only a few of which are fatal. Perforation is the most frequent serious complication of this procedure. Two instances of fatal perforation, one colonic and the other vaginal, are described, and the relevant literature is reviewed.
The upper torso of a man was discovered under a highway sign next to tire tread marks leading from the highway and continuing beyond the sign. The victim's lower torso and automobile were also found along the same path 31 m (101 ft) and 41 m (133 ft) beyond the sign, respectively. The decedent was initially thought to be a disposed, homicide victim who had been dismembered by his assailant(s). Accident reconstruction revealed that the victim was the driver of the automobile and was transected by the highway sign stanchion as he protruded through the passenger side window of his moving vehicle. Based on the scene findings, autopsy, and psychological autopsy, the manner of death was classified as suicidal. The criteria used by medical examiners for vehicular suicide are also discussed.
Superior pancreaticoduodenal artery aneurysms are rare; their rupture often leads to sudden death. We report a case of a 59-year-old hypertensive man who died of a massive retroperitoneal hemorrhage following rupture of an aneurysm of the superior pancreaticoduodenal artery. We also discuss this unusual vascular lesion and review the pertinent literature.
Two hundred seventy-five United States coins were discovered in the stomach of a mentally disturbed individual at autopsy. Many coins containing copper were corroded by prolonged contact with gastric juice, with subsequent absorption and deposition of copper in the liver and kidneys. The patient died from complications related to the acute toxic phase of chronic copper poisoning. A discussion of the case, foreign-body ingestion, gastric bezoars and the mechanism of copper toxicity is presented. To our knowledge, this is the first death due to copper intoxication following a massive ingestion of coins.
This article describes an unusual rectal foreign body resulting from homosexual anal erotic activities. The patient had used an enema containing a concrete mix which became impacted and required surgical removal. The use, abuse, and complications of enemas are reviewed.
A case of a harness racing accident in which the driver died of head injuries is presented. To evaluate the victim's head injury and corresponding helmet damage, a videotape of the race was reviewed and analyzed. Based on calculations of a simplified trajectory analysis and testing of the helmet, it was determined that the helmet design did not provide adequate protection for the victim. The standards for harness helmet design are being re-evaluated by the harness racing industry to ensure the safety of the drivers. A review of 178 harness racing injuries and deaths, current harness helmet research, and recommendations for safer helmets are discussed. A protocol for the forensic investigation of sports-related injuries and/or deaths is also presented to assist medical examiners in fulfilling their roles as practitioners of preventive medicine.
Scald burns are the most common type of thermal injury in child abuse. Death associated with nonaccidental burns, however, is uncommon. We recently investigated the case of a 4-year-old child who died from extensive body burns due to scalding. A contributory cause of death was isopropyl alcohol intoxication resulting from application of this chemical to the burns.
Two adults experienced syncopal episodes before dying suddenly. The autopsies revealed mitral valve myxomas. Mitral valve myxomas producing syncope and sudden death are discussed.
Penetrating injuries of the chest are uncommon in the work-place. We report an unusual case of a machinist who was killed when a drill press broke and a flying metallic fragment penetrated his thorax.
This article discusses the merits of participation by medical examiners in the area of clinical forensic medicine. The present connotation that we deal after the fact should be abandoned with enhanced involvement in assisting the living. The paper focuses on a broad range of categories where forensic scientists by virtue of their training and experience could be most helpful in the application of medical knowledge to the solution of questions of law.
A case is presented involving a patient who underwent an intrapericardial pneumonectomy for lung cancer and died of cerebral hypoxia due to herniation of the heart. The etiology and pathophysiology of cardiac herniation are reviewed.
Sudden death caused by foreign-body perforation of the esophagus is distinctly uncommon. We report the death of an elderly patient in a nursing home who exsanguinated after she swallowed a chicken bone that perforated her esophagus and right common carotid artery.
Scene investigation is an important part of the medicolegal autopsy. In many cases the cause of death cannot be determined without knowledge of the circumstances. A case is presented in which the diagnosis of compression asphyxia and smothering was made only after analysis of the scene findings.
Although the news media has occasionally reported deaths and injuries related to fraternity hazing in the past, little, if any, attention has been given to the subject in the medical literature. In light of the medicolegal implications surrounding many of these incidents, it is important that medical examiners be aware of the problem. One hundred sixty-eight (168) cases of injuries and deaths related to fraternity hazing activities occurring in the past 60 years in the United States have been collected from secondary sources. A descriptive statistical analysis of the data is presented.
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A case of suicidal electrocution in a filled bathtub is presented with a discussion of the mechanism of electrocution in water. A modern safety device, the Ground Fault Interruptor Circuit, is also described.