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Forensic Science International Jan 2022Drowning is a significant public health problem worldwide and the WHO reported that drowning is the world's third leading unintentional injury death. Nevertheless, there...
INTRODUCTION
Drowning is a significant public health problem worldwide and the WHO reported that drowning is the world's third leading unintentional injury death. Nevertheless, there is still uncertainty regarding the estimate of local and global drowning deaths. In addition, the postmortem diagnosis of drowning is challenging and the physiological mechanisms of death by drowning are complex and not very well understood.
PURPOSE
To analyze a large series of bodies retrieved from the water in Connecticut (U.S.) in order to compare epidemiologic and toxicological data with those of the literature, as well as to examine the weights of the lungs and brains in drowning deaths.
MATERIAL AND METHOD
We conducted a descriptive, retrospective, population-based analysis of all bodies retrieved from the water and subjected to a forensic autopsy at the Office of the Chief Medical Examiner in Connecticut (2008-2020, n = 500). Variables collected were sex, age, date of death, location of drowning, season, type of water, cause of death, manner of death, circumstances of death, signs of decomposition, BMI, brain weight, lung weight, presence of pulmonary edema, stomach contents, and toxicological analysis.
RESULTS
The death rates of drownings in Connecticut ranges from 0.75 to 1.28/100,000/year. They occurred predominantly in males (73.4%) and most were accidents (75.6%), though this gender difference diminishes in suicides (55.4% of males). Sex distribution is also different in bathtub drownings, where women drown more frequently (67.3%). Weights of the brains (p = 0.013) and lungs (p < 0.001) were higher in saltwater drownings.
CONCLUSIONS
Drowning is more frequently an accident involving men, except for suicides where there is only a slight difference among sex. Heavy lungs and cerebral edema continue to be identified in numerous drowning deaths. These anatomic findings, however, must still be interpreted in the context of the entire case investigation. Weights of the brains and lungs are higher in salt water, although these organs' weights are mostly dependent on other variables such as BMI and decomposition.
Topics: Autopsy; Drowning; Female; Humans; Male; Retrospective Studies; Suicide; Water
PubMed: 34894613
DOI: 10.1016/j.forsciint.2021.111137 -
The American Journal of Forensic... Sep 2010Corpses found in wells or lime pits must be identified and the cause and manner of death must be determined. There are several circumstances that may lead to the...
Corpses found in wells or lime pits must be identified and the cause and manner of death must be determined. There are several circumstances that may lead to the presence of corpses in wells. In this study, 3940 death examinations and autopsies, performed at the Konya Branch of Forensic Medicine Council (Turkey) between 2000 and 2007, were retrospectively investigated, and it was found that 18 (0.46%) of the bodies had been recovered from wells. The cases were evaluated in terms of their demographic features, manner of death (accidental, suicidal, or homicidal), autopsy findings, cause of death, and the characteristics of the wells in which they were found. The ages of the victims ranged from 4 to 74 years, and the average age was 40. 4 +/- 20.6 years. Of total, 16 cases were males and 2 were females. The manner of death was determined to be accidental in 10 of the cases, suicide in 6 of the cases, and homicide in the remaining 2 cases. In 7 of the cases, death had occurred as a result of drowning in water. A comprehensive scene investigation and autopsy must be performed for corpses recovered from wells and pits for both identification and determination of the cause and manner of death. Wells should be covered and kept closed at all times to reduce the number of accidental deaths resulting from falls into wells.
Topics: Accidents; Adolescent; Adult; Aged; Asphyxia; Brain Injuries; Cardiac Tamponade; Child; Child, Preschool; Confined Spaces; Drowning; Female; Flail Chest; Forensic Pathology; Hemopneumothorax; Hemothorax; Homicide; Humans; Intracranial Hemorrhages; Male; Middle Aged; Retrospective Studies; Suicide; Turkey; Water Supply; Young Adult
PubMed: 20177365
DOI: 10.1097/PAF.0b013e3181d3dbbb -
Tijdschrift Voor Gerontologie En... Mar 2020Physical restraint is frequently used in healthcare institutions, usually in situations where the safety of the person (e.g. fall risk) or that of others (e.g....
Physical restraint is frequently used in healthcare institutions, usually in situations where the safety of the person (e.g. fall risk) or that of others (e.g. aggressive behaviour) is compromised, or where essential medical treatment is at stake. The implementation has a major impact with possible psychological consequences, physical injury and even fatal outcomes. In this retrospective study, fifteen deaths due to physical restraint are described. These have been investigated by the Forensic Medicine departments of UZ Leuven (1998 - 2018) and UZ Antwerpen (1999 - 2018). Death was caused by mechanical suffocation in all instances, mainly as a result of inadequate use of bedrails or belt restraint. These avoidable deaths are an urgent plea for a cautious and careful policy on physical restraint. Institutional guidelines and (further) training of health care personnel are of utmost importance. Central aspects are multidisciplinarity (deliberate decision-making), treatment (provoking factors), reticence (search for alternatives), proportionality (least intrusive method), due care (technical implementation), safety (increased supervision), temporality (re-evaluation of moment and duration), registration (accountability and liability) and communication (with all involved).
