Forensic Medical Examination Research Articles

Стандарты реализации права на обжалование и пересмотр промежуточных решений, вынесенных на досудебном этапе уголовного судопроизводства

Under Article 46 of the Russian Constitution, everyone is guaranteed judicial protection of his or her rights and freedoms. This right must also be realised in criminal proceedings, including during the pre-trial stage of the proceedings. At the same time, the Constitutional Court of the Russian Federation has not formulated in sufficient detail how the right to judicial protection should be realised in the course of the court's interlocutory ruling and its review. In searching for standards for the implementation of the right to appeal and review of interlocutory decisions rendered at the pre-trial stage of criminal proceedings, the authors refer to the provisions of the European Convention as interpreted by the ECHR as legal provisions correlating with the human rights enshrined in the Russian Constitution. For this purpose, more than 50 ECHR judgments and the positions of contemporary domestic and foreign legal scholars have been studied. The authors identified a list of standards of the Convention applicable in case of violation of the right to appeal and interlocutory review, which include the standards guaranteeing protection of fundamental individual rights: Article 5 (right to liberty and security of person), Article 8 (right to respect for private and family life, home and correspondence), Art. 1 Protocol No. 1 (right to protection of and respect for property) as well as the rules laying down the minimum requirements for appeal or review procedures: Article 5(4), Article 6 (right to a fair trial), Article 13 (right to an effective remedy). An analysis of the ECHR legal positions laid down the requirements for an appeal or review procedure against a court decision on "deprivation of liberty" (remand in custody, house arrest, prohibition of certain actions, placing a person in a hospital for forensic medical or forensic psychiatric examination). Such a procedure must meet minimum fair trial standards and be urgent and effective. The authors also substantiate the identification of general and specific standards of effective remedy in relation to the procedure of appeal and review of interlocutory decisions rendered at the pre-trial stage of criminal proceedings. Thus, the procedure will be effective if it is accessible, sufficient and expeditious and if the appeal and review of the interlocutory decision can result in the reversal of the appealed decision and the "rectification of the disputed situation". Private standards apply to cases of appeal and review of specific interlocutory decisions that are made in secret, e.g. an order to monitor and record telephone conversations, obtain information on connections between subscribers and subscriber devices, etc. In such cases, the moment the right to an effective remedy arises is linked to the moment when the person becomes aware (is notified) of the procedural actions taken. On the basis of the analysis of the ECHR legal positions, proposals for improving the criminal procedure legislation were formulated. The authors declare no conflicts of interests.

POST-COVID SUICIDE: FORENSIC SCIENCE ANALYSIS.

The aim: The article draws attention to the raise of suicide incidents after COVID-19 and proposes special knowledge to use in some forensic examinations for patients with COVID-19 and after as a measure of suicide preventing. Materials and methods: Scientific researches and comparative analyzes of criminal cases marked as a suicide were done based on statistics method. 415 suicide cases were fixed in Ukraine in 2020, and other persons' influence for suicide committing was revealed only in 61cases. In 2021, the tendency has increased, and only during the first four months (from January till April) there were 213 suicide cases. Conclusions: There are so many cases of suicide after COVID-19 caused by mental and neurological disorders due to the coronavirus effects on human brain and psyche, not only at hospitals but at home as well. The virus can disrupt nervous system work both directly and indirectly, activating the immune system excessively (the so-called cytokine storm). Complex forensic medical and psychological examination may be appointed to determine the mental state of persons after COVID-19. There are two ways to solve the problem with the help of special knowledge and forensic science. On the one hand, investigate person's predisposition for suicide after covid to prevent a suicide. On the other hand, if you had failed and the person committed a suicide use the information received to prevent other persons' suicides.

Unusual expert observation of death of a man from falling into a working sawmill

An unusual expert observation of the death of a man from falling into a working disk sawmill is presented. As a result of the forensic medical examination of the corpse, a sawn wound of the right lower limb with subtotal traumatic amputation at the level of the upper third of the lower leg was found. The above observation complements the forensic understanding of the relatively rare sawn injuries caused by circular saws in production conditions. Despite the surgical intervention that took place in the described case, which led to a modification of the primary picture of sawn damage, it remains possible to diagnose the damaging factor, some of its characteristics, the mechanism of action and solve the situational problem.

