[Is this iatrogenic pathology or rare disease?] / Yatrogennaya patologiya ili redkaya bolezn'?

The article is devoted to the problem of diagnosis and treatment strategy of Buerger's disease rarely found in the expert and clinical practice, that is inflammatory disease of unknown etiology, affecting mainly small and medium arteries and veins of limbs. Vascular surgeons around the world have been solving this problem for many years, both in terms of timely diagnosis of this disease and its proper pathogenic treatment. The authors of the article described an expert case of Buerger's disease larvated course in 15-years-old girl, which primarily was mistakenly assessed by specialists as iatrogenic pathology of right forearm vessels in injecting aminazin solution that, according to the clinicians' opinion, led to dry gangrene formation of right wrist and its subsequent amputation. The results of the forensic histological study and retrospective analysis of all child's medical documents allowed to correctly diagnose this rare pathology but only on the stage of commission forensic medical examination in the framework of the initiated criminal proceeding against several leading medical organizations in Saint-Petersburg with a pediatric profile. The authors noted the role of routine medical manipulation in manifestation of larvated pathologic process in a teenage girl in addition to full health and well-being. The objective of present article is devoted to understanding this problem.

[Challenges of expert assessment of injury to health in the case of iatrogenic mastectomy due to erroneous histological verification of an oncological condition]. / Problemy ekspertnoi otsenki vreda zdorov'yu v sluchae yatrogennogo udaleniya molochnykh zhelez vsledstvie oshibochnoi gistologicheskoi verifikatsii onkologicheskoi patologii.

A case of commission forensic medical examination in the St. Petersburg Bureau of Forensic Science of a civil case due to an unfavorable treatment outcome is presented. Patient T., 45 years old; due to erroneous histological verification of oncological pathology, she had both breasts removed and received antitumor treatment. It has been shown that defects in histological diagnosis can lead to errors by clinicians and become the subject of lawsuits by patients accusing healthcare professionals of adverse treatment outcomes. It is emphasized that the current legislation lacks medical criteria and an algorithm for assessing the severity of injury to health in women with one or both breasts removed.

[Problems of expert assessment of a case of fatal rupture of the wall of the rudimentary horn of the uterus in ectopic pregnancy]. / Problemy ekspertnoi otsenki sluchaya fatal'nogo razryva stenki rudimentarnogo roga matki pri ektopicheskoi beremennosti.

Recently in the Russian Federation there has been a significant increase in the number of commissions of forensic medical examinations on «medical cases¼ associated with inappropriate provision of medical care to the population. The problem of investigating such crimes is one of the most difficult tasks facing law enforcement agencies. A special place among them is occupied by examinations related to maternal mortality. Bleeding is one of the main causes of maternal mortality, the share of which in Russia in 2019 was 14.5%. An illustrative example of conditionally preventable death is the case of an unfavorable outcome of a pathological pregnancy in patient A., 25 years old, which ended in a sudden spontaneous rupture of the rudimentary horn of the uterus with massive intra-abdominal bleeding. The underestimation of the results of MRI and ultrasound diagnostics led to a medical error in establishing the variant of an anomaly in the development of the uterus in patient A. and entailed the wrong tactics for managing her pregnancy under observation in a private medical organization.

[Problems of expert assessment in gunshot injuries caused by shots from special weapon]. / Problemy ekspertnoi otsenki ognestrel'nykh povrezhdenii, prichinennykh vystrelami iz oruzhiya spetsial'nogo naznacheniya.

Forensic examination of a gunshot injury is the most difficult problem of domestic and foreign forensic medicine. A large amount of knowledge and practical observations on damage from standard samples of handguns has been accumulated. The emergence of new unique samples of special-purpose weapons requires forensic physicians and forensic experts to conduct a complex of morphological, spectral, forensic chemical, medico-forensic, radiological and other special laboratory studies of damage caused by such weapons. The article presents a case of forensic medical examination commission with the issue solution of differential diagnosis of causing a mortal fire wound injuries by a specific sample of special-purpose handgun.

[Forensic assessment of seat belt injuries caused to a minor passenger in the rear seat]. / Sudebno-meditsinskaya otsenka povrezhdenii ot vozdeistviya remnya bezopasnosti, prichinennykh nesovershennoletnemu passazhiru zadnego siden'ya.

