Forensic Autopsy of Human Decomposed Bodies as a Valuable Tool for Prevention: A French Regional Study.

Post mortem changes due to putrefaction sometimes make people wrongly consider the autopsy of a decomposed body as unrewarding. A 5-year retrospective study was conducted and included all types of decomposed body subject to medicolegal autopsy, excluding bone remains and charred bodies. Sociodemographic, medical, and forensic data were collected.

A Death Involving a Fired and Deflected Bullet: A Case Report from Lyon University Institute of Forensic Science, France.

In case of gunshot deaths, atypical wounds can make the distinction between entrance and exit wounds harder. They may be due either to anatomical reasons or to diverse cogent ballistic arguments. The reported case pertains to a fatal hunting accident involving an expanded conical point bullet against the neck with both atypical entrance and exit wounds.

The interest of postmortem bacteriology in putrefied bodies.

A 27-year-old man was found dead in an advanced decomposition stage at home. On external examination, his body showed petechial hemorrhages of the skin. At autopsy, petechial hemorrhages of the epicardium were found, but no sign of meningitis was detected.

Geometric and harmonic study of the aging of the fourth rib.

One of the current reference methods, namely the Işcan method for estimating age at death, consists in the subjective observation of the sternal end of the fourth rib. In this study, we looked to identify the morphometric characteristics of the sternal end of the fourth rib that were most affected by aging by measuring them in an objective way. For this purpose, we collected measurements from the fourth rib tip of 414 French males and used mathematical algorithms derived from pattern recognition and signal processing to identify variables that reflect both geometric characteristics and serration patterns of the ribs.

Air, water, and surface bacterial contamination in a university-hospital autopsy room.

Today, little is known about the bacteriological environment of the autopsy room and its potential interest for medico-legal practices. Seven hundred fifty microbiological samples were taken from surface (n = 660), air (n = 48), and water (n = 42) to evaluate it in a French University Forensic Department. Median bacterial counts were compared before and during autopsy for air samples, and before and after autopsy for surface samples, using Wilcoxon matched pairs signed ranks test.

Interpretation of drug concentrations in an alternative matrix: the case of meprobamate in vitreous humor.

The use of vitreous humor (VH) as an alternative matrix to blood in the field of forensic toxicology has been described for numerous drugs. Interpretation of drug concentrations measured in VH, as in other matrices, requires statistical analysis of a data set obtained on a significant series. In the present study, two diagnostic tests interpreting postmortem VH concentrations of meprobamate in 117 sets of autopsy data are reported.

Sudden death due to a cystic atrio-ventricular node tumour.

Sudden cardiac deaths constitute a major health problem. Most cases are attributed to cardiomyopathies, coronary artery diseases and functional dysregulations. Sudden death in an adult due to a primitive cardiac tumor is a rare occurrence.

Postmortem measurement of human chorionic gonadotropin in vitreous humor and bile.

Postmortem human chorionic gonadotrophin (HCG) blood assay can confirm postmortem diagnosis of pregnancy or document situations in which HCG levels are elevated. In some cases, however, blood sampling is not possible at autopsy. In this study, HCG was quantified by enzyme-linked fluorescent assay (ELFA) in the bile (n = 5), vitreous humor (n = 4), and postmortem blood (n = 4) of five pregnant women.

Critical study of observation of the sternal end of the right 4th rib.

Studies of the method of estimating age at death by the 4th rib exclusively concerned the phase method without fundamentally challenging the method as such. The present study analyzed observation of the variables on which the Işcan method is based. Ten observers made two assessments of the stage of pit depth, pit shape, rim and wall configurations of 59 right 4th ribs harvested from males (mean age: 49 years; range: 47-94 years).

Contribution of long-QT syndrome genetic variants in sudden infant death syndrome.

A cohort of 52 French unrelated infant cases who died unexpectedly before they reached 12 months of age was blindly investigated to better quantify the contribution of long-QT syndrome (LQTS) genetic variants in French cases of sudden infant death syndrome (SIDS). After a standardized autopsy protocol, a blinded molecular screening of the KCNQ1, KCNH2, SCN5A, KCNE1, and KCNE2 genes was performed on each case. These postmortem investigations enabled us to reclassify 18 as non-SIDS cases, 32 as SIDS cases, and 2 as suspected SIDS cases.

Heart lesions associated with anabolic steroid abuse: comparison of post-mortem findings in athletes and norethandrolone-induced lesions in rabbits.

Among 15,000 forensic post-mortem examinations performed on the coroner's order over a 24-year period (January 1981-December 2004) in the area of Lyon, France (population: 2,000,000), 2250 cases of unexpected cardiac sudden death were identified retrospectively according to WHO criteria. Of these, 108 occurred during recreational sport and 12 occurred in athletes. In the latter category, a history of anabolic steroid abuse was found in 6 cases, whereas pre-existing ordinary cardiac lesions were observed in the 6 remaining cases.

Fatal intoxication with milnacipran.

The antidepressant milnacipran is a double serotonin/noradrenalin reuptake inhibitor. The low reported incidence of intoxication indicates excellent tolerance in comparison with tricyclic and second generation antidepressants. We report a fatal intoxication associating milnacipran, at blood levels (femoral=21.

Ethical problems in the investigation of autoerotic deaths: three case reports.

Despite a large body of literature on autoerotic deaths, there are very few articles focusing on the ethical aspect of such deaths. Furthermore, as far as we know, there is no paper that has studied the forensic teams' reactions to those deaths. We present three cases of autoerotic death involving ethical problems in the case's management.

Fatal mephenesin intoxication.

This report describes a death related to the abuse of and intoxication by mephenesin. To the best of our knowledge, this is the first report case of lethal intoxication involving solely mephenesin and reporting mephenesin blood concentrations. The victim was a 48-year-old woman found unconscious at home.

[Compensation for medical accidents resulting from the delivery of health care].

The law of March 4, 2002 created procedure of a friendly, contradictory compensation and rapid in supplement of the already existing procedures. This device financed primarily by the social security allows the integral repair of the no faulty medical accidents that the medical act was carried out at the hospital or within a liberal framework of care. However, certain conditions are required so that the request is admissible: the realization of the medical act must be posterior to the 4/9/2001 and the undergone damage must be serious.

[Medicolegal responsibility].

It was from 1835 onwards that jurisprudence considered that the doctor was responsible for his acts and that he must answer to what he does. Yet it took the Mercier act of 20/5/1936 that specified that between the doctor and his client exists a true contract comprising, for the doctor, an undertaking if not obviously to cure the patient, then at least to not give non-specific care but conscientious and attentive care and, except in exceptional circumstances, to conform to the body of evidence of science. This contract is based on a relationship of confidence, and even an involuntary violation of this contractual obligation is sanctioned.