Medico-Legal Journal

Four hundred adult claimants underwent medico-legal assessment following upper limb injuries. Dynamometry was performed on each using the Jamar five handle-position test. Injury causes loss of power and there is a significant relationship between the percentage loss of power and the measured whole limb impairment. This paper presents a new approach for the analysis of the tests. The normal physiological length–tension pattern of muscle is maintained in the majority of claimants albeit with modifications due to the specific effects of injury on hand function. This paper provides normative data for the analysis of dynamometry in this population and makes recommendations for parameters that suggest that a test is a true reflection of capacity and thus useable in court.

We described a neonate with severe and multiple abnormalities following use of isotretinoin, in spite of the mother's previous knowledge of drug complications. Initial physical examination after delivery showed congenital absence of both eyes and both auricles as well as anal atresia and a cleft palate. Due to severe respiratory distress and atresia of the anus, the neonate was admitted to a neonatal intensive care unit and underwent reconstructive surgery. The drug should not have been used during pregnancy. Using this drug within pregnancy with awareness of its side effects may have legal consequences.

Suicide by inhalation of carbon monoxide is not uncommon and usually involves car exhausts or burning charcoal or defective boilers. We report a case of a 25-year-old man, who committed suicide by inhaling carbon monoxide gas inside a polythene bag in a bathroom. The open carbon monoxide cylinder found inside the polythene bag was purchased online by the deceased a few days earlier. He had stated that the gas would be used for his experiment on the environment. A suicide note recovered from his trouser pocket revealed his intention for a painless death.

Inhalant abuse refers to the inhalation of volatile substances for their euphoric effects. Glues and adhesives have been abused inhalants for decades and so the term “glue sniffing” attached to the habit. These days many substances used are not adhesives and the most accurate title of “solvent abuse” has been given to this widespread and dangerous habit. The various methods of inhalational abuse include huffing, bagging, dusting, glading, and sniffing. We report one such case of a 22-year-old male who was found in an unresponsive state at his residence with a plastic cover around his head and empty tubes of “Fevibond” glue beside him. He died on the way to hospital. At autopsy, conjunctival and visceral congestion were found with pulmonary edema and petechiae over visceral pericardium. The viscera were analyzed, and the presence of toluene in his liver and blood was reported.

Bulldozer fatalities are usually due to accidental crushing of the body at the workplace. However, severance of the skull cap simulating a chopping injury to head is rare in the literature. Medico-legal investigation may be posed with different challenges when carrying out an autopsy of a victim with this devastating head injury. The police will seek an opinion about the type of weapon responsible for the injuries, the nature of injuries produced and manner of death. In the present case, the victim was hit at dusk by a protruding part of the bulldozer blade as he crossed in front of a bulldozer that was approaching his tractor from the opposite side of the road. His skull cap was severed and he died instantly. This report considers the circumstances of his death, its mechanisms and strategies for preventing such deaths.

Venous disease, including varicose veins and chronic venous insufficiency, is one of the most common chronic medical conditions. Haemorrhage from rupture of varicose veins in the legs is rare and can lead to sudden death. Nevertheless, this condition is not included among the causes of sudden death. In this case, an 88-year-old man was found dead in a large pool of blood at home. Initially, investigators mistakenly assumed that it was a case of homicide. Bloodstain pattern analysis was performed. An external examination of the victim showed an ulcer on the left foot and evident varicose veins untreated on the lower limbs. The aim of this study is to emphasize the role of treatment of varicose veins in the prevention of adverse events such as sudden death from acute haemorrhage.

Atypical gunshot wounds present a challenge for the forensic expert, and sometimes differentiating these from a blunt trauma can be difficult. A careful crime scene investigation can be helpful in finding additional evidence and clarifying the nature of the injuries. We describe a case of an unusual craniocerebral injury that was initially interpreted as a blow from a wooden object. The appearance of the wound lacked the classical characteristics of entrance and exit bullet wounds, but the investigation showed it was due to the ricocheting of a destabilized bullet. Potentially lethal, craniocerebral gunshot injuries are a common occurrence in developing countries even in non-conflict areas, with very bad outcomes even when treated aggressively in specialized neurosurgical facilities. The authors briefly discuss similar cases and opinions in the relevant literature, emphasizing the importance of a rational approach during the reconstruction of the crime scene.