Pitfalls Encountered during Documentation of Cases of Fatal Fall from Height Presented to Kafr EL Sheikh-Medico legal Department during the Period from (1999 to 2013)

Abstract

Fall from height represents an important form of blunt trauma in society. The incidence of deaths due to fall from height is increasing day by day. So, determination of the manner of fatal fall from a height is very important issue. When establishing the mode of death, it is essential for the forensic pathologist to reconsider autopsy findings, outcome of toxicology screening, and circumstances at the death scene. The present study aimed first, at throwing light on the pitfalls encountered during examination of medico legal (ML) reports of cases of falling from height. Second, design a ML protocol for documentation of deaths due to falling from height. The current study was a retrospective study of the records of cases of fatal fall from height presented to Kafr EL Sheikh-Medico legal Department during the period from 1st of January 1999 till the 31st of December 2013. The records were examined for: personal data, detailed history of the cases, scene examination, autopsy findings and Toxicological screening. The results of the present study showed that the total number of the reported cases was 21 cases. The age of the victims ranged from 8 to 69 years, males presented (61.9%) of cases. Data about employment was documented in only (38.1%) of cases. Data about the circumstantial events were missing in most of the records. Accidental falls were the most prevalent manner. Suicidal falls were the second prevalent manner .Scene examination revealed that falls of (71.44%) of cases was from buildings. The height of fall was found in majority of records to be from the 4th storey. Examination of the path of fall was not reported in most of cases (95.23%). The nature of impact surface was documented only in (38.1%) of cases. Body orientation in relation to impact surface was mentioned in (38.1%) of cases. Records describing the site of fall from inside were very defective. The presence of barrier and its height was reported in (33.33%) of cases. Whole body radiography and external body measurements were not performed in any of the studied cases. Autopsy findings showed that the head and the thorax were the most affected regions. The probable primary site of impact was concluded by autopsy in (47.62%) of cases. The cause of death was head injuries in the majority of cases either by itself or in conjunction with other injuries. Toxicological screening of the commonly used drugs was carried in (90.48%) of the cases, where it was negative in (85.72%) of cases. Blood alcohol content was performed in (61.9%) of the cases and it was negative. The study concluded deficient documentation of data about the history of the cases; scene examination, autopsy findings and toxicological screening. Many recommendations were suggested and a protocol for documentation of the cases of fatal fall from height was proposed.