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Biomedical subjects

R Hanzlick

Publications and source records attributed to R Hanzlick.

At least 73 records · Page 4Linked to original sources
PubMed1995

National Association of Medical Examiners Pediatric Toxicology (PedTox) Registry Report 3. Case submission summary and data for acetaminophen, benzene, carboxyhemoglobin, dextromethorphan, ethanol, phenobarbital, and pseudoephedrine.

Data are presented from the National Association of Medical Examiners' (St. Louis, MO, U.S.A.) Pediatric Toxicology (PedTox) Registry. A total of 839 case reports have been submitted to the registry. Reported here are the concentrations of several drugs and potentially toxic substances observed in children who have died of various causes, often non-drug-related. Except for carbon monoxide, for each of the substances addressed in this report, there is insufficient information in the literature to distinguish "lethal" from "non- or sublethal" concentrations in children, and the data are presented only to provide a working frame of reference. For 30 infants whose deaths were attributed to causes other than phenobarbital, the median blood phenobarbital concentration was 7.8 mg/L, with a range of 0.1-22.4 mg/L. For eight infants whose deaths were not attributed to ethanol, the mean blood ethanol concentration was 0.029 gm/dl and ranged from 0.011 gm/dl to 0.050 gm/dl. Blood dextromethorphan concentrations in seven infants showed a mean of 0.38 mg/L and ranged from 0.10 mg/L to 0.95 mg/L. In 15 infants, blood pseudoephedrine concentrations ranged between 0.07 mg/L and 13.0 mg/L, with a mean concentration of 3.55 mg/L. Blood carboxyhemoglobin saturations for 38 children aged < or = 5 years, who died in fires and were dead on the scene and not resuscitated, ranged between 29% and 94%, with a mean saturation of 64%. Blood benzene concentrations in eight children aged < or = 6 years who died in fires and were dead on the scene showed a mean concentration of 2.3 mg/L and a range of 0.2-4.9 mg/L. For 33 children aged < or = 5 years whose deaths were attributed to nondrug causes, the mean blood acetaminophen concentration was 9.9 mg/L, and the range was 1.0-34.5 mg/L. These data are not well controlled in terms of testing methodology or cause of death determinations and should not be used as the sole source of information when assessing whether or not a death is caused by one of these substances. Further data and controlled studies are needed to work toward establishing lethal concentrations of certain drugs and toxic substances in children, and the reporting of cases to the PedTox Registry is encouraged.

Acetaminophen↗
PubMed1994

Data quality assurance measures (DQAMs) for electronic death investigation data.

Data quality assurance measures (DQAMs) involve manual and computerized procedures to ensure that essential death investigation data have been collected, essential data have been entered into a data base, electronic data accurately reflect the original information, data entries are consistent with one another, words are spelled correctly, numbers and values are entered correctly, and coding is consistent if codes are used. Quality assurance of death investigation data is essential to ensure accuracy in computer-generated office documents and data used for research and public health purposes. A basic approach to the development of DQAMs is discussed, and specific death investigation variables are presented that lend themselves to quality assurance measures.

Coroners and Medical Examiners↗
PubMed1994

Survey of medical examiner office computerization. From the National Association of Medical Examiners (N.A.M.E.).

Following a suggestion that the National Association of Medical Examiners (N.A.M.E.) develop a N.A.M.E. Information Center (NIC), N.A.M.E. conducted a survey to evaluate the current status of medical examiner office automation (computerization) in the United States. Responses were received from 80 unique reporting areas, including 75 medical examiner offices, which represent approximately 30% of the 258 medical examiner jurisdictions in the country. A total of 58 responders (65%) indicated that their office was automated. At least 38 states have one or more automated death investigation office, and electronic data exist for approximately 145,000 deaths per year, or approximately 30% of all deaths certified by medical examiners and coroners annually and approximately 6% of all deaths per year in the United States. Although computerized offices vary substantially in size and in their choice of hardware and software, a typical computerized medical examiner office (a) is in a single county with 1,000-6,000 death reports per year, (b) keeps electronic records on all cases reported, (c) uses an IBM or compatible personal computer (PC) or PC network with off-the-shelf software, (d) stores data on cause of death, manner of death, how injuries occur, and toxicology results, and (e) is interested in sharing its data. Considerable electronic death investigation data exist that can provide timely and valuable information for mortality and public health studies.

Coroners and Medical Examiners↗
PubMed1994

Embalming, body preparation, burial, and disinterment. An overview for forensic pathologists.

This article is designed as a basic guide for pathologists who are called upon to examine human remains that have been embalmed and buried for periods brief enough that soft tissues are still intact. Included is a discussion of disinterment laws; guidelines for deciding whether disinterment is warranted; funeral home and cemetery procedures; features of caskets, vaults, tombs, and gravesites; basic burial procedures; and a description of embalming chemicals and the embalming and body preparation process. Emphasis is placed on basic, routine procedures and principles of body preparation, burial, and disinterment, and on the recognition of predictable artifacts that result from such procedures. Although decomposition and skeletonization ultimately occur after burial, bodily changes that occur after burial are not discussed in this article. Disinterment is only sometimes warranted and is best accomplished in such cases through a cooperative effort among those requesting disinterment, the funeral director, the cemetery administrator, and the pathologist. If possible, autopsies should be performed according to law and prior to burial so that the need for disinterment is minimized.

Burial↗
PubMed1994

Murder-suicide in Fulton County, Georgia, 1988-1991. Comparison with a recent report and proposed typology.

