Death Investigation Research Articles

A critical review of medicolegal research and information asymmetries in investigating cases of extrajudicial executions and forced disappearances.

Medicolegal systems investigate the cause and manner of death, particularly differentiating between unintentional and intentional deaths. The examination of remains from unlawfully killed individuals is critical in exposing human rights violations. However, forensic medical investigations of these human remains can face multiple challenges, especially in contexts marked by limited resources, political influence, and sub-optimal investigative procedures. When killings are state-sanctioned or facilitated by well-resourced non-state actors, the clandestine disposal of remains can create a culture of impunity, leaving affected families and communities without recourse or resolution. This study aggregates articles in English and Spanish, examining the current state of how forensic medical research on extrajudicial executions and forced disappearances informs practice. It highlights critical gaps in the empirical literature, particularly in the reporting of the scientific findings that impact the investigation of victims of these unlawful killings. These cases' inherently non-linear and unpredictable nature, often influenced by chaotic and unstable conditions, can create disproportionate challenges for forensics practitioners. To address these gaps, this review suggests leveraging epidemiological frameworks to track data trends in these unlawful killings, supporting public health initiatives in prevention and policy. It emphasises the need for comprehensive documentation, robust databases, and adaptive forensic methodologies to navigate uncertainties and systemic limitations inherent in this complex and unpredictable domain of medicolegal death investigation.

The Entomo-Toxicological Effect Of Dichlorvos on Cuticular Hydrocarbon Profiles of Some Sarco-Saprophagous Insects for Forensic Applications.

Forensic entomology has relied on species-specificity, quantitative and qualitative variations of cuticular hydrocarbons to successfully carry out chemotaxonomic identification of insects based on species, age and gender. This work studied the effects of dichlorvos on the cuticular hydrocarbon profiles of some adult sarco-saprophagous insects of forensic importance that fed on dichlorvos-poisoned carrions for utility during death investigations. Cuticular hydrocarbons (CHCs) were extracted from adult insects of the species Chrysomya albiceps, Sarcophaga exuberans, Musca domestica, Hermetia illucens, Dermestes maculatus and Necrobia rufipes from both dichlorvos-poisoned and control pig (Sus scrofa Linnaeus) carrions and subjected to chemotaxonomic profiling using Gas Chromatography-Mass Spectrometry (GC-MS). A total of 41 CHCs were successfully identified from insects of both the dichlorvos-poisoned and control carrions ranging from C8 to C33 carbons consisting of majorly the n-alkanes, methyl branched alkanes and an alkene. There was a higher abundance of CHCs present in the insects of dichlorvos-poisoned carrions than the control group. The highest mean peak concentration and abundance of the CHCs was recorded by 2,6,10,14 -Tetramethyl Pentadecane (10.38 ± 0.53μg/mg for dichlorvos-poisoned carrions and 8.99 ± 1.13μg/mg for the control carrions). The visualization of the species-specific differences in CHCs compositions showed less overlapping CHCs clusters and quantitative metrics of principal component analysis plots of the insects from both carrion groups with high eigenvalues > 3 which were indications of good species level discrimination. The study showed that insects' CHCs profiles of dichlorvos-poisoned and control carrions exhibited uniqueness cum variations in terms of abundance and chemical identity.

A retrospective review of the circumstances and characteristics of 72 adult autoerotic neck compression deaths in Australia, between 2000 and 2022.

Autoerotic asphyxial deaths are a rare but recurring phenomenon, the most common modality of which involves neck compression. Autoerotic neck compression can involve any compression to the neck during individual sexual activity performed to heighten arousal. This retrospective study examines 72 such deathsoccurring in Australia between 2000 and 2022. The study aims to provide detailed medico-legal interpretation of such deaths and recommendations for investigation within Australian contexts, and globally. Demographic analysis reveals a predominance of Caucasian males under 50 years of age, with diverse employment and health status. Pathological examination uncovers a spectrum of injuries, from superficial abrasions to rare skeletal and cartilaginous injuries, providing insights into the mechanics and characteristics of these fatalities. Contextual examination highlights sexual paraphernalia, evidence of genital stimulation, and isolation are consistent features in most autoerotic deaths within the sample. There was a wide variety of tool usage (ropes, belts, etc.), and geo-temporal features associated with autoerotic neck compression. The study provides comprehensive examination of the circumstances and characteristics of autoerotic neck compression which may assist in differentiation between suicidal and homicidal neck compression deaths such as hanging or ligature strangulation respectively. This study is an Australian first and is the first study of autoerotic asphyxial deaths to focus solely on deaths with a neck compression component. The study incorporates new variables and suggests ways these should be considered in future death investigations. The authors argue for delineation and subcategorization of autoerotic neck compression from other autoerotic asphyxial death due to their distinct injury characteristics and mechanism of injury.