Comparative analysis of the volume and structure of non-violent death in St. Petersburg and Novgorod region over the past 5 years

The purpose of the work is to study the dynamics of the volume and structure of forensic medical research on cases of non-violent death in the Russian Federation for the period from 2016 to 2020 using the example of two regions of the Federation that differ in socio-economic terms. The material for the study was the annual reports of the «St. Medical Examination» and «Novgorod Bureau of Forensic Medical Examination». It was established that during the study period in St. Petersburg and the Novgorod region, non-violent death was dominant in the structure of forensic medical examinations of corpses, accounting for about 80%. The leading place was occupied by diseases of the circulatory system and neoplasms, they were more common among residents of the Novgorod region. A positive fact was that since 2016, the residents of the Novgorod region, in contrast to the residents of St. Petersburg, there has been a trend towards a decrease in the number of deaths from diseases of the cardiovascular system. Mortality from oncological diseases increased from year to year in both subjects of the Federation. The most rare causes of death were infectious diseases and diseases of the nervous system. For both groups of diseases, higher mortality was also among residents of the Novgorod region. Both in St. Petersburg and in the Novgorod region there was a gradual decrease in the total number of cases of stillbirths and deaths of children under the age of 1 year. For the entire study period, this indicator, as for most diseases, was higher in the Novgorod region. In the year of the spread of a new coronavirus infection, mortality from most non-communicable diseases increased.

Problems of appointment and conduct of forensic medical examinations

Problems of appointment and conduct of forensic medical examinations

Analysis of the frequency and structure of cases of violent death according to the data of the Republican centre for forensic medical examination of the Ministry of health of the Kyrgyz Republic for 2019-2021

Analysis of the frequency and structure of cases of violent death according to the data of the Republican centre for forensic medical examination of the Ministry of health of the Kyrgyz Republic for 2019-2021

Physical evidence of rape against children and adolescents in Brazil: Analysis of 13,870 reports of sexual assault in 2017.

Introduction:The medical literature reports child and adolescent maltreatment since the 8th century. Unfortunately, even today, the incomplete knowledge of this event persists. Several forms of violence are applied to children and adolescents, mainly sexual violence including rape and sexual assault. Forensic medical examinations routinely include the genital area, anus, and the body of the victims for signs of a recent or old injury. The main goal of this study is to show the results of physical and sexual examinations regarding confirmation of rape in children and adolescents, based on the medicolegal reports.Methods:We made a descriptive cross-sectional study conducted by collecting data from Medicolegal Institute (IML-São Paulo, Brazil) in 2017. We examined 13,870 reports of sexological examinations of victims of the alleged rape. The variables analyzed were age; sex; physical examination; sexological examination; and direct search for sperm in the vaginal, anal, or oral cavity. We selected 11,725 reports from victims under 18 years.Results:As for the medical-legal findings, only 1735 reports (14.8%) confirmed sexual abuse. The most affected ages were between 3 and 5 years in the male group and 11 to 14 years in the female group. The most frequent injuries were bruises and abrasions, fissures in the anal region. In 96.2% of the examined males and 85.8% of the females under 14 years old, the examination was inconclusive, and somebody cannot prove the alleged rape. Only 1735 reports (113 from men and 1622 from women) concluded beyond any doubt the alleged rape (14.8%). The search for sperm was positive in only 1582 cases (13.5%).Conclusion:This study shows that the results of the medicolegal examinations were quite limited in recording evidence. Sexual violence against children and adolescents reaches mostly females under 13 years of age. Besides, it is a complicated crime to prove, as 85.8% of female examinations and 96.2% of male exams revealed: “no supporting elements” or “undetermined” to characterize the felony. Therefore, to prevent it, the communication of the alleged rape must be made as quickly as possible.

Medical expert evaluation of medical care for patients with musculoskeletal injuries

The objective of the study is to analyze 220 forensic medical examinations on criminal and civil cases and pre-investigation checks concerning the quality of emergency trauma care, involving an orthopedic traumatologist as a member of the expert panel. The main aspects of the forensic evaluation of medical care for patients with musculoskeletal injuries are described, including a thorough review of medical documentation data, completeness of past and present medical history in the medical records, injury mechanism, and completeness of the trauma course description in the medical records. The reasons for the forensic examinations, the causes of the main types of defects in medical care, and their relation to adverse outcomes were determined.

Criteria for assessing the severity of the lesion and the outcome of the electric injury, depending on the parameters of the current and its pathways

The purpose of the work is to establish the relationship between the magnitudes of the electric current and clinical and physiological manifestations (outcome) on the basis of data from special literature. When performing forensic medical examinations, questions are often raised about the possibility of saving the life of an injured person in the provision of timely medical care, as well as the possibility of taking active actions after causing damages. The totality of the above information will enable to answer these questions reasonably. Besides, the data summarized in the article are necessary when planning experimental work in the study of electropathology and when conducting biomedical tests.

