Two Bullet Wounds, One Bullet: The Atypical Fragmentation of a .223 Caliber Ammunition.

As the fifth leading cause of death in individuals aged 1 to 64 years in the United States, forensic pathologists frequently encounter firearm-related deaths and are trained to approach these cases by utilizing information from the investigation, radiographs, and autopsy findings to discern the logical sequence of events that lead to death. We also emphasize the importance and utility of various factors such as bullet wound characteristics, type of ammunition used, and type of tissues involved in a forensic pathologist's determination of events and in medicolegal investigations. However, the unusual presentations of firearm-related deaths can cause confusion and even frustration when there are contradicting circumstances or findings at work.

A pen as an intermediate target becomes a secondary projectile.

Firearm projectiles striking intermediate targets have the potential to create secondary projectiles, which can produce identifiable patterns of injury. We present a case in which a father, manipulating a handgun, was demonstrating how the firing pin worked to his adolescent son. He placed a pen inside the barrel of the gun for demonstration but did not recognize that a bullet was loaded into the firing chamber.

Sudden Unexpected Death in a Child From Acute Myeloid Leukemia.

Acute myeloid leukemia can rarely cause sudden, unexpected death in children. Presentation may be non-specific and death may occur in children with no prior medical history. Herein we present the case of a previously healthy 2-year and 2 month-old White girl, who on autopsy, was found to have acute myeloid leukemia with KMT2A rearrangement extensively involving all major thoracic and abdominal organs.

Hyperoxalosis Secondary to Intravenous Vitamin C Administration as a Non-Allopathic Treatment for Cancer.

Vitamin C (ascorbic acid) has long been known to have antioxidant properties, with associated claims that it can boost the immune system, fight off infection, and help in the treatment of cancer. Similar to many other over-the-counter and herbal medicines, vitamin C can cause potential side effects with significant morbidity and rarely mortality. We discuss a case of an elderly woman with metastatic adenocarcinoma of the lung that was treated with several rounds of allopathic chemotherapy; however, treatment was stopped because of worsening quality of life and disease progression.

Forensic Radiology Pitfalls: CT Imaging in Gunshot Wounds of the Head.

Computed tomography (CT) imaging is increasingly used in emergency departments and trauma services and is being offered as a supplemental tool with autopsy in coroner's and medical examiner's offices throughout the United States. The availability of CT images in lieu of traditional X-rays for medicolegal autopsies may lead to misinterpretation of images for forensic pathologists who are not familiar with these types of images. Forensic pathologists must become familiar with CT imaging, the basis of CT image formation and how to interpret CT images appropriately.