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ZusammenfassungDie körperliche Untersuchung gewaltbetroffener, lebender Personen, aber auch in Fällen von Selbstbeschädigung, gehört zur täglichen Routine der rechtsmedizinischen Institute. Gleichwohl sind auch Ärzte anderer Fachrichtungen mit Opfern von fremder Gewalt konfrontiert. Die vorliegende Studie soll die Bedeutung einer gerichtsfesten Befunddokumentation bei Betroffenen häuslicher Gewalt außerhalb eines Strafverfahrens unterstreichen. In einer retrospektiven Querschnittsstudie wurden die Daten aus der rechtsmedizinischen Gewaltopferambulanz des Instituts für Rechtsmedizin Greifswald der Jahre 2011–2017 systematisch untersucht. Die Untersuchung ergab u. a. einen steigenden Anteil weiblicher Betroffener im Untersuchungsgut und als häufigsten Untersuchungsanlass den Verdacht auf häusliche Gewalt. Durch die jährlich steigenden Fallzahlen wird die Bedeutung der rechtsmedizinischen Gewaltopferambulanz für die umfassende Versorgung von Betroffenen von (häuslicher) Gewalt deutlich.

Death in water is a challenging issue in forensic pathology since from natural death to homicide all circumstances of death in water are conceivable. Therefore, the correct interpretation of all abnormal autopsy findings is important. In order to determine a death by drowning, numerous internal and external signs of drowning are already described. However, these are supposed to be influenced by various factors reducing their significance and evidence. Moreover, the autopsy of water corpses often reveals further pathological findings that should not be underestimated for determining the cause of death. The aim of this study was to set frequencies of the observed drowning signs in context to the forensic literature and to identify possible influencing factors. In this study, we observed that pathological organ changes of the cardiovascular system were significantly more common in corpses after shortened (atypical) drowning processes than in classical drowned victims. Furthermore only a complete formation of external foam, immediately after the corpse’s recovery, was exclusively found in drowning victims. All other drowning signs were either also observed in non-drowning deaths in water or no information could be provided with reasonable assurance. In addition, many of the examined drowning signs were negatively affected by prolonged postmortem intervals, putrefaction, or resuscitation attempts. It can be concluded from our analysis that morbidity is an important factor in deaths in water. Morbidity can support a death by drowning in case of incidents in water. For the examined drowning signs, no high diagnostic certainty could be observed. Nevertheless, these findings can increase their diagnostic value—if forensic physicians take influencing factors into consideration.

Im Rahmen einer Treibjagd erlitt ein 50 Jahre alter Jager bei der Nachsuche nach einem angeschossenen Wildschwein in einem Schilfgurtel eine stark blutende Verletzung am linken Oberschenkel, an der er wenig spater verstarb. Der genaue Unfallhergang war zunachst unklar. Die gerichtliche Obduktion ergab als Todesursache Verbluten durch traumatische Zerreisung der Oberschenkelarterie und der begleitenden Vene. Diese Verletzungen konnten einem frontalen Angriff durch ein Wildschwein zugeordnet werden. Wenige Tage nach der Treibjagd wurde das angeschossene Wildschwein erlegt. Dabei handelte es sich um einen ausgewachsenen Keiler mit rasiermesserscharfen Hauern.

Recently, an increasing number of an uncommon weapon type based on a caliber 6-mm Flobert blank cartridge actuated revolver which discharges 10-mm-diameter rubber ball projectiles has been confiscated by police authorities following criminal offenses. A recent trauma case presenting with a penetrating chest injury occasioned an investigation into the basic ballistic parameters of this type of weapon. Kinetic energy E of the test projectiles was calculated between 5.8 and 12.5 J. Energy density ED of the test projectiles was close to or higher than the threshold energy density of human skin. It can be concluded that penetrating skin injuries due to free-flying rubber ball projectiles discharged at close range cannot be ruled out. However, in case of a contact shot, the main injury potential of this weapon type must be attributed to the high energy density of the muzzle gas jet which may, similar to well-known gas or alarm weapons, cause life-threatening or even lethal injuries.

Amongst hundreds of different projectiles for air guns available on the market, hollow-point air gun pellets are of special interest. These pellets are characterized by a tip or a hollowed-out shape in their tip which, when fired, makes the projectiles expand to an increased diameter upon entering the target medium. This results in an increase in release of energy which, in turn, has the potential to cause more serious injuries than non-hollow-point projectiles. To the best of the authors’ knowledge, reliable data on the terminal ballistic features of hollow-point air gun projectiles compared to standard diabolo pellets have not yet been published in the forensic literature. The terminal ballistic performance (energy-dependent expansion and penetration) of four different types of .177 caliber hollow-point pellets discharged at kinetic energy levels from approximately 3 J up to 30 J into water, ordnance gelatin, and ordnance gelatin covered with natural chamois as a skin simulant was the subject of this investigation. Energy-dependent expansion of the tested hollow-point pellets was observed after being shot into all investigated target media. While some hollow-point pellets require a minimum kinetic energy of approximately 10 J for sufficient expansion, there are also hollow-point pellets which expand at kinetic energy levels of less than 5 J. The ratio of expansion (RE, calculated by the cross-sectional area (A) after impact divided by the cross-sectional area (A 0) of the undeformed pellet) of hollow-point air gun pellets reached values up of to 2.2. The extent of expansion relates to the kinetic energy of the projectile with a peak for pellet expansion at the 15 to 20 J range. To conclude, this work demonstrates that the hollow-point principle, i.e., the design-related enlargement of the projectiles’ frontal area upon impact into a medium, does work in air guns as claimed by the manufacturers.

