The American journal of forensic medicine and pathology
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Am J Forensic Med Pathol · Mar 1999
Case ReportsTissue distribution of tramadol and metabolites in an overdose fatality.
Tramadol (Ultram) is a centrally acting, synthetic analgesic agent. Although it has some affinity for the opiate receptors, tramadol is believed to exert its analgesic effect by inhibiting the re-uptake of norepinephrine and serotonin. There are several published cases of tramadol's involvement in drug-related deaths and impairment. ⋯ In each tissue or fluid except urine, the tramadol concentration was greater than either metabolite, consistent with other reports of drug-impaired drivers and postmortem cases. The O-desmethyl metabolite concentration was greater than the N-desmethyl metabolite concentration in all tissues; this is in contrast to other postmortem reports, in which the majority of cases report concentrations of O-desmethyl as less than those of N-desmethyl. This may be useful as an indicator of time lapse between ingestion and death.
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Am J Forensic Med Pathol · Mar 1999
Case ReportsEntrance, exit, and reentrance of one shot with a shotgun.
The case being reported is one of a homicidal shotgun fatality with an unusual wound pattern. A 34-year-old man was shot at close range with a 12-gauge shotgun armed with No. 5 birdshot ammunition. ⋯ The entrance wound in the axilla was larger than the other wounds, and before autopsy it was believed that the shotgun had been fired twice, causing one wound in the neck and one wound perforating the infraclavicular region and exiting through the left axillary region. Thus, this case shows that unusual wound patterns in shotgun fatalities can easily lead to incorrect assumptions with regard to number and direction of shots fired unless thorough investigation is carried out postmortem.
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Am J Forensic Med Pathol · Mar 1999
Case ReportsAsplenia as a cause of sudden unexpected death in childhood.
Sudden unexpected death in childhood is rare. The commonest causes of such deaths are a result of fulminating infections of the respiratory or nervous systems. Other causes include unsuspected congenital abnormalities of the heart, acute metabolic disorders, and rarities such as internal hemorrhages and pulmonary thrombosis. ⋯ Previously healthy children who clinically deteriorate very rapidly should have a blood smear done as part of their clinical workup. The detection of Howell-Jolly bodies on a peripheral blood smear can be an indicator of asplenia, and this diagnosis can be confirmed by medical imaging of the abdomen. Such steps may aid in the aggressive management of isolated congenital asplenia and thereby avert untimely death.
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Am J Forensic Med Pathol · Dec 1998
ReviewToxicologic evaluation of pepper spray as a possible weapon for the Dutch police force: risk assessment and efficacy.
The efficacy and possible health risks of pepper spray were evaluated. In a number of countries, pepper spray is being used by police forces to aid in arresting aggressive individuals. Pepper spray is commercially available as a canister filled with Capsicum extract, which contains capsaicin as the active component. ⋯ It was concluded that the risk of long-term health effects is negligible. Because pepper spray may induce bronchoconstriction, people suffering from chronic obstructive lung disease may be hypersensitive to it. Although the results of one study indicate that asthmatics do not develop additional bronchoconstriction following inhalation of capsaicin, the number of experimental data are too few to draw sound conclusions.
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Am J Forensic Med Pathol · Dec 1998
Centerfire frangible ammunition: wounding potential and other forensic concerns.
Recently developed frangible ammunition of copper particulate construction in .38 Special, 9 mm, and .223 calibers was evaluated for wounding performance by firing into pigs' heads. The ability to match fired bullets with the corresponding gun was also examined. ⋯ High-velocity .223-caliber rifle bullets fragmented extensively within target tissues, causing severe wounding. Radiologic examination of resulting wounds showed images strikingly similar to the lead "snowstorm" picture caused by high-velocity hunting ammunition.