Death and non-lethal weapons: A case of homicide by penetrating injury without projectile.

Herein, we report the death of a man, approximately thirty years old, victim of a short-range shot to the thorax from a PIEXON JPX4, a hand weapon classed category D in France, said to be non-lethal. External examination of the lesion revealed characteristics similar to those of ballistic injuries. The autopsy found an intercostal wound that reached the pulmonary parenchyma and the pulmonary artery, with severe hemothorax. By the end of the autopsy, no projectile had been found in the body, nor any exit orifice. Death was caused by the effects of hemorrhagic shock. The PIEXON JPX4 has four cartridges, projecting a capsaicin gel that is designed to irritate the ENT area (ear nose throat) to incapacitate an assailant. The manufacturer recommends not to use it at distances of less than 1.5 m. Experimental shots were performed on gelatine blocks at point-blank range and at distances of 5, 10, 20, 30, 50, 100 and 150 cm to evaluate the distance necessary for the jet of gel to have a penetrating effect. Shots at 5-30 cm penetrated the structure. None of the other shots were penetrating. The autopsy and experiment data therefore show the penetrating potential of the jet of gel. Herein, we report the first death due to use of the PIEXON JPX4. From a forensic investigation viewpoint, we add a new exception to the "bullet rule". (The odd and even bullet rule states that if the number of gunshot wounds of entrance and exit found in the body is even, the presumption is that no bullet is lodged in the body. If the number of gunshot wounds of entrance and exit is odd, the presumption is that one or more bullets have been lodged in the body.).

Ocfentanil testing in hair from a fatality case: Comparative analysis of a lock of hair versus a single hair fiber.

In clinical and forensic toxicology, hair analysis offers a larger window for detecting drug exposure than blood or urine. Drug measurements are generally carried out using a segmented lock of hair, but few articles report the use of a single hair to document drug exposure. Nevertheless, single hair analysis can be very useful, particularly if only small amounts of biological matrices are available. More data on analyzing new synthetic opioids (NSOs) in hair are needed to help interpretation in future cases. In this study, segmental single hair analysis is compared with segmental hair lock analysis to document an ocfentanil-related death. The hair lock and single hair analyses were performed using the LC-MS/MS method after decontamination and incubation. Ocfentanil (OcF) concentrations ranged from 42 to 150 pg/mg in the segmented hair lock, depending on the segments. The hair lock and single hair analyses showed similar results: the highest concentrations were measured in the first two centimeters and decreased from root to tip. The similar profiles obtained from both the lock of hair and the single hair demonstrate the relevance of single hair analysis in cases where very few data are available. This article describes OcF concentrations in an authentic hair sample after a documented intake of this molecule in a fatality.

Fatal aluminum phosphide poisoning.

A 39-year-old man committed suicide by ingestion of aluminum phosphide, a potent mole pesticide, which was available at the victim's workplace. The judicial authority ordered an autopsy, which ruled out any other cause of death. The victim was discovered 10 days after the ingestion of the pesticide. When aluminum phosphide comes into contact with humidity, it releases large quantities of hydrogen phosphine (PH3), a very toxic gas. Macroscopic examination during the autopsy revealed a very important asphyxia syndrome with major visceral congestion. Blood, urine, liver, kidney, adrenal, and heart samples were analyzed. Phosphine gas was absent in the blood and urine but present in the brain (94 mL/g), the liver (24 mL/g), and the kidneys (41 mL/g). High levels of phosphorus were found in the blood (76.3 mg/L) and liver (8.22 mg/g). Aluminum concentrations were very high in the blood (1.54 mg/L), brain (36 microg/g), and liver (75 microg/g) compared to the usual published values. Microscopic examination revealed congestion of all the organs studied and obvious asphyxia lesions in the pulmonary parenchyma. All these results confirmed a diagnosis of poisoning by aluminum phosphide. This report points out that this type of poisoning is rare and that hydrogen phosphine is very toxic. The phosphorus and aluminum concentrations observed and their distribution in the different viscera are discussed in relation to data in the literature.

Increasing rate of sexual assaults by adults appearing before the Assize Court of Rennes, France, during 1987-1997.