Ein 17-jahriges Madchen wurde somnolent und mit Erbrechen in der Hauslichkeit aufgefunden und in ein Krankenhaus gebracht. Dort zeigte sich eine zunachst sehr schwer zu terminierende ventrikulare Tachykardie. Im Verlauf kam es zur Ausbildung eines kardiogenen Schocks, an dessen Folgen das Madchen verstarb. Bei ungeklarter Todesart erfolgte eine gerichtliche Obduktion. Diese erbrachte als Todesursache eine letale Flecainidintoxikation.

Background During hand antisepsis, health care workers (HCWs) are exposed to alcohol by dermal contact and by inhalation. Concerns have been raised that high alcohol absorptions may adversely affect HCWs, particularly certain vulnerable individuals such as pregnant women or individuals with genetic deficiencies of aldehyde dehydrogenase. Methods We investigated the kinetics of HCWs' urinary concentrations of ethanol and its metabolite ethyl glucuronide (EtG) during clinical work with and without previous consumption of alcoholic beverages by HCWs. Results The median ethanol concentration was 0.7 mg/L (interquartile range [IQR], 0.5-1.9 mg/L; maximum, 9.2 mg/L) during abstinence and 12.2 mg/L (IQR, 1.5-139.6 mg/L; maximum, 1,020.1 mg/L) during alcohol consumption. During abstinence, EtG reached concentrations of up to 958 ng/mL. When alcohol consumption was permitted, the median EtG concentration of all samples was 2,593 ng/mL (IQR, 890.8-3,576 ng/mL; maximum, 5,043 ng/mL). Although alcohol consumption was strongly correlated with both EtG and ethanol in urine, no significant correlation for the frequency of alcoholic hand antisepsis was observed in the linear mixed models. Conclusions The use of ethanol-based handrub induces measurable ethanol and EtG concentrations in urine. Compared with consumption of alcoholic beverages or use of consumer products containing ethanol, the amount of ethanol absorption resulting from handrub applications is negligible. In practice, there is no evidence of any harmful effect of using ethanol-based handrubs as much as it is clinically necessary.

Potato guns are popular homemade guns which work on the principle of gas combustion. They are usually constructed for recreational rather than criminal purposes. Yet some serious injuries and fatalities due to these guns are reported. As information on the internal ballistics of homemade gas combustion-powered guns is scarce, it is the aim of this work to provide an experimental model of the internal ballistics of these devices and to investigate their basic physical parameters. A gas combustion gun was constructed with a steel tube as the main component. Gas/air mixtures of acetylene, hydrogen, and ethylene were used as propellants for discharging a 46-mm caliber test projectile. Gas pressure in the combustion chamber was captured with a piezoelectric pressure sensor. Projectile velocity was measured with a ballistic speed measurement system. The maximum gas pressure, the maximum rate of pressure rise, the time parameters of the pressure curve, and the velocity and path of the projectile through the barrel as a function of time were determined according to the pressure-time curve. The maximum gas pressure was measured to be between 1.4 bar (ethylene) and 4.5 bar (acetylene). The highest maximum rate of pressure rise was determined for hydrogen at (dp/dt)max = 607 bar/s. The muzzle energy was calculated to be between 67 J (ethylene) and 204 J (acetylene). To conclude, this work provides basic information on the internal ballistics of homemade gas combustion guns. The risk of injury to the operator or bystanders is high, because accidental explosions of the gun due to the high-pressure rise during combustion of the gas/air mixture may occur.

In the practice of legal medicine in Germany, the assessment of brain death is of minor importance and attracts little attention. However, since several years, international criticism on the concept of brain death has culminated. By reviewing literature and the results of a questionnaire distributed among the participants of the 93rd Annual Congress of the Germany Society of Legal Medicine, the state of knowledge and the current views on brain death were evaluated. Literature search of recent publications regarding brain death was performed (PubMed database, references of legal medicine, Report of the President’s Council on Bioethics, USA 2008). A questionnaire was developed and distributed among the participants of the Congress. The assumption that individual and brain death are synonymous is criticized. Internationally, there are trends to harmonize the very different clinical criteria to assess brain death. The diagnostic advantage of novel techniques such as CT angiography is controversially discussed. It becomes apparent that procedures which record the blood flow and perfusion of the brain will be applied more in the future. Regrettably, these developments are not described in the literature of legal medicine. Moreover, among German forensic scientists, different views concerning brain death exist. The majority favors its equivalent treatment with individual death. The thanatological background can be improved concerning certain aspects of brain death as well as its legal implications. Teaching and research in legal medicine should include the subject brain death. Expertise in forensic science may contribute to the interdisciplinary discussion on brain death. The transfer of actual knowledge, also on disputed ethical aspects of thanatology, to physicians of all disciplines is of great importance.

Medical literature abounds with reports of injuries and fatalities caused by arrows and crossbow bolts. Crossbows are of particular forensic and traumatological interest, because their mode of construction allows for temporary mechanical storage of energy. A newly developed type of pistol (Arcus Arrowstar), which belongs to the category of air and carbon dioxide weapons, discharges arrow-shaped bolts actuated by carbon dioxide cylinders. As, to the best of the authors' knowledge, literature contains no information on this uncommon subclass of weapons it is the aim of this work to provide the experimental data and to assess the trauma potential of these projectiles based on the ascertained physical parameters. Basic kinetic parameters of these carbon dioxide-actuated bolts (velocity v = 39 m/s, energy E = 7.2 J, energy density E' = 0.26 J/mm(2)) are similar to bolts discharged by pistol crossbows. Subsequent firing resulted in a continuous and fast decrease in kinetic energy of the arrows. Test shots into ballistic soap blocks reveal a high penetration capacity, especially when compared to conventional projectiles of equal kinetic energy values (like, e.g., airgun pellets). To conclude, these data demonstrate the high efficiency of arrow-shaped projectiles, which are also characterized by a high cross-sectional density (ratio of mass to cross-sectional area of a projectile).