Misclassification of opioid-involvement in drug-related overdose deaths in the United States: A scoping review.

Most drug-related deaths in the United States (US) in 2022 involved opioids. However, methodological challenges in overdose surveillance may contribute to underestimation of opioid involvement in the overdose crisis. This scoping review aimed to synthesize existing literature to examine the breadth and contributing sources of misclassification of opioid-related overdose deaths. In October 2022, we searched PubMed, Web of Science, and Scopus for studies on overdose surveillance, death certificates, and medicolegal death investigation (MDI) systems in the US published in 2013-2022. Two reviewers independently screened abstracts, reviewed full-texts, and performed data extraction of study characteristics. We identified 17 studies examining misclassification in drug-related deaths. Across studies, opioid involvement in drug-related deaths was underestimated nationally by 20-35 %. Unspecified drug-related deaths differed by geographic areas and MDI systems and decreased over time. States/counties with coroner MDI systems were more likely to report unspecified overdose deaths than those with medical examiners. Integrating toxicology testing, death scene investigations, and other data with death certificates identified additional opioid-related overdose deaths, particularly those involving heroin. Findings highlight the need for additional resources for surveillance efforts, training for coroners, and data integration to improve reporting of opioid involvement in overdose deaths to inform interventions.

Intrauterine and Neonatal Deaths: The 2013-2023 Experience of the Cuyahoga County Medical Examiner's Office.

Forensic investigation of intrauterine and perinatal deaths can be challenging, given their relative infrequency and the possible involvement of maternal substance use, trauma, and socioeconomic factors. Intrauterine and perinatal deaths investigated by the Cuyahoga County Medical Examiner's Officer between 2013-2023 were reviewed. One hundred twenty-eight cases were identified (83 stillborn and 45 live births). The predominant indications for referral were concern for maternal substance use (57.8%) or trauma (35.2%). Gestational ages ranged from 11.5 to 42.5 weeks; 36.7% were <22 weeks, and only 10.2% were full term (>37 weeks). The maternal age range was 16-41 years, with most (65.2%) between 20-34 years. Not all case files included obstetric history or home address; of those which did, 53.0% received no prenatal care and 81.7% came from zip codes in the bottom quartile of household incomes. Causes of death included acute and/or chronic maternal substance use (28.9%), chorioamnionitis (21.9%), and abruption (19.5%). Manners of death (when applicable) included natural (53.3%), accident (26.7%), homicide (8.9%), and undetermined/unassigned (11.1%). Potentially confounding socioeconomic factors were identified in most cases. This demonstrates the importance of considering these factors and exercising caution when assigning specific causes and manners to intrauterine and perinatal deaths.

A descriptive study of fatal drownings among children and adolescents in the United States, with a focus on retention pond deaths, 2004-2020.

The objective of this study was to characterize fatal drownings among children and adolescents, with a focus on retention pond drownings, and identify risk factors for these fatalities using child death review data. We acquired 2004-2020 National Fatality Review-Case Reporting System data for drowning deaths among youth 0-19 years. Retention pond drownings were identified through case narratives. We analyzed demographics, primary caregiver, supervisor, death investigation, and drowning-related variables across age groups (<1, 1-4, 5-9, 10-14, and 15-19 years) using either the Chi-square test or Fisher's Exact test, as appropriate, with a p-value of <0.05 indicating statistical significance. Of 7,539 drowning deaths reported during the study duration, 265 deaths occurred in retention ponds. Children 1-4 years comprised a greater proportion of retention pond drowning deaths (59.3%) compared to overall drowning deaths (50.9%) in this age group. In 51.3% of retention pond drowning deaths among children <5 years, supervision was needed but not provided. Most (80.4%) retention pond-related deaths among children <5 years and 50.7% of deaths among children 5-19 years were attributed to child neglect, poor or absent supervision, or exposure to hazards. Among all decedents who drowned in retention ponds, 19.1% were found to have a disability or chronic illness. Most retention ponds lacked local ordinances regulating water access (83.5%) and did not have barriers or protection (66.1%) or warning signs (82.0%). Younger children with poor or absent supervision who cannot swim are at high risk of drowning. Retention pond drownings are not infrequent, and most locations lack ordinances regulating water access or requiring barriers, such as fences. Greater efforts are needed to address this common hazard and environmental and policy strategies should be implemented to prevent future deaths.

