Archiv für Kriminologie
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Archiv für Kriminologie · Sep 2011
Case Reports[Survived stab to the heart in a schizophrenic man].
Schizophrenia is associated with a significant risk of suicide. According to recent research, 10-15 % of all schizophrenic patients die by suicide. It is not uncommon that the victims show sharp force injuries, so that the forensic pathologist first has to differentiate between self-infliction and involvement of another person. ⋯ In the criminal investigation, a suicide attempt made 13 days before could be ascertained. As the patient did not want to be taken to a hospital at that time, the injury had never been examined or documented. Since there was no evidence suggesting homicide, the older stab to the heart was interpreted as a tentative injury.
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Archiv für Kriminologie · May 2010
[Medicolegal experiences in external post-mortem examinations before cremation--a retrospective analysis of the years 1998-2008].
The paper presents a retrospective analysis of 16,541 external post-mortem examinations carried out before cremation by the Institute of Forensic Medicine of the University of Bonn between 1998 and 2008 with regard to different variables (age, sex, place of death, cause of death etc.). In more than 50 % of cases, the individuals had died in a hospital followed by their apartment or a nursing home. The first post-mortem examination was mainly performed by hospital doctors followed by emergency doctors and office practitioners. ⋯ Although the second external examination before cremation is very useful in detecting previously overlooked signs of homicide, it is only of limited value in homicides with few external traces or for detecting underlying diseases and causes of death. In this respect, the second external examination before cremation can only check the plausibility of the cause of death given by the attending physician. The gold standard for a reliable certification of the manner and cause of death remains the autopsy.
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Archiv für Kriminologie · Jan 2010
[Reliability of the diagnoses of external post-mortem examinations in non-natural deaths before and after the German reunification].
In Germany, the unsatisfactory quality of external post-mortem examinations and the low autopsy rate of only 5 % of all deaths are often criticized. Based on the autopsy protocols of 8,593 cases of non-natural death of the Leipzig Institute of Legal Medicine (1985 to 1989--practice in the former German Democratic Republic; 1990 to 1994 - time around the fall of the Berlin wall, and 2000 to 2004--practice in the Federal Republic of Germany) the diagnosis indicated in the death certificate was compared with that of the autopsy report. ⋯ The low rate of correspondence in the causes of domestic deaths was particularly alarming. There were obvious differences in quality among different groups of specialists in determining the cause of death.
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Since Werkgartner described and correctly interpreted the muzzle imprint mark around the gunshot entrance wound in 1922, this finding has been generally accepted as a sign of a contact shot. In further studies, it could finally be clarified that the muzzle imprint mark is caused by the expansive power of the powder gases with pressure on and abrasion of the skin at the muzzle (weapon imprint). Its shape depends on the firearm, the ammunition and the anatomical conditions, but does not require a bullet. ⋯ Occasionally, the muzzle imprint mark requires a certain "drying period" in order to become clearly visible. In rare cases, muzzle imprint marks also form on textiles perforated by the projectile. Characteristically shaped muzzled imprint marks can provide clues to the type of the firearm and its position at the time of discharge.
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This paper presents statistical data on medico-legal autopsies at the three Berlin institutes from 1999 to 2003. With an autopsy frequency of 6.5% in 1999, Berlin was ranking at the top in Germany. ⋯ In accordance with studies from other major cities, there were more cases with an unknown cause of death and a higher number of drug victims than in rural areas. The negative consequences of a far too low autopsy rate in Germany regarding legal certainty, the quality of medical care and the validity of the statistics of causes of death are discussed in connection with possible measures to increase the frequency of autopsies.