Todliche Unfalle im Zusammenhang mit Kuhen sind in landlichen Gebieten nicht selten. Todesursachlich konnen Verletzungen, bedingt durch stumpfe und spitze Gewalt, sein. Die vorliegende Kasuistik stellt den Fall einer 53-jahrigen Frau vor, die am Blutverlust aufgrund massiver Weichteilverletzungen im Unterbauch und in der Genital-/Analregion, verursacht durch eine behornte Kuh, verstarb. Zum Zeitpunkt der Feststellung der Todesursache konnte nicht eindeutig geklart werden, welche Kuh diese Verletzungen verursacht hatte, sodass die molekulargenetische Untersuchung der Horner einer Kuh angeordnet wurde.

Das Patientenrechtegesetz (PatRG), das 2013 als Artikelgesetz in Kraft trat, sah einige Neuerungen im Burgerlichen Gesetzbuch (BGB) vor. So wurde unter den Informationspflichten des § 630c BGB in Abs. 2 S. 2 und 3 eine Pflicht des Behandelnden kodifiziert, den Patienten auf dessen Nachfrage oder zur Abwendung gesundheitlicher Gefahren uber einen eigenen oder fremden Behandlungsfehler zu informieren. Dabei mussen fur den Behandelnden Umstande erkennbar sein, die die Annahme eines solchen Behandlungsfehlers begrunden. In einem Straf- oder Busgeldverfahren gegen den Behandelnden oder dessen Angehorigen gemas Auflistung in § 52 Abs. 1 Strafprozessordnung (StPO) sollen diese Informationen allerdings nur Verwendung finden, wenn der Behandelnde seine Zustimmung gegeben hat. Anhand der Gesetzesbegrundung wird die Intention des Gesetzgebers erlautert und die Norm unter Berucksichtigung der aktuellen Literatur und Rechtsprechung kritisch gewurdigt. So bleibt u. a. fraglich, ob diese Offenbarungspflicht bei eingeschrankter Verwertbarkeit in lediglich den vom Gesetzgeber genannten Verfahren dem Grundsatz der Selbstbelastungsfreiheit (Nemo tenetur se ipsum accusare) genugt. Unklar bleibt zudem, wen diese Pflicht der Fehleroffenbarung im Krankenhausalltag trifft und ob sie auch gegenuber Angehorigen nach dem Tod des Patienten Anwendung findet.

Im Zuge des jahrlich auf dem ehemaligen Flughafen Larz stattfindenden Fusion Festivals werden von den lokalen Polizeibehorden rund um den Veranstaltungsort gros angelegte Strasenverkehrskontrollen durchgefuhrt und dabei regelmasig Blutuntersuchungen auf Drogen gemas § 24a Strasenverkehrsgesetz (StVG) in Auftrag gegeben. In den Jahren 2012 und 2013 wurden insgesamt 355 polizeilich angeordnete Blutuntersuchungen auf Betaubungsmittel vom Institut fur Rechtsmedizin Greifswald durchgefuhrt. Dabei kamen immunchemische Screeninguntersuchungen und rechtssichere Bestatigungsuntersuchungen mithilfe der Gaschromatographie mit Massenspektrometriekopplung (GC-MS) zur Quantifizierung zum Einsatz. Im Jahr 2012 waren etwa 65 % und 2013 etwa 50 % der untersuchten Falle positiv gemas § 24a StVG, sodass eine ordnungswidrige Handlung vorliegen sollte. Fur die Zuordnung wurden die von der Grenzwertkommission vorgeschlagenen „Cut-off“-Werte fur die infrage kommenden Wirkstoffe herangezogen. Die Analysen zeigen, dass in abnehmender Haufigkeit Cannabis als Einzeldroge, Cannabis und Amphetamine in Kombination sowie Amphetamine als Einzeldrogen konsumiert wurden. Bei den Amphetaminen bzw. Amphetaminderivaten wurde Ecstasy mit dem Wirkstoff 3,4-Methylendioxy-N-methylamphetamin (MDMA) weitaus am haufigsten nachgewiesen. Im Jahr 2013 wurden gegenuber 2012 fast 67 % mehr drogenauffallige Verkehrsteilnehmer im Zusammenhang mit dem Fusion Festival festgestellt, die zwar weniger grenzwertuberschreitende Wirkstoffkonzentrationen im Blut aufwiesen, diese dafur aber haufiger im grenzwertigen Bereich lagen. Es zeigt sich deutlich, dass entgegen den bisher im Einzugsgebiet der Rechtsmedizin Greifswald beobachteten Konsumtrends Ecstasy, neben der Einnahme von Amphetamin und Methamphetamin, im Zusammenhang mit dem Festival besondere Bedeutung zukommt.

Hintergrund Im Rahmen der forensischen Fahreignungsbegutachtung wird Ethylglucuronid (EtG) als Alkoholkonsummarker im Urin bestimmt. Der Einsatz von ethanolischen Handedesinfektionsmitteln in Kliniken und Laboren dient bei Teilnahme an einem Alkoholabstinenzprogramm gelegentlich als Rechtfertigung bei grenzwertuberschreitenden EtG-Werten (> 100 ng/ml).

Hintergrund Aus neuen Arbeitsmitteln oder Arbeitsablaufen resultieren neue Unfallgefahren. Der Augenarzt hat dann nicht nur die Versorgung von Augenverletzungen zu ubernehmen, er muss im gewissen Umfang auch die Plausibilitat eines Unfallherganges evaluieren konnen.