The purpose of this work is to draw attention to the problem of child injuries in road traffic accidents. Children are the most vulnerable road users. Seat belts as elements of passive safety of cars cannot always provide the necessary protection. In some cases, they act as traumatic objects. A case of a thoracic spine injury (fractures of the bodies of two thoracic vertebrae) in a minor child who was on a booster and fixed with a standard seat belt is presented. The data of clinical and special research methods are presented, as well as options for solving some forensic issues are considered.

[Problematic issues of the forensic medical examination of a fatal injury induced by modern small-scale water transport]. / Problemnye voprosy sudebno-meditsinskoi ekspertizy smertel'noi travmy, prichinennoi sovremennym malomernym vodnym transportom.

Relevance of studying the conditions and mechanisms for the formation of water transport trauma is evaluated on the example of forensic medical situational examination of a young girl, who received multiple injuries with a propeller and keel of a speedboat. The victim died from drowning in water. Authors present the features of the morphology of chopped injuries on the skin and flat bones of the skull, proving the fact that they were caused by the screw of one of the three vehicles suspected of hitting victim and causing her severe traumatic brain injury during swimming time. Attention is drawn to the need for strict adherence to safety rules on water, including in places of mass rest and large crowds.

[The forensic medical aspects of the problem of victimization of the elderly persons as exemplified by a case of suicide of an oncological patient]. / Sudebno-meditsinskie aspekty problemy viktimnosti lits preklonnogo vozrasta (na primere samoubiistva onkologicheskogo bol'nogo).

The frequency of suicides is an indirect indicator of the social welfare without distinction as to the social and political system. This problem is of special importance as regards the well-being of elderly people whose numbers grow steadily all over the world. The extending life expectancy at older ages in the combination with the resulting demographic disproportions have widespread repercussions on the older generation because they are associated with the increase of the negative social trends as exemplified by a case of suicide of the 89 year-old man A who had for a long time suffered from an oncological disease and was entirely dependent upon the assistance from other people. The authors emphasize that the most important factors responsible for the currently enhanced frequency of suicidal attempts among the elderly persons include the life below the poverty line, permanent stress, poor housing conditions, family conflicts, the ever increasing prevalence of somato-neurological and psychic pathologies, etc. The comprehensive forensic medical and socio-hygienic analysis of all cases of suicide and numerous relevant risk factors may be instrumental in the systematization of the statistical information on the nosological forms of specific pathologies, and the development of the adequate measures for the prevention of the deviant behaviour among the old-age subjects at the regional level. Such analysis may contribute to the reduction of the mortality among the populations of the advanced age especially in the high-risk groups including the elderly people.

[Three-dimensional scanning of the forensic medical objects: the instrumental support and peculiarities of the technology]. / Trekhmernoe skanirovanie sudebno-meditsinskikh ob''ektov: pribornoe obespechenie i osobennosti tekhnologii.

The objective of the present study was to develop 3D-technologies for the investigations of objects for to purpose of their forensic medical expertise and to propose the rationale for their practical application. The advantages and disadvantages of the commercial 3D-scanners are disused. The development of a new original 3D-scanner is described. The data on the authors' technology for three-dimensional scanning of the forensic medical objects are presented.

[The diagnostic criteria for the improper care of the elderly subjects and their forensic medical significance]. / Diagnosticheskie kriterii nenadlezhashchego ukhoda za liud'mi preklonnogo vozrasta i ikh sudebno-meditsinskoe znachenie.

The demographic ageing of the population is accompanied by the gradual increase in the number of the people of the advanced age both in Russia and in other countries all over the world. This situation enhances the probability of violence and the improper care of the elderly subjects both in their families and in the specialized socio-medical facilities. The objective of the present work was to study the experience of the foreign specialists dealing with the problem of the improper care for the elderly subjects with a view to the identification of the diagnostic criteria for the application in the forensic medical practice. The improper care of the elderly subjects is one of the most widespread forms of violence because the associated inadequate actions or the absence of thereof are likely to be a cause of high morbidity and mortality among the persons of this age group as a result of infectious diseases. In the case of the lethal outcomes, the measures of investigation have the purpose not only to elucidate the cause of death but also to establish the relationship between the fact of death and the form of violence including the improper care. The latter can be manifested as the poor hygienic conditions, untidiness of attire, marked dehydration, nutritional dystrophy, injuries and skin burns, persistent and/or refractory cutaneous eruption in the anogenital and inguinal regions, inadequately treated decubital sore of atypical localization. The most dangerous complication of decubital ulcers in the elderly subjects is the systemic infection making up the commonest case of death. Such lethal outcomes are considered to be accidents and sometimes are qualified as murder. The report of the careful forensic medical examination is indispensable for the reliable evaluation of the circumstances of death and the quality of the medical treatment provided for the elderly subjects. Not infrequently it is of crucial importance in the civil and criminal procedures.