Potential postmortem microbial biomarkers of infant and younger children death investigation.

Microbial communities associated with the human body are highly dynamic and reflect the host environment and lifestyle over time. Studies show death is no exception, with data demonstrating similar antemortem and postmortem microbiomes up to 48 h following death. These predictable microbial biomarkers can inform death investigation by helping to estimate the postmortem interval and build models to identify cause and manner of death. However, no attempts have been made to model potential microbial biomarkers in pediatric (≤2 years) deaths. This study provided a cross-sectional survey of the microbiota of 53 pediatric cases (black, white, both sexes) seen in Wayne County, Michigan. Autopsy cases represented accidents, homicides, or natural causes. Postmortem microbiome were collected by swabbing the eyes, ears, nose, mouth, umbilicus, brain, rectum, trabecular space, and cardiac blood. 16S rRNA sequence analyses indicated that sex, race, age, body site, and manner of death (MOD) had significant effects on microbiome composition, with significant interactions among MOD, race, and age. Amplicon sequence variants identified intra- and interhost dispersion of the postmortem microbiome depending on death circumstance. Among manners of death, non-accidental deaths were significantly distinct from all other deaths, and among body sites the rectum was distinct in its microbial composition. There is a real need for robust postmortem microbiome before it can be standardized as a practical tool for use in forensic investigation or public health. These results inform postmortem microbial variability during pediatric death investigation that contributes to a larger effort to understand the postmortem microbiome.

Forensic Botany: The Growing Discipline Revolutionizing Plant Science and Criminal Investigations

Introduction: Forensic botany is the study of plants in legal cases. It's a fast-growing field. Changing criminal investigations and plant research. Forensic botanists analyze plant parts. These include seeds, pollen, leaves, and wood. They give vital evidence. It can establish timelines, connect suspects to murder scenes, and locate secret graves. This field is multidisciplinary. It offers new tools for crime investigation. It fuses botanical knowledge with modern forensic procedures. Forensic botany's advancement has a big impact. It affects our understanding of nature and the law. Aim and objectives: This study aimed to observe the forensic botany growing discipline revolutionizing plant science and criminal investigations. Materials: This Observational Study outline offers a thorough method for forensic botany, facilitating accurate identification of plants and making a major contribution to criminal investigations. The all-encompassing method highlights the interdisciplinary nature of this developing discipline by fusing cutting-edge molecular and chemical investigations with conventional botanical procedures. Results: This page provides details on a number of fields. subfields within forensic botany. The several fields of forensic botany. The right order for forensic evidence the identification of evidence at the criminal scene must come first. The second, and no less crucial, need is that the evidence be thoroughly recorded. In order to retain the integrity of the evidence, collecting and preservation must be maintained. As with any sort of evidence, investigators are attempting to create links or linkages between the suspect, victim, scene, and particular things. The study's overall findings support the usefulness of forensic botany as a tool in criminal investigations. It provides a scientific basis for linking suspects to crime scenes, reconstructing events, and uncovering vital evidence. Conclusion: The study's results highlight a potential link. It's between forensic botany and criminal investigations. The use of plant evidence to support forensic death investigations is known as forensic botany. Plants can give useful information. By analyzing plant evidence, forensic investigators can find key information. It can help solve cases and catch criminals.

Partially inverted and degloved penile skin mimicking the appearance of female genitalia in cases of deaths caused by trains.

Death by collision with an incoming train is common in countries where a railroad network exists. In such cases, when there is severe pelvic trauma, the penis may be partially degloved and turned inside out. The inverted penile skin may then resemble a vulva and the scrotum may mimic labia majora, causing the injured male genitalia to strongly resemble female genitalia. Forensic pathologists should be aware of this possibility when they are called to such a scene of death and are asked by the police to immediately determine the sex of the victim. In the challenging circumstances of a chaotic on-site railway death investigation, an inexperienced doctor might easily mistake male genitals for female genitals and thus delay correct identification of the victim by the police.