Purpose The aim of this study was to investigate whether urinary bladder volume (UBV) and blood alcohol concentration (BAC) correlate in a cohort of emergency trauma patients. Furthermore, the feasibility of semi-automated 3D-CT volumetry for urinary bladder volumetry calculations in whole-body CT examinations was elucidated. Material and methods Whole-body CT scans of 831 individuals treated in the emergency department with suspected multiple injuries were included. Manual 3D-CT volumetry of the urinary bladder was performed and the mechanism of injury, patient demographics, BAC, serum creatinine, and hematocrit were retrospectively analyzed. Semi-automated calculation of UBV was performed in 30 patients. Statistical analysis included ROC analysis to calculate cut-off values, sensitivity, and specificity. The Mann-Whitney test and Spearman's correlation coefficient were used to detect significant correlations between UBV and BAC. Results Manual 3D-CT volumetry showed maximum sensitivity and specificity with a cut-off value for urinary bladder volume of 416.3 mL (sensitivity 50.9%; specificity 76.3%; AUC 0.678). With a cut-off value of 4.2 mL/μmol for the creatinine quotient (quotient of serum creatinine and UBV), the sensitivity was 64.2% (specificity 67.0%; AUC 0.681). Semi-automated 3D-CT volumetry resulted in lower UBV values compared to those obtained with manual 3D-CT volumetry. Conclusion Semi-automated 3D-CT volumetry is a reliable method to quantify UBV. UBV correlates with positive BAC results. A UBV above 416 mL seen on an initial whole-body CT must raise suspicion of alcohol intoxication. The creatinine quotient is an even more sensitive and specific parameter for the detection of alcohol intoxication.

Hand-held pistol crossbows, which are smaller versions of conventional crossbows, have recently increased in popularity. Similar to conventional crossbows, life threatening injuries due to bolts discharged from pistol crossbows are reported in forensic and traumatological literature. While the ballistic background of conventional crossbows is comprehensively investigated, there are no investigations on the characteristic ballistic parameters (draw force, potential energy, recurve factor, kinetic energy, and efficiency) of pistol crossbows. Two hand-held pistol crossbows (Barnett Commando and Mini Cross Bow, rated draw force 362.9 N or 80 lbs) were tested. The maximum draw force was investigated using a dynamic tensile testing machine (TIRAtest 2705, TIRA GmbH). The potential energy was determined graphically by polynomial regression as area under the force-draw curve. External ballistic parameters of the bolts discharged from pistol crossbows were measured using a redundant ballistic speed measurement system (Dual-BMC 21a and Dual-LS 1000, Werner Mehl Kurzzeitmesstechnik). The average maximum draw force was 190.3 and 175.6 N for the Barnett and Mini Cross Bow, respectively. The corresponding total energy expended was 10.7 and 11 J, respectively. The recurve factor was calculated to be 0.705 and 1.044, respectively. Average bolt velocity was measured 43 up to 52 m/s. The efficiency was calculated up to 0.94. To conclude, this work provides the pending ballistic data on this special subgroup of crossbows which operate on a remarkable low kinetic energy level. Furthermore, it demonstrates that the nominal draw force pretended in the sales brochure is grossly exaggerated.

Since their introduction in the 1950s in the construction and building trade, powder-actuated fastening tools (nail guns) are of forensic and traumatological importance. There are countless reports on both accidental and intentional injuries and fatalities caused by these tools in medical literature. While the ballistic parameters of so-called low-velocity fastening tools, where the expanding gases act on a captive piston that drives the fastener into the material, are well known, ballistic parameters of "high-velocity" tools, which operate like a firearm and release the energy of the propellant directly on the fastener, are unknown. Therefore, it was the aim of this work to investigate external ballistic parameters of cal. 9 and 6-mm fastening bolts discharged from four different direct-acting nail guns (Type Ideal, Record Piccolo S, Rapid Hammer R300, Titan Type 1). Average muzzle velocity ranged from 400 to 580 m/s, while average kinetic energy of the projectiles ranged from 385 to 547 J. Mean energy density of the projectiles ranged from 9 to 18 J/mm(2). To conclude, this work demonstrates that the muzzle velocity of direct-acting high-velocity tools is approximately five times higher than the muzzle velocity of piston-type tools. Hence, the much-cited comparison to the ballistic parameters of a cal. 22 handgun might be understated and a comparison to the widespread and well-known cal. 9 mm Luger might be more appropriate.

Although potato cannons are an area of great interest among internet users, they are almost completely unknown in the medical community. These simple ballistic devices are made from plastic plumbing pipes and are powered with propellant gas from aerosol cans. By combustion of the gas-oxygen mixture, a high pressure is produced which propels the potato chunks through the barrel. It is the aim of this study to investigate the hazardous potential of these shooting devices. Test shots were performed using three illegally manufactured potato cannons that were confiscated by police authorities. Velocity, impulse, kinetic energy, and energy density were calculated. The risk of head and chest injuries was investigated by using Sturdivan's Blunt Criterion (BC), an energy based five parametric trauma model assessing the vulnerability to blunt weapons, projectile impacts, and behind-body-armor exposures. The probability of lethality due to blunt impact trauma to the chest was assessed using Sturdivan's lethality model. For potential head impacts, all test shots far exceeded the critical BC (head) value which corresponds to a 50% risk of skull fracture. The risk of injury with regard to chest impacts was similar. All but two test shots far exceeded the critical BC (chest) value corresponding to a 50% risk of sustaining a thoracic skeletal injury of Abbreviated Injury Scale 2 or 3. The probability of a lethal injury due to blunt chest impact was as high as 20%. To conclude, this work demonstrates that potato cannons should be considered dangerous weapons rather than as toys used by adventurous adolescents.