In this paper, we analyse all the sentences handed out by the Assize Court of Rennes in France, in the last decade. A recent increase in the number of sexual offences has been observed. An increase in the number of cases of incest has also been noted. This paper analyses the sex ratio, the age of the victim, the association with other violence and the relationship between the victim and his or her aggressor. The outcomes of the trials are discussed.

Gunshot fatalities: correlation between post-mortem multi-slice computed tomography and autopsy findings: a 30-months retrospective study.

In this study we compared retrospectively the autopsy and the CT-scan findings in 47 gunshot victims (96 wounds) in order to assess the accuracy of the two methods in injury and ballistic diagnoses. Firing distance was determined in 46 wounds (47.9%). Firing range was determined by autopsy alone in 37 cases (80.5%) and by CT-scan alone in three cases (6.5%). In the six remaining cases (13%), autopsy and CT-scan reports concluded both to the same firing range. Entrance wounds were detected concordantly by both CT-scan and autopsy in 63 of the 91 penetrating wounds (69.2%). Exit wounds were present in 69 shots. They were concordantly detected by autopsy and CT-scan in 36 cases (52.2%). It was possible at CT imaging to determine the track of the bullet in up to 62 wounds (72.1%). CT-scan was superior to autopsy in determining two items: face fractures and pneumencephalon. CT scan was of limited value in demonstrating skull base fractures and contusions of the brain. There was good correspondence in demonstrating subarachnoid hemorrhage. CT-scan was accurate to demonstrate presence of gas, either in the pleural cavity (pneumothorax) or in the vessels' lumen (air embolism). Both autopsy and CT-scan were concordant in demonstrating thoracic well injuries, heart lacerations and intra thoracic hemorrhage. CT-scan was far below autopsy in detecting solid organs injuries except for kidneys. The present survey shows that CT-scan is second to none in demonstrating features as pneumencephalon, facial fractures, midline shifts, air embolism, pneumothorax, and pelvic bones fractures. It may contribute to determine the firing range in cases of contact-range and of intermediate range though the firing range assessment remains beyond post-mortem imaging possibilities, at least at the current state of knowledge.

Post-traumatic dissection of the internal carotid artery associated with ipsilateral facial nerve paralysis: diagnostic and forensic issues.

Traumatic internal carotid artery dissection may result from a direct blow to anterolateral aspect of the neck, or an extreme extension and rotation of the neck. Traumas involved are variable ranging from high speed motor vehicle accident to trivial traumas. The most frequent presentations of carotid artery dissection are stroke, Hörner syndrome, and paralysis of a cranial nerve. Time of ischemic signs onset is very variable too, diverging from immediate to several months delay. We report the case of a 60-year-old woman, who was assaulted by a young man. Immediately, she complained of headache and posterior cervical pain. Three months later she developed a left hemifacial paralysis. MRI and MRA showed a dissection of the left internal carotid artery. The causal relationship between the trauma and the carotid artery dissection as well as forensic issues are discussed.

Risks of non-lethal weapon use: case studies of three French victims of stinger grenades.

The development of non-lethal weapons started in the 1960s. In France, they have been used by the police for about 10 years. We relate the cases of three French women, victims of stinger grenades, non-lethal weapons recently adopted by the French law enforcement to distract and disperse crowds. The three victims presented serious injuries requiring emergency surgical care. One lost her eye. Based on these cases, we discuss the lethal character of these weapons and propose measures to be taken to prevent their dramatic consequences. Although the danger is obviously less than for firearms, stinger grenades are nonetheless potentially lethal and cause serious physical injuries.

[Problems and advantages of autopsy in the case of out-of-hospital childhood death: report of 2 cases]. / Difficultés et intérêt de l'autopsie dans le cas de décès d'enfant hors établissement de santé : à propos de 2 observations.

In France, the number of deaths remains high in the pediatric population. These deaths are rarely subject to a scientific or forensic autopsy. However, this medical act appears necessary to answer the many private and public questions (public health, prevention, judicial, or even institutional) that can arise. Two pediatric clinical observations raising these questions in the context of a household accident are presented. In the first one, the death led to the establishment of a forensic obstacle to the burial and a forensic autopsy. The autopsy results provided answers, both to the relatives and to the court. The second concerns a deceased child managed within the protocol for sudden infant death syndrome. The autopsy was not authorized by the parents and no answer on the causes of death could be determined. These 2 observations underline the importance and utility of this medical act.