A Spectrum of Violence: The Intersection of Antemortem and Postmortem Embodiment in Migrant Death Investigation at the US-Mexico Border

A Spectrum of Violence: The Intersection of Antemortem and Postmortem Embodiment in Migrant Death Investigation at the US-Mexico Border

A Spectrum of Violence: The Intersection of Antemortem and Postmortem Embodiment in Migrant Death Investigation at the US-Mexico Border

A Spectrum of Violence: The Intersection of Antemortem and Postmortem Embodiment in Migrant Death Investigation at the US-Mexico Border

An Investigation of Cell Death Induced By Electrochemical Stimulation in Ovarian Cancer

Recent research has focused on ion-permeable channels in cancer, aiming to reduce proliferation and induce apoptosis in cells. Voltage-gated calcium channel blockers [1] and ligand-gated ion/calcium channels [2,3] have been explored. By maintaining low cytoplasmic calcium concentrations at rest and mobilizing calcium in response to stimuli, calcium ions serve as second messengers, regulating diverse cellular stimulus-response reactions [4]. Disruptions in intracellular calcium homeostasis can impact cell proliferation and trigger programmed cell death.In our study, we cultured ovarian cancer (ES-2 cells) on indium tin oxide (ITO)-coated glass as a working electrode. We optimized parameters, including membrane potential amplitude (±60 mV), pulse frequency (1 to 36 times), and duration (2 to 60 seconds). Fig. 1a shows that a single depolarization pulse increases the highest intracellular calcium levels in ES-2 cells. After 24 hours of depolarizing stimulation, the survival rate of ES-2 cells is 66.0±6.2% for single pulses and 74.7±3.7% for multiple pulses. In contrast, the survival rate following hyperpolarization electrical stimulation is 86.3±5.6% for single pulses and 76.5±2.0% for multiple pulses. Fig. 1b indicates that sequential alternating depolarizing and hyperpolarizing stimulation can further induce cell death. Within a possible consideration, the activation of voltage-dependent calcium channels during depolarization stimulation following a stimulation causes calcium influx, and each hyperpolarization stimulation increases permeability of voltage-dependent anion channels to calcium ions between cytosol and mitochondria. This reaction ultimately affects mitochondrial calcium homeostasis and causes cell death. This study of electrical stimulation may have highly possibility for clinical value on therapy method. Reference [1] Int J Mol Sci. 2020 Apr; 21(7): 2327.[2] Front Physiol. 2022 Mar 8;13: 839437.[3] Cancers (Basel). 2020 Aug; 12(8): 2232.[4] J Pharmacol Sci. 2006;100(5):519-24. Figure 1

A review of accidental residential fire death investigations in Alberta 2012–2021

Residential fires continue to be a significant safety concern, especially as the majority are preventable. This study investigated 139 accidental residential fire deaths in Alberta between 2012 and 2021 to identify key characteristics and risk factors. The findings generally reinforce previous research on fatal accidental residential fires indicating that more deaths occurred amongst males (60.4%) than females (39.6%); seniors (65 and older) were found to be a high risk group; the majority of the fatal fires occurred in small population centres and rural areas (51.8%); alcohol consumption was prevalent among a large proportion of the decedents (46.7%); smoke inhalation was the leading cause of death (57.6%); a sizable number of fires occurred in the winter season (35.3%); a notable number of fires occurred during the 12am-6am time period (44.6%); and smoking material was the leading source of ignition in these residential fires (23%). The assessment of area-based deprivation in relation to fatal residential fires revealed that fatal fires were more frequent in communities with higher situational vulnerability and economic dependency.

Examination protocol of dismembered bodies in railway track: A suggestive review in the Indian railways backdrop

Railway-related fatalities often involve dismembered bodies, which pose unique forensic challenges. There is the need for standardized examination procedures, especially in India, where about 30% of bodies in railway track are unidentified. Distinguishing accidental trauma from criminal dismemberment requires sophisticated forensic expertise. The protocol emphasizes a systematic approach, including scene investigation, body part documentation, and post-mortem examination. Key aspects include proper handling of multiple body parts, assessment of postmortem intervals, and precise injury documentation. Ancillary investigations, such as radiological examination including PMCT and Micro CT, histological sampling, object or tool mark analysis and entomological analysis are to be used to meet the secondary objectives of autopsy. The review aims to standardize investigation procedures, improve forensic reporting accuracy, and enhance the quality of railway-related death investigations.