Introduction Blank cartridge actuated dummy launching devices are used by migratory bird hunters to train dogs to retrieve downed birds. The devices create a loud noise while simultaneously propelling a hard foam dummy for retrieval. A newly developed dummy launcher is based on a modified cal. 9mm P.A. blank handgun with an extension tube pinned and welded to the barrel imitation. Currently, there are no experimental investigations on the ballistic background and trauma potential of these uncommon shooting devices. Methods An experimental test set-up consisting of a photoelectric infrared light barrier was used for measurement of the velocity of hard foam dummies propelled with an automatic dummy launcher. Ballistic parameters of the dummies and an aluminium sleeve as improvised projectile (kinetic energy ( E ), impulse ( p ), energy density ( E ′) and threshold velocity ( v tsh ) to cause penetrating wounds as a function of cross-sectional density ( S )) were calculated. Results The average velocity ( v ) of the dummies was measured 25.71m/s exerting an average impulse ( p ) of 3.342Ns. The average kinetic energy ( E ) was calculated 43.04J with an average energy density ( E ′) of 0.069J/mm 2 . The average velocity ( v ) of the aluminium sleeves as improvised projectiles was measured 79.58m/s exerting an average impulse ( p ) of 2.228Ns. The average kinetic energy ( E ) of the aluminium sleeves was calculated as 88.70J with an average energy density ( E ′) of 0.282J/mm 2 . Conclusion The energy delivered by these shooting devices is high enough to cause relevant injuries. The absence of skin penetration must not mislead the emergency physician or forensic expert into neglecting the potential damage from these devices.

Introduction Cal. 9 mm × 17 mm industrial blank cartridges deserve special interest in the field of forensic ballistic. This calibre is most often used in Kerner-type livestock stunners, but also in different power tools. The legal framework of these industrial blank cartridges is provided by the C.I.P. and DIN 7260 regulations. The aim of this investigation is to describe and compare two experimental test procedures for measurement of maximum gas pressure and kinetic energy of cal. 9 mm × 17 mm industrial blank cartridges according to standardized C.I.P. and DIN 7260 protocols and to provide these ballistic data. Methods Using two different pressure measurement barrels and standardized test projectiles, the maximum gas pressure and the kinetic energy of the test projectiles are investigated. While the pressure take-off point in C.I.P. protocol is at the cartridge mouth, the DIN 7260 protocol is modified using a pressure take-off point in the cartridge chamber. For each test protocol (C.I.P. and DIN), maximum gas pressure, velocity, impulse and energy of the test projectiles are measured. Each ten cartridges from the same ammunition lot of four different energy levels (red, blue, yellow, green) are investigated. Results While the cartridge energy values are comparable between the two different test protocols, maximum gas pressure measured in the DIN set-up (3907 bar) far surpasses the gas pressure in the C.I.P. protocol (1586 bar). Both test protocols observed higher energy values of the green and yellow cartridges than regulated in DIN 7260. Conclusion Enormous gas pressure values of more than 3900 bar emphasize the power of industrial blank cartridges. Once again, the harmlessness of these blank cartridges and the weapons/tools that are operated with these propellants is refuted.

Introduction Vole captive bolt devices are powder actuated spring guns that are used as a pest control mean. After having triggered the explosion of the blank cartridge by touching a metal ring around the muzzle, the vole is killed by the massive propulsion of the gas jet. Improper use and recklessness while handling these devices may cause severe injuries with the hand of the operator at particular risk. Currently, there are no experimental investigations on the ballistic background of these devices. Methods An experimental test set-up was designed for measurement of the firing pressure and the dynamic force of the gas jet of a vole captive bolt device. Therefore, a vole captive bolt device was prepared with a pressure take-off channel and a piezoelectric transducer for measurement of the firing pressure. For measurement of the dynamic impact force of the gas jet an annular quartz force sensor was installed on a test bench. Each three simultaneous measurements of the cartridges’ firing pressure and the dynamic force of the blast wave were taken at various distances between muzzle and load washer. Results The maximum gas pressure in the explosion chamber was up to 1100 bar. The shot development over time showed a typical gas pressure curve. Flow velocity of the gas jet was up to 2000 m/s. The maximum impact force of the gas jet at the target showed a strong inverse ratio to the muzzle's distance and was up to 11,500 N for the contact shot distance. Energy density of the gas jet for the close contact shot was far beyond the energy density required for skin penetration. Conclusion The unique design features (short tube between cartridge mouth and muzzle and narrow diameter of the muzzle) of these gadgets are responsible for the high firing pressure, velocity and force of the gas jet. These findings explain the trauma mechanics of the extensive tissue damage observed in accidental shots of these devices.

Petechial hemorrhages or ecchymoses in the skin of the face and/or in eyelids and/or conjunctivae are one important feature in postmortem diagnosis of lethal strangulation. On the other hand, petechial bleedings can occur in various causes of death, especially in cases of neck or thoracic compression, they can occur in acute cardiac failure, as a result of blood or skin diseases or as a postmortem phenomenon. The focus of this investigation (retrospective study of 279 corpses, found initially in a prone position or some other face down position) was to analyse the frequency of postmortem (hypostatic) hemorrhages and factors which may influence their development. Petechial hemorrhages in livor mortis in the skin of the trunk and extremities were found in 110 cases (39%). The frequency ranged from 41% in the side position and 44% in the kneeling position to 50% in the prone position. Increasing intensity of livor mortis resulted in an increasing frequency of hemorrhages, up to 59%. In cases with a body-mass-index (BMI) of more than 26 the frequency of hemorrhages increased up to 64%. In cases without livor mortis when the corpses were found as well as in cases with complete movement of livor mortis after turning the corpses, no hemorrhages were found. If hypostasis was partly or completely fixed, the rate of hemorrhages increased up to 50%, without additional increase in longer postmortem intervals. Obviously postmortem petechiae develop neither very soon nor days after death, but within a period of several hours after death.