[The conditions and the character of the work of the mortuary personnel in the Great Britain: the problems of health protection, anti-infectious prophylaxis, and reduction of the risk of contamination]. / Usloviia i kharakter raboty meditsinskogo personala morgov Velikobritanii: voprosy okhrany zdorov'ia, obespecheniia infektsionnoi bezopasnosti i snizheniia riskov zarazheniia.

The objective of the present work was to study the specific approaches to the organization of the work of the foreign specialists performing post-mortem autopsies of the subjects who died from infectious pathology and consider the proposals of the representatives of the National Confidential Enquiry into Patient Outcome and Death (NCEPOD) concerning accreditation of mortuaries in the Great Britain. It is shown that the algorithm for the evaluation of the possible risks of contamination of the medical personnel suggests the solution of five problems that envisages obtaining the answers to the following questions: (1) what biological agents can be present in a particular case? (2) what is their virulence factor? (3) what are the transmission routes (mechanisms)? (4) what are the manner of their realization? (5) what is the amount of the pathogen(s) needed to cause a given infectious disease? The anti-infectious prophylactic measures and the prevention of the contamination risks for the medical personnel of the British mortuaries are designed to safeguard the people against the infection with the causative agents of tuberculosis, viral hepatitis B and C, HIV, and Kreutsfield- Jacob's disease. All the employees engaged in the pathological studies must wear specialized clothing in a mandatory manner and make use of the equipment for the personal and collective protection. An indispensable condition for the safe work in a mortuary is the efficient ventilation system, the special viewing equipment, and separate premises. The NCEPOD experts maintain that the general approach to the investigations of the cases of infectious diseases presently adopted in the country needs to be radically re-considered and standardized. Diagnostics of contamination and morbidity of the medical personnel from the corpses has not yet become a routine practice. The principal recommendation to be implemented at the national level consists of the strict observance of the safety precautions as opposed to the total pre-mortem testing of the suspicious cases.

[The analysis of the judicial practice of treating the civil lawsuits concerning the inadequate dental health service appeals launched by the patients in the Russian Federation during the period from 1993 to 2017]. / Analiz sudebnoi praktiki po grazhdanskim delam, sviazannym s defektami okazaniia stomatologicheskoi pomoshchi naseleniiu Rossiiskoi Federatsii za period s 1993 po 2017 g.

The objective of the present study was to elucidate the characteristic features and peculiarities in the dynamic of the civil legal proceedings concerning the quality of the stomatological aid to the population of the Russian Federation during the period from 1993 to 2017. We have undertaken the analysis of the official sources containing the court reports on the statements of claim launched by the patients. The study gave evidence of the currently well apparent sustained tendency toward the increase in the number of such civil lawsuits. The probabilities of legal proceedings in connection with the unfavourable outcomes of the dental treatment are roughly identical in all areas of the stomatological practice. The maximum number of the respective civil lawsuits arise from the claims of the patients against the dental surgeons employed by the healthcare settings designated as the limited liability companies. The majority of the statements of case coming from the patients contain the demanding financial claims for the compensation of the moral damage. It is concluded that the aforementioned tendencies in the strategy of the development of the stomatological aid for the population of the Russian Federation dictate the necessity of the priority development of the quality standards (including the clinical guidelines, protocols, etc.) designed to improve the medical assistance for the patients presenting with dental problems, the modernization of the validated methods for the evaluation of the effectiveness of the stomatological aid for the population, the implementation of the measures needed to introduce the mechanisms of professional liability insurance into the routine stomatological practice. These measures are believed to allow to meet the demand of the population of this country for the high-quality stomatological services.

[The coroner's autopsies in the Great Britain: the problems related to the quality of the studies, standardization, auditing, financial support and the approaches to their solution]. / Koronerskaia autopsiia v Velikobritanii: problemy kachestva issledovanii, standartizatsii, audita, finansirovaniia i puti ikh resheniia.

