Planned Complex Occupation-related Suicide by Sulfuric Acid Ingestion and Thorax Stab Wound: Case Report

Sulfuric acid is a colourless, odorless liquid, which causes typical injury patterns such as cutaneous and ocular burns, respiratory complications from inhalation, and ingestion injuries (coagulative necrosis of the mucosa, gastric and intestinal perforations) with significant dermal and mucosal injury because of its corrosive action. Most injuries caused by sulfuric acid ingestion are accidental, especially in the paediatric population. Intentional cases of ingestion have rarely been reported in adults as a method of suicide following a major depressive disorder. In this paper, we report the case of a 44-year-old woman who was found dead outside her home with a retained fillet knife embedded in her left chest wall and cutaneous chemical burns extending from her mouth down her chin and anterior torso. During the crime scene investigation, a half empty bottle of chemical drain cleaner containing concentrated sulfuric acid was found next to her body. An autopsy revealed chemical burns to the tongue, trachea, larynx, pharynx and oesophagus along with a blackish fluid in the peritoneal cavity. Histological analyses showed extensive corrosive changes in the gastrointestinal tract. Toxicological screening of blood and urine samples was negative; gastric contents contained a high quantity of concentrated (≈ 96%) sulfuric acid with a pH value of < 1.0. Death was attributed to shock following sulfuric acid ingestion. Circumstantial evidence and autopsy findings proved that the manner of death was suicidal. Complex suicides can be challenging for the forensic pathologist because of the plurality of methods used. The authors highlight the importance of systematical exhaustive postmortem investigation in order to ascertain the cause and manner of death in cases of planned complex suicide

Analisi e ricostruzione delle lesività scheletriche mediante indagini radiologiche

Il ricorso in ambito forense a tecniche di imaging per l’analisi e ricostruzione delle lesività scheletriche, è oggetto di crescente interesse, in ragione delle indiscutibili prerogative offerte dalla “virtopsy”. L’Istituto di Medicina Legale di Bari, in collaborazione con la Radiologia di Bari, già da diversi anni riconosce l’efficacia delle tecniche eidologiche nell’ambito della localizzazione di proiettili e frammenti ritenuti in ambito balistico, nonché nella valutazione dei complessi lesivi derivanti da grandi traumatismi o nei cadaveri “preziosi”. Dopo la disamina delle possibilità applicative individuate in letteratura medico-legale, gli Autori discutono i limiti e le prospettive della virtopsy, con particolare riferimento alle esperienze maturate su casistica rilevante

Robber's Personal Identification by Morphometric Comparison Between Recorded Images and 3D Avatar of the Suspect

Personal identification based on 3D digital photogrammetry presents a natural evolution of a previous research in this field by "parameterized superimposition" (PS). The authors' experience was based on 2D/2D comparison between video frames taken from the surveillance camera system during the robbery and frames of the suspect brought back in the same place where the robbery was perpetrated. This technique involves four steps: The PREPARATORY PHASE, in which the recorded images of the robber are studied and improved. Frames with better view of robber's face landmarks are then chosen. The 3D ACQUISITION PHASE, during which a 3D photogrammetric avatar of the suspect face is created; this phase only requires 4 photos made simultaneously with a calibrated camera. The SUPERIMPOSITION PHASE is preparatory for the final step and involves a meticulous spatial orientation of the 3D avatar in the same position taken by the offender in the selected frames. A snapshot of the 3D avatar is now taken. During the METRIC IMAGE ANALYSIS a quantitative comparison between the image of the robber's face and the snapshot obtained is used. To perform this step it is necessary to clearly recognize at least five landmarks on the robber's face using a suitable software

The professional training oe residents in legal medicine in clinical risk management state of the art and proposals for the new ministerail training plan

The clinical risk management as a tool to improve the quality and appropriateness of health services, in recent years has proved to conquer a central position in the politics of Clinical Governance. The main reason behind this rise is the need to contain the increasing litigation in the Jield of medical liability through instruments able to assess the risk profile oj health services and in the meantime to get toolsJor prevention / correction of critical issues. Another reason is the introduction of high insurance deductibles (sometimesgreater than One million euros) and the retirement oj many insurance companies in the market of medical malpractice that hasforced many hospitals (somewhere even entire Regions) lo activate schemes for self-management of claims. In this context an essential role is played by the legal medical examiner oj the hospital; therefore, it is mandatory to guarantee the acquisition of theoretical and practical principlesjrom the beginning of the professional training in legal medicine. This should led up to a highest co-operation among the professionals involved in the clinical risk management and, consequently, to an improvement of the effectiveness and efficiency of the whole health system. 1 his paper shows the state of the art of the Italian professional training in legal medicine with regard to the Jield of clinical risk management through the analysis of the main existing rules and a survey distributed to 29 Italian Schools of Specialization of Legal Medicine. Our results have demonstrated a lack of attention of ministerial training plans to the issue of clinical risk management, especially in terms oj practical activities; we have also noticed a heterogeneous pattern in the survey. According to these results, the A uthors suggest to insert specific formative objectives in the ministerial training plans that should be rewritten in order to conform them to the reduction from S to 4 training years in many medical specialties provided by the laws n. 128/2013 andn. 114/2014