Suicides by ligature strangulation are rare events. In Berlin (3.5 million inhabitants; ca. 500 suicides per year) approximately one case per year occurs. Here, we present the main findings of 19 cases investigated between 1978 and 1998, compared to 47 cases of homicidal ligature strangulation. Two of the 19 suicidal victims had single fractures of the upper thyroid horns and one victim a fracture of a lower thyroid horn; other types of laryngohyoid injuries were not observed. In the homicidal series, the laryngohyoid structures were unaffected in 26 cases (12 of these victims were children or adolescents), single thyroid horn fractures were present in three cases and more significant injuries in 18 cases. Macroscopic bleedings of the laryngeal muscles were found in 12 victims of the homicidal group and in none of the suicidal. Bleedings in the neck muscles seldom occurred in suicides. According to these findings, the laryngohyoid injuries can be helpful in the differentiation of suicide from homicide, if more than a single thyroid horn fracture or a laryngeal soft tissue trauma is present.

The problems of assessment of aspiration (foreign bodies, stomach contents, food material) in forensic practical work are well-known, especially if 'suffocation due to aspiration' is considered to be the cause of death (or a concurrent cause of death). In the last 4 years (1998-2001) in the Department of Legal Medicine of the Free University, Berlin, 14 deaths with massive aspirations were investigated. The lethal aspiration cases consisted of seven men and five women between 55 and 91 years old, as well as two children (boy 6 years and girl 19 months old). All but one of the victims had severe neurological alterations (dementia, apoplexia, sequelae of head injuries). In six cases the victims died during or a short time after a meal; they had been fed by the nursing staff, a family member or another caregiver. The witness statements pertaining to clinical symptoms or the course of events ranged from 'no symptoms' to intensive cyanosis, congestion and no clear reactions of distress.

Vor dem Hintergrund der aktuellen Diskussionen in unserer Fachgesellschaft uber einen effektiven praktischen Studentenunterricht im Fach „Rechtsmedizin“ stellen wir den Ablauf unseres Kurses „Rechtsmedizin“ vor. Neben den Vorlesungen zur Rechtsmedizin und zur arztlichen Rechts- und Berufskunde, die sich am Gegenstandskatalog orientieren, konzentriert sich unser Kurs auf die arztliche Leichenschau sowie die forensische Verletzungskunde. Bei der Leichenschau lernen die Studierenden die korrekte Einordnung der Todesart sowie ihre arztlichen Pflichten im Zusammenhang mit den Bestattungsgesetzen. Bei der Verletzungskunde werden sie uber die richtige Befunderhebung und Dokumentation sowie Rekonstruktion von Verletzungsbefunden geschult. Jeder Studierende bekommt 28 Stunden im Kleingruppenunterricht, verteilt uber 12 Wochen. Der Kurs beinhaltet 12 Stunden im Horsaal, 7 Stunden praktischer Unterricht an der Leiche, 5 Stunden systematische Verletzungskunde im Seminarraum sowie ¶3 Stunden Prufungen und 1 Stunde ein freier Test uber Todesarten. Die Prufungen in der 3., 9. und 12. Woche haben sich als Wissenskontrollen bewahrt.

This article gives a short overview of medical education in Germany. The legal basis and organization of the medical studies program as well as the course in forensic medicine and the training duration for forensic pathologists are described.

Es wird uber eine Selbsttotung berichtet, bei der der Suizident zunachst versucht hatte, sich mittels Elektrogeraten in der mit Wasser gefullten Badewanne zu toten. Die mehrfachen frustranen Versuche der todlichen Strombeibringung wurden von dem Mann mit kurzen handschriftlichen Notizen dokumentiert. Der Mann erhangte sich schlieslich in seiner Wohnung. Der Fall legt erneut nahe, wie die experimentell ermittelten Parameter und Daten das Gefahrdungspotential des elektrischen Stromes in einer mit Wasser gefullten Badewanne mitbestimmen.

Medical literature abounds with reports on injuries and fatalities caused by airgun projectiles. While round balls or diabolo pellets have been the standard projectiles for airguns for decades, today, there are a large number of different airgun projectiles available. A very uncommon — and until now unique — discarding sabot airgun projectile (Sussex Sabo Bullet) was introduced into the market in the 1980s. The projectile, available in 0.177 (4.5 mm) and 0.22 (5.5 mm) caliber, consists of a plastic sabot cup surrounding a subcaliber copper-coated lead projectile in typical bullet shape. Following the typical principle of a discarding sabot projectile, the lightweight sabot is supposed to quickly loose velocity and to fall to the ground downrange while the bullet continues on target. These sabot-loaded projectiles are of special forensic interest due to their non-traceability and ballistic parameters. Therefore, it is the aim of this work to investigate the ballistic performance of these sabot airgun projectiles by high-speed video analyses and by measurement of the kinetic parameters of the projectile parts by a transient recording system as well as observing their physical features after being fired. While the sabot principle worked properly in high-energy airguns (E > 17 J), separation of the core projectile from the sabot cup was also observed when discharged in low-energy airguns (E

The capability of conventional air gun lead pellets (diabolo pellets) to cause severe injuries or fatalities even at low kinetic energy levels is well documented in medical literature. Modern composite hunting pellets, usually a metal core (made of steel, lead, zinc, or a zinc and aluminum alloy) encased in a plastic sleeve, are of special forensic and traumatological interest. These projectiles are advertised by the manufacturers to discharge at higher velocities than conventional air gun pellets, thus generating very high tissue-penetrating capabilities. Lack of experimental data on these uncommon air gun projectiles induced this work. Ballistic parameters of 12 different caliber .177 (4.5 mm) composite pellets, discharged from two spring-piston air guns (Weihrauch HW 35, Webley CUB) and three pneumatic air guns (Walther LGR, Walther LG400, Walther LP300), were investigated using a ballistic speed measurement system and compared to a conventional diabolo pellet (RWS Meisterkugel) as reference projectile. Although overall results were inconsistent, for some projectile–weapon combinations (particularly spring-piston air guns), a significant change of the kinetic energy (−53 up to +48 %) to the reference projectile was observed. The data provided in this work may serve as a basis for forensic investigation as well as traumatological diagnosis and treatment of injuries caused by these uncommon projectiles.

