Forensic science international
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The population of Curaçao, Netherlands Antilles (133,000) shows a very high prevalence of end-stage renal disease (approximately 1 per 1,000). These patients are often treated chronically with haemodialysis. As the drinking water on the island is prepared by distillation of sea water, the haemodialysis fluid used to be prepared with tap water without further treatment. ⋯ Investigations of the tap water supply revealed that a few weeks before the onset of the symptoms, a water conduit pipe to the dialysis unit had been replaced, which was lined with Al- and Ca-rich cement mortar. These ions leached into the distilled water and caused both Ca- and Al-intoxication through uptake from the dialysate into the patients' circulation. The symptoms of the latter were initially not recognized as they were masked by the symptoms of hypercalcaemia.
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A homicidal fatality is presented to demonstrate that the pattern of injuries may suggest the use of an unusual sharp force, a survival-knife, the characteristics of which are in any case well defined. This knife has saw teeth along the back that can leave characteristic scrape marks on the skin.
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Bullet embolism of the arterial, venous and paradoxical types are well known but rare complications of penetrating missile injuries. Retrograde transthoracic venous bullet embolization is extremely rare with only four cases previously reported in the literature. ⋯ We present the autopsy findings of a retrograde transthoracic bullet embolism to the right external iliac vein after a single gunshot with multiple wounds in the left arm and thorax. Problems related to medico-legal investigations of gunshots are reviewed.
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We investigated retrospectively the forensic autopsy cases of suicide by self-immolation in Berlin from 1990 to 2000. There were 46 cases (35 men and 11 women), corresponding to 0.76% of all known suicides committed in Berlin during this period. The most common reasons for self-immolation were separation from a partner or financial problems. ⋯ The median body surface area burnt was 78% for all cases. The blood had a mean 21% carboxyhemoglobin concentration and 0.07 microg/ml of cyanide. Suicide by self-immolation was committed under the influence of drugs in nine cases and of alcohol in 11 cases.
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It has been known for years that mixing household cleaning products can be hazardous. Nonetheless, from time to time, episodes of pneumonitis from such mixing occur. ⋯ We present the case of a woman with an undiagnosed oligodendroglioma who mixed bleach and ammonia (resulting in the formation of chloramine gas), and died while cleaning her bathroom. To our knowledge, this is the first such death reported from chloramine gas intoxication.