An Investigation of Dengue Deaths in Vientiane Capital and Champasack Province, Lao People’s Democratic Republic, 2013

An Investigation of Dengue Deaths in Vientiane Capital and Champasack Province, Lao People’s Democratic Republic, 2013

Forensic Pathology and Unnatural Death Investigations: A Systematic Review of Case Studies and Procedures

Forensic pathology plays a crucial role in investigating unnatural deaths, providing insights that influence legal and judicial outcomes. This systematic review examines case studies and procedures in forensic pathology to identify common methodologies, challenges, and trends in unnatural death investigations. By analyzing a selection of case studies across various regions and types of deaths, including homicide, suicide, and accidental deaths, this review highlights the standard forensic techniques employed—such as autopsy, toxicology, DNA analysis, and imaging technologies—and discusses their impact on case resolution. Findings indicate significant advancements in technology and methodology, yet also reveal challenges such as jurisdictional variations, resource limitations, and inconsistencies in procedure standardization. This review underscores the need for uniform forensic protocols to improve investigative outcomes and legal accuracy. Recommendations include adopting standardized practices, improving resource allocation, and encouraging further research into underexplored areas of forensic pathology. This work aims to provide forensic professionals, policymakers, and researchers with insights that contribute to the refinement of death investigation procedures and support the justice system.

Management of a Five-Decades-Old Nonunion of the Ulna: A Rare Case Report

Introduction: Chronic nonunion of fractures, especially of long-duration standing, is challenging to manage. The nonunion of forearm bones is now often effectively treated with open reduction and internal fixation using a plate. Case report: A 71-year-old male was presented with a nonunion of the ulna following the fractures of radius and ulna, 51 years ago, which was treated with open reduction and internal fixation, using square nails. Later, an attempt to remove the broken ulnar nail was successful partially. Now, the patient presented with stiffness and decreased range of motion of the elbow and wrist joints, along with features of ulnar nerve palsy. We managed this case by open reduction and internal fixation of the ulna fractures, removal of broken square nail and bone grafting. Additionally, anterior ulnar nerve transposition was done. This treatment resulted in fracture union and neurological improvement. Conclusion: This rare case is the longest nonunion ever reported. It demonstrates the complexity of managing long-standing nonunions, through a combined approach of providing mechanical stability and biological augmentation.

The use of dietary isotopes as a preliminary step in the death investigation of unidentified skeletal human remains in British Columbia, Canada.

In British Columbia, Canada, unidentified skeletal human remains are often recovered by law enforcement or civilians and there is a question if they are modern and of medicolegal significance, or historical or archaeological. We used relatively fast and inexpensive carbon and nitrogen stable isotope analysis of human bone collagen from a selection of these remains (n = 48) combined with a logistic regression model to classify remains as modern, historical, or archaeological. We then confirmed our temporal classification through directly radiocarbon dating each individual and found that we could predict the temporal group with 93% accuracy. In regions where archaeological remains have dietary isotope values distinct from living people, dietary stable isotope analysis can provide a time-, and resource-efficient method to screen cases of unidentified human remains early in death investigation.

Barriers to Family History Collection and Family Medical Screening Recommendation in the Sudden Death in the Young Case Registry.

Sudden death in the young (SDY) poses a public health problem affecting thousands of individuals annually in the United States. The SDY Case Registry utilizes existing infrastructure of death investigation programs, including medical examiner/coroner (ME/C) systems, to enhance understanding of SDY causes and risk factors to inform prevention strategies. This includes identifying and promoting screening recommendations for at-risk family members. To explore barriers to family history collection and familial screening recommendation procedures across Registry sites, nine individuals from seven SDY sites were interviewed. Interviews focused on logistics, methods to address barriers, and recommendations for improvements. Despite variability in practices, data analysis revealed three common themes related to barriers of these processes: (1) timing and grief, (2) lack of family history in medical records, and (3) families lost to follow-up. This study offers insights into these processes within the Registry and sheds light on broader practices within the death investigation domain. Data analysis led to recommendations for the improvement of these practices including the prioritization of three key family history questions during the initial death investigation by a designated individual in each office/system.

Suicides in the Bernese mountains

Abstract: Introduction: Jumping/falling from high structures is a common form of suicide. Mostly, these suicides occur on artificial structures. However, there are also natural formations which are used for committing suicide. It was the aim of this study to investigate the use of mountains and other natural rock formations for the means of suicide. Methods: The files of the investigations of mountain deaths from 2002 to 2016 commissioned by the public prosecutor’s office of the canton of Bern, Switzerland, or carried out by the Institute of Forensic Medicine in Bern itself, were evaluated retrospectively regarding the existence of suicides within alpine environment. Results: 20 cases were analyzed concerning various parameters such as method, age, gender and mental diagnoses. A mountain suicide occurred with a ratio of 1 to 69. The gender difference was more pronounced with 80% being male victims. Discussion: Suicide is rare in the mountains. Jumping/falling from heights was the most common manner of suicide. Most of those affected were male and a significant proportion had a psychiatric diagnosis.