This article continues the series of previous publications of the authors based on the analysis of the detailed report of the experts of the National Confidential Enquiry into Patient Outcome and Death program (NCEPOD) designed to evaluate the quality of autopsies carried out by the coroners in the Great Britain. It was shown that only in 13 to 55% of the 1,691 case the operators had an opportunity to refer the necropsy materials for the pathological study. The problems encountered in association with histological and toxicological analysis arose from the misunderstanding between the coroners and the pathologists as regard the organizational aspects of autopsy studies as swell as the financial and economic considerations. The Coroner Rules that had been adopted in 1984 and remained in force in the country until 2005 needed to be radically revised, corrected, and amended to facilitate the solution of a number of problems and eliminate the formal organizational and technical contradictions that hampered the further improvement of the quality of autopsies that must be performed by the corners at the national rather than the local level. The maximum number of the unacceptable results were revealed in the protocols of autopsires carried out by the forensic medical experts. All pathologists in the Great Britain are recommended to pay special attention to all cases of sudden death of the adult subjects and the deceased epileptic patients. The detailed investigations are mandatory in all cases of death following medical manipulations, such as surgical interventions, and complications.

[The principal and auxiliary immunohistochemical markers of intravital mechanical strangulation asphyxia]. / Osnovnye i dopolnitel'nye immunogistokhimicheskie markery prizhiznennosti stranguliatsionnoi mekhanicheskoi asfiksii.

The objective of the present study was the evaluation of the auxiliary methods for the diagnostics of the intravital formation of the constriction marks; the secondary objective was to determine the pace at which the death and asphyxia occur. MATERIAL AND METHODS: The materials on which the study was based included 17 cases of mechanical strangulation asphyxia involving 13 men and 4 women at the age from 8 to 28 years. All cases of hanging were associated with different blood alcohol levels. Their characteristic feature was the formation of the obliquely ascending constriction marks. The group of comparison was comprised of three cases of death by drowning and one case of manual strangulation. The control group consisted of 10 patients who died from the acute form of coronary heart disease and 5 cases of death from traumatic shock. All the corpses were examined with the use of the traditional methods within the first 24 hours after death. The special laboratory studies were performed by means of the standard histological and immunohistochemical methods with the use of the polyclonal antibodies against total cytokeratin, fibrinogen, immunoglobulin-lambda, fibronectin, and CD-117 antigen. The histological preparations were stained by the method of Spielmeyer and with toluidine blue. RESULTS: The results of the study give evidence of the possibility of diagnostics of mechanical strangulation asphyxia making use of the reaction with anti-fibrinogen antibodies in the stromal tissue of the constriction mark even in the absence of other intravital signs of death. Such diagnostics is also possible with the use of the CD-117 antigen in the pulmonary tissue. The expression of this antigen is characteristic of the cases of alveolar hypoxia. The possibility of application of other markers for the differential diagnostics of mechanical strangulation asphyxia from other causes of death is discussed.

[The efficiency of the application of the modern computed technologies in the clinical practice and the prospects for the further use of the biomechanical 3D-models in forensic medicine]. / Éffektivnost' ispol'zovaniia sovremennykh komp'iuternykh tekhnologii v klinicheskoi praktike i perspektivy primeneniia biomekhanicheskikh 3D-modelei v sudebnoi meditsine.

To-day, the computer-assisted 3D-technologies for the mathematical simulation of the engineering facilities are extensively used for the purpose of technical calculations in all branches of industry and building. The positive experience gained with the application of the 3D-models finds wide application in the joined investigations on the topical problems of the prosthetic and surgical treatment of bones, teeth, joints, cardiac valves, blood vessels, etc. The objective of the present study was the analysis of the positive experience with the involvement of the specialists in the design and practical application of 3D-models for the solution of problems facing the medical prosthetics and the management of various pathological conditions. Another objective was to discuss the possible prospects for the interdisciplinary collaboration in these fields with a view to improving the quality of expert conclusions in the framework of forensic medical and criminalistics examinations. The data readily available from the official domestic and foreign Internet resources were used for the purpose of the study. The analysis of the published data has demonstrated the obvious advantages of the application of the mathematical 3D-models and the biomechanical studies for the solution of the concrete medico-biological problems. The currently available positive experience gained due to the participation of domestic specialists in biomechanics in the solution of the specific clinical problems gives hope that their collaboration between themselves and with the forensic medical experts will open up the promising prospects for the further investigations of the issues of common interest.

