Search

Cases in which several persons who died from an unnatural cause are found together are often difficult. It is necessary to exclude homicide committed by another person and to clarify whether the deaths are the result of a homicide-suicide or a joint suicide of persons wishing to die. Two cases in which couples with gunshot wounds to the head had been found lifeless in their homes are presented. In both cases, the deceased were of advanced ages and suffered from severe pre-existing diseases. Due to the circumstances at the scene, the results of the investigations and the autopsies as well as the suicide notes found, a double suicide was assumed in both cases. The husbands killed themselves after shooting their wives. Based on the presented cases the so-called double suicide and the need for a thorough investigation of the death scene with the problem of differentiating it from homicide-suicide and double homicide are discussed.

Two rare causes of iatrogenic pericardial effusions are presented. In the first case, a 61-year-old woman who had undergone laparoscopic surgery for a diaphragmatic hernia was resuscitated without success the next day. As cause of death circulatory failure as a result of post-operative pulmonary embolism was reported. Autopsy results showed that the pericardium and the heart had been sewn to the diaphragm. The suture was torn from the tissue, which caused a hemorrhage into the pericardium and the chest cavity, so that death was diagnosed to be due to cardiac tamponade and hemothorax after an iatrogenic heart injury. In the second case, a 62-year-old man who had developed a massive incisional hernia after treatment of an abdominal gunshot wound underwent open herniotomy with mesh repair. Postoperatively, the man complained about increasing pain and shortness of breath. He was transferred to another hospital for further assessment, where a cardiac tamponade was diagnosed. Autopsy results showed that three of the plastic staples used to fix the mesh had perforated the diaphragm and the pericardium thus injuring the adjacent right ventricle with subsequent perforation and development of a hemopericardium.

Estimation of the time of immersion is a common problem in forensic medicine. In Germany since about 50 years a table for estimating the minimum time interval of immersion is used. This table was developed taking into account signs of progressive putrefaction and maceration and the monthly average water temperature. The reliability of this table was already checked some years ago. In the study presented, 33 further cases were evaluated. When the average monthly water temperatures used in the table are compared to the actual values, the temperatures in the river Rhine have risen during the last 40 years. Therefore, always the actual water temperature has to be measured and to be taken into consideration for the estimation of immersion time. Since there may be also fluctuations of the monthly water temperatures in cases of longer lasting immersion, a temperature profile has to be taken and the mean water temperature has to be calculated. Besides, the table of Reh should be adapted to the increased water temperatures.

Over one year, 7 autopsy cases with narrow diameters of the descending aorta were seen in the Institute of Forensic Medicine at the University of Bonn. The autopsy results were supplemented by chemical-toxicological, alcohol and histological examinations. In all cases middle-aged men (24-38 years) died suddenly and predominantly in a domestic environment. To some extent the inner aortic diameters ranged significantly below the expected values in relation to body surfaces or were lower than the 5th percentile related to men aged 45 years. In four cases, potentially lethal concentrations of alcohol or intoxications, e.g. with heroin, were noted. In one case, the blood sugar level was significantly elevated. In the other two cases, all further investigations were unremarkable.

Synthetic amphetamines such as 3,4-methylenedioxy-N-methylamphetamine (MDMA, Ecstasy) have become recreational drugs in German discotheques because of their euphoric and mood-brightening effects. However, their consumption involves considerable risks, which may even be lethal under certain circumstances. A 19-year-old man was taken to a university hospital for suspected intoxication with a narcotic drug, where he died the next day. As cause of death "fulminant liver failure" was diagnosed. In blood from the femoral vein, MDMA was found in a concentration of 4.27 mg/l. Histological examination showed acute necrosis of the liver and parenchymatous bleeding. The second case is that of a 39-year-old man who collapsed at his workplace and died in hospital shortly afterwards. In his rucksack, a small bag with 1.6 g of amphetamine was found. Analysis of blood from the femoral vein showed an amphetamine concentration of 1.08 mg/l.

Civilians are rarely killed by military weapons except in times of war. In early 2014, a 50-year-old man died in an explosion of an aerial mine from the Second World War when he was crushing concrete chunks with an excavator at a recycling plant. In the burned operator's cab, the remains of a body were found on the driver's seat. The thorax and the head were missing. Still sticking in the shoe, the right foot severed at the ankle was found about 7 m from the excavator together with numerous small to tiny body parts. At autopsy, the completely disrupted, strongly charred lower torso of a male connected to the left extremities as well as a large number of small tissue fragments and calcined bones were found. According to calculations performed by the seismographical station on the basis of seismic data, only about 45-60 percent of the charge had detonated. The autopsy results illustrate all the more the massive impact of such an explosion.