Topics: Accidental Falls; Aggression; Asphyxia; Humans; Restraint, Physical; Retrospective Studies
PubMed: 32951392
DOI: 10.36613/tgg.1875-6832/2020.01.02 -
International Journal of Legal Medicine Sep 2012Accidents constitute one of the greatest risks to children, yet there are few medical reports that discuss the subject of accidental asphyxia. However, a systematic...
Accidents constitute one of the greatest risks to children, yet there are few medical reports that discuss the subject of accidental asphyxia. However, a systematic analysis of all documented cases in Germany over the years 2000-2008 has now been conducted, aiming at identifying patterns of accidental asphyxia, deducing findings, defining avoidance measures and recommending ways of increasing product safety and taking possible precautions. The analysis is based on a detailed retrospective analysis of all 91 relevant autopsy reports from 24 different German forensic institutes. A variety of demographic and morphological data was systematically collected and analysed. In 84 of the 91 cases, the sex of the victim was reported, resulting in a total of 57 boys (68 %) and 27 girls (32 %). The age spread ranged between 1 day and 14 years, with an average of 5.9 years. Most accidents occurred in the first year of life (20 %) or between the ages of 1 and 2 years (13 %). In 46 % of cases, the cause of death was strangulation, with the majority occurring in the home environment. In 31 % of all cases, the cause of death was positional asphyxia, the majority resulting from chest compression. In 23 % of cases, the cause of death was aspiration, mainly of foreign bodies. Today, accidental asphyxiation is a rare cause of death in children in Germany. Nevertheless, the majority of cases could have been avoided. Future incidence can be reduced by implementing two major precautions: increasing product safety and educating parents of potentially fatal risks. Specific recommendations relate to children's beds, toys and food.
Topics: Accidents; Accidents, Home; Adolescent; Airway Obstruction; Asphyxia; Autopsy; Cause of Death; Child; Child Day Care Centers; Child, Preschool; Consumer Product Safety; Female; Foreign Bodies; Germany; Hemorrhage; Humans; Infant; Infant, Newborn; Male; Parents; Purpura; Retrospective Studies; Risk Factors
PubMed: 22752751
DOI: 10.1007/s00414-012-0737-z -
Statistical Bulletin (Metropolitan Life... Jun 1972
Topics: Accident Prevention; Accidents; Adolescent; Adult; Age Factors; Aged; Child; Child, Preschool; Drowning; Female; Humans; Infant; Male; Middle Aged; Mortality; Sex Factors; United States
PubMed: 5069059
DOI: No ID Found -
Journal of Forensic and Legal Medicine Nov 2008Drowning remains a significant cause of accidental death in young children. The site of drowning varies among communities and is influenced by cultural and geographic...
Drowning remains a significant cause of accidental death in young children. The site of drowning varies among communities and is influenced by cultural and geographic factors, including the availability of particular water sources. The drowning deaths of a twin two-year-old brother and sister in a rainwater tank are reported to demonstrate specific issues that may arise. Ladders, vegetation and trellises may provide access to tanks and should be removed. Secure child-proof access points should also be installed, particularly on in-ground tanks (given the ready accessibility of the latter). As there has been a recent trend in Australia to install more domestic rainwater tanks, the number of childhood rainwater tank drownings and near-drownings will need to be monitored by forensic pathologists and child death review committees to ensure that this has not led to the introduction of a new hazard into the home environment.
Topics: Accidents, Home; Australia; Cause of Death; Child, Preschool; Diseases in Twins; Drowning; Fatal Outcome; Female; Forensic Medicine; Fresh Water; Humans; In Vitro Techniques; Male
PubMed: 18926509
DOI: 10.1016/j.jflm.2008.05.003 -
Forensic Science International Jan 2011"Autoerotic asphyxia" typically involves an individual hanging or ligature, resulting in self-induced oxygen deprivation brought about by neck compression during sexual...
"Autoerotic asphyxia" typically involves an individual hanging or ligature, resulting in self-induced oxygen deprivation brought about by neck compression during sexual activity. Little about the so-called "atypical forms" of autoerotic asphyxia, which also involve compression of the chest or abdomen, has been published in forensic literature. When death results from such practices, they are usually deemed accidental, however, suicide or homicide must also be considered. The authors present a single case of accidental fatal asphyxia by the simultaneous compression of the neck, chest, and abdomen using a chair-bed. The victim was known to have had masochistic tendencies. In order to confirm the hypothesis of accidental death, the results of crime scene investigations, and autopsy findings, including histological and toxicological analysis, are summarized here.