Our study of the characteristics of murder-suicide in Fulton County, Georgia is compared with published data, and the usefulness of a proposed typology for classifying murder-suicides is evaluated. Twelve murder-suicides involving 26 decedents occurred in Fulton County (Atlanta), Georgia, during 1988-1991. Similar to national statistics, most offenders were male (100%), there was usually one victim (83%) who was most often female (71%), a spousal or love relationship often existed between the victim and offender (64%), and a firearm was the lethal weapon in almost all incidents (92%). Important differences from published data included a higher incidence of murder-suicide (0.46/100,000), which accounted for a lower proportion of all homicides (1.4%) and a higher proportion of all suicides (3.6%) than is reported nationally, and a lower proportion of white offenders (17%) and higher proportion of male victims (29%). A total of 83% of incidents were intraracial. Murder-suicide in Fulton County was different from national data in ways that might be due to local demographics, the local homicide rate, and the local suicide rate. The proposed typology for classification of murder-suicides is in need of more precise definitions of terminology; further, it does not permit inclusion of some major details that might be useful for study. An alternative classification scheme is offered that enables documentation of more comprehensive information.

Adult↗
PubMed1994

Death investigation report forms (DIRFs): generic forms for investigators (IDIRFs) and certifiers (CDIRFs).

On the basis of data collection procedures and forms used in various death investigation offices, we developed generic death investigation report forms (DIRFs). One form was designed for documenting information collected by the initial investigator of death, and another form was designed for documenting information collected by the medical examiner, pathologist, or other person who certifies the death or otherwise finalizes the investigation by determining the cause, manner, and circumstances of death. The benefits, problems, and criteria associated with designing the forms are discussed. Both the investigators DIRF (IDIRF) and the certifier's DIRF (CDIRF) are available in printed or electronic form for those who wish to use them or to modify them according to their specific needs. We hope that these DIRFs will be useful and promote uniformity in documenting death investigations.

Autopsy↗
PubMed1994

Standard language in death investigation laws.

Death investigation statutes and practices vary among the 50 states. We reviewed the Model Postmortem Examinations Act, recommendations of the National Association of Medical Examiners, the College of American Pathologists' "criteria for autopsies," and the death investigation statutes and practices in each state. By consolidating the terminology from these various information sources, we developed a list of death categories for which investigation by medical examiners or coroners in the United States is either mandated, commonly performed, or recommended. The list contains specific categories of death, which fall under these three more general areas: 1) unexpected and unexplained deaths, 2) deaths from intentional and unintentional external causes, and 3) deaths that fall under specialized categories related to the decedent's age, environment, or medical conditions, or to the method of bodily disposition. To promote greater uniformity in the death investigation practices among states, we recommend that the Model Postmortem Examinations Act be modified to explicitly recommend certain types of deaths for investigation and that states modify their death investigation statues to conform to such provisions. Presently, in states where death investigation statutes lack specificity in detailing the types of deaths that should be reported for possible medico-legal investigation, our recommendations, if not in conflict with local statutes, might be used as practice guidelines for the reporting and investigation of certain types of deaths.

Autopsy↗
PubMed1994

Proceedings of "Workshop on Guidelines for Scene Investigation of Sudden Unexplained Infant Deaths"--July 12-13, 1993.

The 1992 Senate Report #102-104 and House Report #102-121 recommended that the Interagency Panel on Sudden Infant Death Syndrome (SIDS) review and establish an updated standard death scene investigation protocol for scene investigation of unexplained infant deaths. As a result of the recommendation, the Centers for Disease Control and Prevention's (CDC) Division of Reproductive Health (DRH), and the National Institute for Child Health and Human Development (NICHD) organized a workshop entitled "Workshop on Guidelines for Scene Investigation of Sudden Unexplained Infant Deaths," which was held in Rockville, Maryland, on July 12-13, 1993. This article outlines the proceedings of the workshop. The goal of the workshop was to gather information and ideas that could be used to establish guidelines which could be useful in developing a model death scene investigation protocol. It was not a goal of this workshop to produce a specific protocol during the workshop. The workshop was successful in generating a variety of information and ideas concerning the desirable attributes of a protocol including essential items of data, identification of certain training needs, specification of procedures for data collection, reporting, and quality assurance, and proposed strategies for implementation. This information can now be considered by the HHS Interagency SIDS Panel to develop specific guidelines for developing a standard scene investigation protocol for sudden unexplained infant deaths.

Autopsy↗
PubMed1993

BLURBs. A coding scheme for toxicologic data.

A simple scheme is presented to enable coding of toxicologic data by medical examiners or coroners who can design or direct the structure of their computer databases. Based on the English language, BLURBs are created, which consist of a prefix describing the specimen, a root word indicating the substance analyzed, and a suffix indicating the test results. BLURBs are easily interpretable and can reduce computer disk space usage, facilitate useful queries, and promote uniformity of data.

Coroners and Medical Examiners↗
PubMed1993

Automation of medical examiner offices.

General information and principles regarding the automation of medical examiner and coroner offices are presented. Topics discussed include the importance of using available resource groups, questions that should be answered to determine the need for automation, the importance of specifically defining office needs and goals prior to automation, the value of capturing data in multiple ways, the importance of maintaining some hardcopy files, the value of ensuring capability to modify and enlarge the computer system, the need to tailor systems to the needs of specific offices, possibilities for generating money or acquiring equipment at little or no cost, the use of personal computers and commercially available software, the value of having all operations inhouse, transition to new operating systems and environments, and the foreseeable use of emerging technologies.

Coroners and Medical Examiners↗