[A change in the direction of the wound channel in the case of the combined injury inflicted by a shot from the 9.0 mm Makarov pistol]. / Izmenenie napravleniia ranevogo kanala v sluchae sochetannogo ognestrel'nogo raneniia iz 9,0 mm pistoleta Makarova.

The authors present an example from the expert practice demonstrating the influence of such factors as the properties of the ammunition fired from a weapon (including its weight, size, shape, and speed) as well as the anatomical features of the body tissues being affected on the mechanism of formation of a gunshot wound in the human body. The investigation of the suicide of subject P. has demonstrated the penetrating bullet wound of the neck and the head. The entrance wound was located at the anterior neck surface and the exit one in the left half of the occipital region. The examination of the cranial bones revealed perforating fractures of the cribriform and occipital bones. A specific feature of the case under consideration was a change in the bullet direction during its passage through the cribriform bone that made up the internal osseous barrier. A result the initially vertical wound canal turned into the horizontal one within the cerebral cranium and looked on the whole like a zigzag line. The present observation confirms the possibility of a marked change in the direction of the bullet's trajectory in the cranial cavity even when a 9.0 mm bullet fired from the Makarov pistol hits a relatively soft internal bone structure.

[The possibilities for the expert diagnostics of the influence of the glance of a bullet on the character of the injuries inflicted by shooting a hunting weapon]. / Vozmozhnosti ékspertnoi otsenki vliianiia rikosheta pul' na kharakter povrezhdenii ot vystrelov iz okhotnich'ego oruzhiia.

The objective of the present work was to study and analyze the available data concerning the influence of the glance of a bullet on the character of the injuries inflicted by shooting certain types of hunting weapons. This review gives evidence of the possibility of the objective diagnostics of the injuries inflicted by gunshots using the rifle-bore weapons. However, we have failed to find information about the diagnostic criteria for the evaluation of the wounds inflicted by the bullets shot from smooth-bore hunting rifles after their glance from various surfaces in the available special literature publications. Such situation creates the prerequisites for the erroneous conclusions from the results of forensic medical expertise of the after-penetration blunt wounds.

[The possibilities for the expert diagnostics of the injuries for the purpose of examination of the remains of the strongly burnt and carbonized corpses]. / Vozmozhnosti ékspertnoi diagnostiki povrezhdenii pri issledovanii ostankov sil'no obgorevshikh i obuglennykh trupov.

The objective of the present study was the analysis of the publications in the domestic and foreign literature containing the reports concerning the experience with forensic medical expertise of the strongly burnt and carbonized human corpses. Flame is known to sometimes cause injuries simulating the intravital wounds. Such injuries are categorized into the following types. Thermal ruptures reminiscent of the classical stab and slash wounds unaccompanied by swelling and hemorrhage in the surrounding tissues. Thermal epidural hematomas characterized, unlike traumatic hemorrhages, by the loose cellular structure, brown or reddish-brown colour, and localization at the convex surfaces of both hemispheres of the brain. Thermal amputations differs from the intravital injuries in that they have the polished edges as well as the smoothed and rounded ends the bones bearing no residual soft tissues. The morphological picture of the thermal fractures depends on the time and temperature of the thermal impact. As a rule, the compact bone tissue separates into layers in both longitudinal and transverse directions with the formation of even cortical and through cracks of different length and width. The comprehensive investigation of bone injuries accompanied by the alteration of their physical properties makes it possible to determine the type and the sequence of the combined (mechanical and thermal) actions. The bone of the base of the skull and cervical vertebrae sometimes retain the signs of intravital mechanical injuries. Post-mortem tomography provides an important accessory tool for the examination of the remains.

[Determination of the barrel inclination of the AK-74 assault rifle from the specific features of soot deposition after a shot around the inlet wounds caused by a burst of shots]. / Ustanovlenie ugla naklona avtomata AK-74 po osobennostiam otlozheniia kopoti vystrela vokrug vkhodnykh ognestrel'nykh ran, prichinennykh ochered'iu vystrelov.