Региональные особенности структуры детской транспортной травмы с летальным исходом в Саратовской и Тамбовской областях

To identify regional features of the structure of fatal child transport trauma we conducted a retrospective study based on the materials of forensic medical examinations of children’s corpses under the age of 18 who died as a result of transport injury in the Saratov and Tambov Regions in 2010–2020. Significant differences in the studied regions were revealed when comparing the proportions of different types of transport injuries with a significant predominance of automobile injuries in the Saratov Region and a greater frequency of railway injuries and injuries on two-wheeled vehicles in the Tambov Region. Most significantly, these differences were in children aged 12–17 years, among whom in the Tambov region all types of transport and automobile inju-ries were distributed almost evenly, and in the Saratov Region, this age group was significantly dominated by passenger injury with a slight frequency of other injury types. We note regional pe-culiarities in the ratio of types of car injuries, manifested in a greater proportion of dead pedestrian children in the Saratov Region, child passengers in the Tambov Region. Similar indicators in the structure of children's transport injuries in the regions were the ratio of the proportions of boys and girls, seasonality and the proportion of alcohol-associated injury cases.

Current view on stab/cut injuries

Currently, mechanical trauma is the most significant cause of violent death. The injuries caused by sharp objects rank high in the structure of mechanical trauma. The study objective is to review domestic and foreign literature on the study of stab/cut injuries, identify the main issues and consider new promising diagnostic methods. The stab/cut wound morphology is widely described in the available literature, but little attention has been paid to their study of late postmortem changes. This issue requires consideration since putrefactive corpses (hidden by placing the corpse in water, burying it in the ground, etc.) are often the object of forensic medical examination. New methods for assessing stab/cut injuries are also considered: computed tomography, multilayer computed tomography, scanning electron microscopy, and energy dispersive x-ray spectroscopy. Each of the diagnostic methods has its undeniable advantages and prospects for widespread use in expert practice, but they cannot completely replace the main methods and are intended only to supplement them.

Determination of zaleplon and clobazam by high performance liquid chromatography - high resolution tandem mass spectrometry using Orbitrap technology

Was to develop a method for the qualitative and quantitative determination of benzodiazepine receptor agonists (zaleplon and clobazam), taking into account different chemical structures, by high-performance liquid chromatography-high-resolution tandem mass spectrometry using Orbitrap technology for the purposes and tasks of forensic medical examination. A method has been developed for the identification and quantitative determination of zaleplon and clobazam by high-performance liquid chromatography-high-resolution tandem mass spectrometry using Orbitrap technology. The proposed identification method can be used in the future to form a database of domestic mass spectra for potent and narcotic substances.

Diagnostics of the presence of once of death and peculiarities of performance of the forensic medical examination in post-mortal facial condition

The purpose of the research is to summarize the current information about post-mortem interval (PMI) estimating and the peculiarities of the forensic medical examination in postmortem glaciation of the corpse. On the territory of most regions of the Russian Federation, the autumn-winter period passes with a significant decrease in ambient temperature, which makes this topic relevant. The article describes in detail the mechanisms of freezing of human cells and tissues, methods for diagnosing PMI, the peculiarities of the examination in postmortem glaciation, and also put forward directions for further research.Обобщить информацию о диагностике давности наступления смерти (ДНС) и особенностях проведения судебно-медицинского исследования при посмертном оледенении трупа. На территории большинства регионов Российской Федерации в осенне-зимний период происходит значительное понижение температуры окружающей среды, что делает данную тему актуальной. Подробно описаны механизмы замерзания клеток и тканей человека, методы диагностики ДНС, особенности проведения экспертизы при посмертном оледенении, а также намечены направления дальнейших исследований в этой области.

Evaluation of the efficiency of the system of ensuring epidemiological safety in the bureau of forensic medical examination of the Tyumen region

Evaluation of the efficiency of the system of ensuring epidemiological safety in the bureau of forensic medical examination of the Tyumen region

Disputable issues of application of the medical criterion «persistent loss of general work capability» in determining the severity of harm caused to human health

The purpose of the work is to identify challenging issues that arise during the forensic determination of the severity of harm caused to human health, which entailed permanent loss of general ability to work, by means of a content analysis of the existing regulatory documents, results of forensic medical examinations and the formulation of proposals for their modification and supplementing with regard to elimination of existing contradictions. The analysis of expert practice on a selective study of 1.000 expert conclusions for 2016-2022 is given, which showed that, when assessing the severity of harm caused to human health in a number of cases (3.3%) in identical situations, various options for establishing harm caused to human health are possible depending on its severity. The conclusion was made that the requirement specified in the clause 6.11 of the Medical Criteria for Determining the Severity of Harm Caused to Human Health (approved by the Order of the Ministry of Public Health and Social Development of the Russian Federation No. 194H dated April 24, 2008, Moscow) to determining serious harm as causing persistent loss of general work capability by not less than one third, regardless of the outcome, in all cases listed in paragraphs 6.11.1-6.11.9, cannot be unconditionally applied in expert practice.