Nails and driving pins discharged from powder-actuated fastening tools bear some special ballistic characteristics. Compared to the usual pistol or revolver projectiles, the sectional density (S) of fastening pins is extremely high. The general prevailing opinion is that the kinetic energy delivered by fastening tools is not high enough to cause a temporary cavity. Therefore, it was the aim of this study to investigate the wound morphology due to fastening bolts discharged from a powder-actuated direct-acting nail gun (where, in contrast to modern piston-type tools, the expanding gases act directly on the fastener) using ballistic soap blocks as simulants. For test shots, a direct-acting powder-actuated nail gun which features three interchangeable barrels (caliber (cal.) 6, 8, and 10 mm) was used. The average kinetic energy was 537, 532, and 694 J for the 6-, 8-, and 10-mm cal. bolts, respectively. Test shots on the ballistic soap blocks demonstrated that free-flying projectiles discharged from direct-acting fastening tools are able to create a temporary cavity.

The recent clinical observation of two unintentional penetrating ocular and cerebral injuries due to 90-mm construction nails gave occasion to an experimental study to check the alleged trauma mechanism for plausibility. Both casualties reported that they had attached a mason’s lacing cord to the masonry using a nail as anchoring when suddenly the nail was yanked from its moorings and propelled like a missile by the overstretched lacing cord. As to the best of the authors’ knowledge, this mechanism of injury has not yet been reported in any of the literature; it was the aim to find an experimental approach to review the plausibility of the alleged sequence of events leading to the accidents. The tensile strength at break and strain at break of different mason’s lacing cords (diameter of 1 and 2 mm) were measured according to DIN EN ISO 2062 by using a tensile testing machine. Based on the maximum spring energy of the lacing cords, which was determined 174.9 J for the 1-mm cord (length 10 m) and 747.4 J for the 2-mm cord (length 10 m), the maximum possible velocity of the nails as projectiles was calculated to be 243.5 m/s for the 1-mm cord and 503.4 m/s for the 2-mm cord. The critical elongation a cord of a certain length has to be stretched to deliver enough kinetic energy to a 90-mm nail to surpass the threshold velocity for skin penetration, which was investigated by Sellier (1977) to be approximately 18 m/s, was also calculated. To conclude, the energy delivered by the cords is high enough to surpass the rather low threshold velocity of nails. The details of how these accidents occurred, which seemed questionable at first, can be reasonably explained by trauma biomechanics.

The investigation of sexual offences is a real challenge, as the injuries are often unspecific or faint and may sometimes be missing completely. Evidence recovery and analysis as well as the statements of the victims and suspects are therefore of vital importance. In both presented cases, the results of trace evidence analysis were basically consistent with a sexual assault, but the victims' statements regarding the course of events and the pattern of traces showed severe discrepancies.

A 79-year-old man, who was in a helpless situation due to cardiac decompensation, suffered dog bite injuries on the left thigh and in the genital region while still alive. Two extensive soft-tissue defects with contused and bruised wound edges were surrounded by multiple slit-like skin lesions. The outer genitals were almost completely missing. Because of surgical emergency treatment, molecular biological investigations were no longer possible. Therefore, the cause of the bite injuries had to be determined solely on the basis of the documented morphology of the wounds.

Background: Blunt ballistic impact trauma is a current research topic due to the widespread use of kinetic energy munitions in law enforcement. In the civilian setting, an automatic dummy launcher has recently been identified as source of blunt impact trauma. However, there is no data on the injury risk of conventional dummy launchers. It is the aim of this investigation to predict potential impact injury to the human head and chest on the basis of the Blunt Criterion which is an energy based blunt trauma model to assess vulnerability to blunt weapons, projectile impacts, and behind-armor-exposures. Methods: Based on experimentally investigated kinetic parameters, the injury risk of two commercially available gundog retrieval devices (Waidwerk Telebock, Germany; Turner Richards, United Kingdom) was assessed using the Blunt Criterion trauma model for blunt ballistic impact trauma to the head and chest. Results: Assessing chest impact, the Blunt Criterion values for both shooting devices were higher than the critical Blunt Criterion value of 0.37, which represents a 50% risk of sustaining a thoracic skeletal injury of AIS 2 (moderate injury) or AIS 3 (serious injury). The maximum Blunt Criterion value (1.106) was higher than the Blunt Criterion value corresponding to AIS 4 (severe injury). With regard to the impact injury risk to the head, both devices surpass by far the critical Blunt Criterion value of 1.61, which represents a 50% risk of skull fracture. Highest Blunt Criterion values were measured for the Turner Richards Launcher (2.884) corresponding to a risk of skull fracture of higher than 80%. Conclusion: Even though the classification as non-guns by legal authorities might implicate harmlessness, the Blunt Criterion trauma model illustrates the hazardous potential of these shooting devices. The Blunt Criterion trauma model links the laboratory findings to the impact injury patterns of the head and chest that might be expected.

This report concerns a passenger car crash, which at first looked like a case of multiple trauma resulting in the death of the pinned-in driver. Conspicuous was a cuff that had been applied to the left forearm. No significant injuries could be determined during the autopsy of the corpse. The forensic toxicology results showed lethal toxic concentrations of the painkiller pethidine, which suggests that the driver had applied a lethal dose of the medication immediately before the collision as part of a complex suicide.