The specific features of soot deposition after a shot fired from the Kalashnikov AK-74 assault rifle are determined by the influence of the multiple factors, with the effect of the muzzle brake (MB) designed to enhance fire density and decrease the fire recoil energy being prevalent over other factors. The special windows, slots and holes in the muzzle brake mechanism are responsible for the appearance of the specific topographic features of soot deposition formed by the combustion gases passing through the assembly. Apart from the characteristic butterfly-shaped soot deposition patterns that appear due to the presence of two windows in the muzzle brake assembly, the additional zones of soot deposition can sometimes be seen on the objects and targets due to the escape of the combustion gases through the MB compensator openings. This phenomenon enables a forensic medical expert to determine orientation and position of the AK-74 rifle with respect to the shooting target. This article reports the results of the forensic medical expertise of a serviceman who died from the injuries to the head inflicted by a burst of shots fired from the Kalashnikov AK-74 assault rifle. The direction of the wound canals and their topographic patterns (including the shape, size, number, and localization) of soot deposition around the inlet wounds made it possible to determine the position of the AK-12 rifle with respect to the affected regions of the head and thereby to prove that the death of the serviceman was a result of suicide.

[The coroner's autopsies in the Great Britain: the problems related to the quality of the studies, standardization, auditing, financial support and the approaches to their solution (part 2)]. / Koronerskaia autopsiia v Velikobritanii: problemy kachestva issledovanii, standartizatsii, audita, finansirovaniia i puti ikh resheniia (chast' 2).

This article extends the previous publication of the authors based on the analysis of the detailed report of the experts of the National Confidential Enquiry into Patient Outcome and Death program (NCEPOD) issued in the Great Britain in 2006. The analysis has demonstrated that all autopsy studies should invariably involve measurement of the corpse length and weight (including body mass index) as well as the detailed description of all injuries to the body (or references to their absence). All autopsy studies should be carried out only by a medical professional (e.g. a pathologist, histologist, forensic medical expert, etc.). The thorough examination of the cadaver is mandatory prior to evisceration. The maximum scope of the examination of all body cavities with the comprehensive description of all internal organs and systems is compulsory. Putrefaction and decomposition of the corpse can not be regarded as a justification for its perfunctory ('restricted') inspection; on the contrary, these dictate the necessity of a more careful examination with the compulsory description of all organs and body systems as well as harvesting biological fluids and tissues for the laboratory analyses (including histological, toxicological, and other relevant studies).

[The significance of the results of crash-tests with the use of the models of the pedestrians' lower extremities for the prevention of the traffic road accidents]. / Znachenie rezul'tatov krash-testov s modeliami nizhnikh konechnostei peshekhodov v profilaktike dorozhno-transportnogo travmatizma.

The disabling injuries inflicted during road traffic accidents (RTA) create a serious challenge for the public health services and are at the same time a major socio-economic problem in the majority of the countries throughout the world. The injuries to the lower extremities of the pedestrians make up the largest fraction of the total number of the non-lethal RTA injuries. Most of them are responsible for the considerable deterioration of the quality of life for the participants in the accidents during the subsequent period. The objective of the present study was to summarize the currently available results of experimental testing of the biomechanical models of the pedestrians' lower extremities in the framework of the program for the prevention of the road traffic accidents as proposed by the World Health Organization (WHO, 2004). The European Enhanced Safety Vehicle Committee (EEVC) has developed a series of crash-tests with the use of the models of the pedestrians' lower extremities simulating the vehicle bumper-pedestrian impact. The models are intended for the assessment of the risk of the tibia fractures and the injuries to the knee joint ligaments. The experts of EEVC proposed the biomechanical criteria for the acceleration of the knee and talocrural parts of the lower limbs as well as for the shear displacement of the knee and knee-bending angle. The engineering solution of this problem is based on numerous innovation proposals being implemented in the machine-building industry with the purpose of reducing the stiffness of structural elements of the bumper and other front components of a modern vehicle designed to protect the pedestrians from severe injuries that can be inflicted in the road traffic accidents. The activities of the public health authorities (in the first place, bureaus of forensic medical expertise and analogous facilities) have a direct bearing on the solution of the problem of control of road traffic injuries because they are possessed of comprehensive and reliable objective information about all forms of the damage to health associated with vehicle-pedestrian collisions and their victims' condition. It is concluded that making use of the experience and professional knowledge of forensic medical experts and automotive specialists could considerably contribute to the enhancement of safety of all the participants in the vehicular traffic.