Topics: Accidents, Home; Adenocarcinoma; Asphyxia; Forensic Pathology; Humans; Lung Neoplasms; Male; Masochism; Middle Aged; Posture; Suicide
PubMed: 20554408
DOI: 10.1016/j.forsciint.2010.05.021 -
Annals of Emergency Medicine Apr 1989Epidemiologic analysis of submersion cases admitted to the intensive and respiratory care unit showed that several interrelated factors preceded submersion. Accidental... (Review)
Review
Epidemiologic analysis of submersion cases admitted to the intensive and respiratory care unit showed that several interrelated factors preceded submersion. Accidental submersion and traffic accidents represented one third of the causes of submersion. Other relevant causes were illness (29.9%), psychosocial causes (20.1%), alcohol (18.1%), and suicide (9.1%). Age distribution, gender, and mortality rate were different in each group. Young age, submersion during recreational activities, summer months, and normothermia were epidemiologic factors with a favorable prognosis. Our data were compared with national data. WHO-ICD code 994.1 (drowning and nonfatal submersion) is the best entrance for epidemiologic analysis. Five hundred twenty deaths and 690 hospital admissions due to submersion occur in The Netherlands each year. About 460 victims die before they reach a hospital.
Topics: Accidents; Adolescent; Adult; Aged; Aged, 80 and over; Child; Child, Preschool; Drowning; Female; Humans; Immersion; Male; Middle Aged; Near Drowning; Netherlands; Prognosis; Suicide
PubMed: 2650589
DOI: 10.1016/s0196-0644(89)80571-2 -
Archives of Psychiatric Nursing Apr 1989Grief reactions of two types of sudden untimely deaths were compared: the loss of a child by accidental death and the loss of a child by suicidal death. Three hypotheses... (Comparative Study)
Comparative Study
Grief reactions of two types of sudden untimely deaths were compared: the loss of a child by accidental death and the loss of a child by suicidal death. Three hypotheses were tested. The degree of disturbed grief and the degree of loneliness in parents who lost a child to suicidal death were compared to those reactions in parents who lost a child to accidental death. The relationship between the degree of disturbed grief and the degree of loneliness was assessed. For suicide survivors, grief and loneliness tended to rise over time, whereas grief and loneliness decreased over time for accidental death survivors. The findings from this study indicate that the loss of a child from an accidental death places a parent at high risk for disturbed grief and loneliness, and at even higher risk when the loss is a result of suicidal death.
Topics: Accidents; Adolescent; Adult; Death, Sudden; Female; Grief; Humans; Loneliness; Male; Parents; Suicide; Time Factors
PubMed: 2712595
DOI: No ID Found -
The American Journal of Forensic... Jun 2001Overlaying, the accidental death by smothering caused by a larger individual sleeping on top of an infant, is a cause of death that has been documented for centuries....
Overlaying, the accidental death by smothering caused by a larger individual sleeping on top of an infant, is a cause of death that has been documented for centuries. The hazard of death has been reported to be greater in infants less than 5 months of age but may occur in children up to the age of 2 years. When an adult or older child rolls on top of an infant, mechanical asphyxia results. The face may be pressed into the mattress or into the body of the sleeping adult or older child. The infant's air may be expressed, and he or she is unable to cry due to pressure on the thorax and the inability to inhale. Some pathologists and investigators believe that the victims of overlaying have no pertinent physical findings at autopsy and that any injury is indicative of inflicted trauma. Others believe that one may see contusions and abrasions from overlaying in and of itself. Wedging is another form of accidental mechanical asphyxia that may have negative autopsy findings. The prevalence of bruising, contusions, or facial and ocular petechiae is not clear. The author reviewed all pediatric forensic cases referred for autopsy to the Forensic Section of the Medical University of South Carolina/Medical Examiners' Office over the past 15 years, from 1985 to 1999. Of these, all cases of overlaying, cases listed as undetermined sudden infant death syndrome versus overlaying, and wedging were included. The cases were analyzed as to victims' age, sex, race, location/bedding, bed-sharer, and whether the bed-sharer was known to have ingested drugs or alcohol before sleep. Postmortem physical findings were also reviewed, particularly for documentation of contusions, abrasions, or facial or ocular petechiae. By clarifying not only the victim, bed-sharer, and scenario but also the presence or absence of physical findings in cases of overlaying, wedging, and other accidental asphyxia, we can better categorize these cases.
Topics: Accidents, Home; Asphyxia; Autopsy; Female; Humans; Infant; Infant, Newborn; Male; Medical Records; North Carolina; Retrospective Studies; Sudden Infant Death
PubMed: 11394749
DOI: 10.1097/00000433-200106000-00008