«Психопаты»: история понятия и его литературные трансформации на рубеже XIX–XX веков

The article traces the genesis of the term «psychopath» and its terminological status in the history of psychiatry (from the theory of hereditary degeneration and up to personality disorders), as well as in the context of forensic medical examinations at the high-profi le criminal trials of the 1880s (in particular, the «Semenova Case»). As media events, they generated a number of literary responses, in the stories by N. S. Leskov, A. P. Chekhov, Ya. P. Polonsky, A. V. Amfi teatrov analyzed in the article, and contributed to the introduction of the term to the vernacular. Making the descriptions of clinical and criminal cases (pathological incidents) and «confessions» available to the general public, psychopathology and psychiatry paved their path to literature, either through fictionalization or through conversion into «human documents».

Arterial fibromuscular dysplasia as a factor in sudden cardiac death in young adults

The objective of the study is to consider the problem of diagnostics of a rare vasculopathy, fibromuscular dysplasia of coronary arteries, by the case study of a 19-year-old serviceman, an athlete with sudden death occurred during slight physical exertion. After repeated histological examination as part of the forensic medical examination, the diagnosis was made: «multifocal fibromuscular dysplasia of the coronary arteries and ascending aortic arch, complicated by acute left ventricular failure.» This disease often manifests with the acute coronary syndrome in people of young age. Therefore, special attention was given to the macroscopic and histological features of fibromuscular dysplasia of arteries.

Prevention of adverse events following the use of local anesthetics in traumatology and orthopedics

The article analyzes the frequency of development of adverse toxic reactions when using local anesthetics in the practice of an orthopedic traumatologist; based on the conclusions of commission forensic medical examinations conducted in the framework of criminal proceedings on the death of patients, the features of the onset of LAST syndrome are studied, which significantly increases the medical risk for the patient and the legal risk for the doctor. An analytical study of scientific publications on the possibilities of using the local anesthetic Articaine-Binergia 20 mg/ml in the daily work of both polyclinic and inpatient doctors to ensure the safety of medical activities was conducted.

To the 100th anniversary of the Crimean Republican Bureau of Forensic Medical Examination

The article briefly presents the history of the formation of the forensic medicine service in Crimea. Information on the main legislative acts that determined the activities of forensic experts and the service in general at different historical stages is provided. The data on the heads of the service and well-known experts - forensic doctors, organizers of forensic medical examination in Crimea are presented. In parallel, the history of the organization and development of the Department of Forensic Medicine is described, the role of its employees in organizing the work of the Crimean Bureau of Forensic Medical Expertise is presented. In this article, in addition to the available sources of literature and bibliography of legislative acts, materials from the archive of the Department of Forensic Medicine of Medical Academy named after S.I. Georgievsky of Vernadsky Crimean Federal University are used.

Implicaciones médico forenses del desarrollo de la Ley 8/2021, de 2 junio, por la que se reforma la Legislación Civil y Procesal para el apoyo a las personas con discapacidad en el ejercicio de su capacidad jurídica

With the entry into force of Law 8/2021 of June 2, which reforms civil and procedural legislation for the support of people with disabilities, it is intended to apply and adapt our legislation to the International Convention on the Rights of Persons with Disabilities. Disability of December 13, 2006. This recognizes that people with disabilities have legal capacity on equal terms with others, and it must be ensured that the measures adopted to exercise said capacity respect their will, desires and preferences, avoiding conflict of interest and undue influence. The will is at the center of the new system and its influence on the ability to decide is a fundamental task in forensic medical work. The dimensions that make up this capacity are analyzed, as well as the elements that constitute it. The support measures will be analyzed according to their legal classification and will be related to the multidimensional result of the forensic medical examination, indicating the intensity of the support required and the functional area involved. At the end, the forensic medical protocol that has been followed in the Forensic Psychiatry Service of the Institute of Legal Medicine and Forensic Sciences of Seville is exposed.