Fractures of the upper thyroid horns are a frequent finding after a variety of neck injuries - resulting from a direct mechanical trauma, e.g. compression of the neck in manual strangulation or ligature strangulation, from blunt injuries (falls or blows against the neck), and sometimes from indirect trauma (whiplash-injuries). Although it is well known that thyroid horns can be broken with relatively little pressure, no quantitative data are available in the literature. In an experimental investigation, the isolated thyroid cartilage was prepared (divided into two parts, measured, X-rayed, photographed, embedded in paraplast) and clamped in a simple apparatus. Weight was applied on the upper thyroid horn (imitating pressure on the horns), beginning with 1 kg and gradually increased by increments of 250 g to a maximum of 8 kg, until an 'injury' occurred. In this study, 120 thyroid cartilages (77 men, 43 women, 16-95 years) were investigated. The location of the fractures was in nearly all cases the base of the horns. The mean weight resulting in an injury of the horn was 3 kg (men: 3.3 kg, women: 2.6 kg). The required weight was dependent on the degree of ossification. The highest rate of fractures was found in cases with incomplete ossification; in cases without ossification, specimens often remained macroscopically uninjured.

The authors report on 4 deaths. 3 of the victims had been bitten by dogs shortly before death; in one case the victim had close contacts with a dog. In 3 of the cases death was caused by septicemia; microorganisms occurring in the saliva of dogs, but rarely causing infection could be determined in 2 of the cases. While in case 1 there was no bite injury so that transmission must have occurred by droplet infection (without trauma) or via a discrete skin lesion, case 2 showed a penetrating dog-bite injury; in both cases the spleen had been surgically removed some years before. In case 3 a causal relationship had to be assumed between a dog bite and death, although no pathogen could be identified in microbiological tests. In case 4 death was not attributable to the dog-bite injury suffered, but was due to an internal pathological cause.

Hemorrhages of the tongue can be useful for the diagnosis in cases of lethal neck compression. The reported frequencies of tongue bleedings in the literature in cases of suicidal hanging range from 0 to 14% and in homicidal strangulation (str.) from 5 to 37%. This study gives a summary of the incidence and intensity of tongue bleedings in cases of homicidal str. by ligature, manual str., suicidal str. by ligature and suicidal hanging. In 25% of all homicides significant or massive hemorrhages of the tongue were detected. In contrast to this, in suicidal hanging the tongue was unaffected in 95%. The causes of massive hemorrhages here (2%) could be explained by an “abnormal” position of the loop.

Doxylamine is an antihistamine of the ethanolamine class. It is used primarily as a sleep-inducing agent. Only a few reports can be found in the literature about lethal intoxications with doxylamine, but many with combined intoxications. Doxylamine is, aside from diphenhydramine, the only chemically defined active ingredient in some sleeping medications which is available without a prescription in the Federal Republic of Germany. Two cases of doxylamine poisoning are presented, in which high doxylamine concentrations were found in the blood and organs.

The t(14;18) translocation associated with follicular lymphoma can be detected in healthy individuals when highly sensitive PCR-based techniques are applied on blood and tissue samples. We studied the prevalence and frequency of t(14;18)-positive cells in a total of 632 healthy individuals (newborns to elderly adults). A standardized quantitative real-time PCR was carried out for the detection of t(14;18)-MBR-positive cells [Dölken,L. et al.; Biotechniques1998;25:1058–1064]. The K-ras wild-type gene served as reference gene to determine the number of cells in a given sample. The individuals under study were divided into eight age groups (A: 0–9; B: 10–19; C: 20–29; D: 30–39, E: 40–49; F: 50–59; G: 60–69; H: 70–91 years). The prevalence of t(14;18) positive cells within these ten groups strongly correlates with age (χ2 Test: P < 0.0001). Until the age of 10 no individual (n=87; cord blood samples: n=36, 0–1 year: n=12; 1–9 years: n=39) had detectable circulating t(14;18)-positive cells. In the age groups between 10 to 50 years (n=336) the prevalence of circulating t(14;18)-positive cells shows a significant increase from each younger to the following older age group (Fisher’s exact test; each p value significant). The prevalence rises by a constant linear rate of 1.62% per year (r2=0.9945) beginning in a median age of 7.7 years (prevalence=1.62*[years]−7.7). We did not observe any further increase in the prevalence in individuals older than 50 years of age. The median frequencies of t(14;18) positive cells in the seven age groups from 10 – 91 years show an association with age (Kruskall Wallis test: P=0.0009). A one-by-one comparison of the seven age groups that had circulating t(14;18) positive cells (10–91 years) showed a significantly higher median frequency of t(14;18) positive cells in the two oldest age groups G (60–69yrs.) and H (70–91) than in younger groups (Mann Whitney test). Therefore, we were interested in determining the age when t(14;18) positive cells appear in different lymphoid tissues as well as peripheral blood and bone marrow. 12 tonsil samples with no pathological abnormality were obtained from 12 newborns. There were no detectable t(14;18)-positive cells in all cases. From further 11 individuals we analyzed peripheral blood, bone marrow, tonsil tissue, spleen tissue and lymph node tissue for t(14;18)-positive cells. Two individuals younger than 1 year had no detectable t(14;18)-positive cells in any tissue sample. In the remaining 9 individuals (17 – 32 years) t(14;18)-positive cells could be detected: 5+/9 spleen tissues, 5+/9 tonsil tissue, 4+/9 peripheral blood, 2+/9 lymph node tissue, 1+/9 bone marrow. The 5 positive spleen tissue samples had a significant higher frequency of t(14;18) positive cells than observed in peripheral blood and all other tissue samples. In conclusion, expanded t(14;18)-positive cell clones can be detected circulating in the peripheral blood after the age of 10 years with an increasing prevalence and frequency until the age of 50. Among various lymphoid tissues obtained from individuals in the age of 17–32 years the highest frequency of t(14;18)-positive cells can be found in the spleen.