[Case of death occurred after an injection of aetoxisclerol. The responsibility of the product should be discussed]. / L'aetoxisclerol accusé à tort d'entraîner une mort subite.

A 35-year-old woman has suffered from faintness with cardiovascular failure at the end of a sclerotherapy session for varix management. The injected product was Aeloxisclerol (DCI lauromacrogal 400). The death came up very quickly. The autopsy didn't reveal any traumatic lesion. The anaphylactic choc could be ruled out. Macroscopically, the heart showed a right ventricular dilatation. The toxicological analysis didn't reveal any medicinal substances. Histology showed the presence of lipid degeneration of all the right-ventricle wall The discussion is carried out on the role played by this previous health-state on the onset of death, and also on the incidence of sclerotherapy using this product. and the onset of death. We are carrying out this discussion by taking in mind the nature of the product injected and the information available in the literature concerning the lipid degeneration of cardiac muscle. Quickly after this case, the AFSSAPS (The French Agency for Sanitary Security of Health Products) has emitted an written alert which correlates with the requirements of principles of precaution although it is not founded on the totality of investigation results done for this medicolegal case.

[Comparison of the kinetics of the response of salivary and plasma 17-hydroxyprogesterone to the administration of HCG in men]. / Comparaison de la cinétique de la réponse de la 17-hydroxyprogestérone salivaire et plasmatique à l'administration de hCG chez l'homme.

17-hydroxyprogesterone (17-OHP) time course response to hCG (5,000 IU) was studied simultaneously in the saliva and the plasma of 12 adult healthy men. In both fluids, 17-OHP was determined by radioimmunossay after chromatography on Sephadex LH-20 columns of diethyl ether extracts. The use of an iodinated tracer has greatly increased the sensitivity of the technique. Baseline levels in plasma and saliva were: 1.0 +/- 0.1 ng/ml (mean +/- SEM) and 24 +/- 2 pg/ml respectively. After hCG, a biphasic pattern was observed in both fluids with a similar early response but the peak elicited at 33 h in plasma was not observed in saliva where the levels were lower than those recorded at 24 h. At 48 h saliva 17-OHP increased again to levels similar to those at 24 h. Thus the 17-OHP pattern in saliva was the mirror image of that found in plasma. Since saliva steroids are believed to reflect the plasma non-protein bound fraction, this difference was assumed to be due to the decrease of the unbound fraction of plasma 17-OHP in the late afternoon as a consequence of the increase of the CBG-bound fraction since at that time cortisol levels are low. Indeed the ratios of saliva to plasma 17-OHP levels were found to be significantly correlated with plasma cortisol levels: r = 0.44 (p less than 0.01; n = 140). Thus the absence of the secondary peak at 33 h may be due to cortisol circadian rhythm. However the similar response in saliva at 24 and at 48 h after hCG was enough important to make reliable the evaluation of the endocrine testicular function so that saliva may be collected instead of plasma in the hCG stimulation test protocol.

Radioimmunoassay of plasma and urine 6 beta-hydroxycortisol: levels in healthy adults and in hypercortisolemic states.

A reliable radioimmunoassay for plasma and urine 6 beta-hydroxycortisol after chromatography on Sephadex LH 20 column has been described and evaluated. The antiserum used was raised in the rabbit injected with 6 beta-hydroxycortisol-3(O-carboxymethyl)oxime-bovine serum albumin. In control subjects, urine 6 beta-hydroxycortisol levels ranged from 137 to 348 micrograms/24 h (mean +/- SD: 238 +/- 66) in adult males (n = 14) and from 80 to 432 micrograms/24 h (mean +/- SD: 210 +/- 93) in adult females (n = 15). In plasma, 6 beta-hydroxycortisol levels ranged from 0.53 to 3.13 ng/ml (mean +/- SD: 1.14 +/- 0.57) in adult males (n = 17) and from 0.53 to 2.69 ng/ml (mean +/- SD: 1.22 +/- 0.53) in adult females (n = 19). In patients with Cushing's syndrome high levels were found in urine as well as in plasma. Finally the higher concentrations of 6 beta-hydroxycortisol found in adrenal effluent in comparison with those of the peripheral vein blood has clearly demonstrated that 6 beta-hydroxycortisol is secreted by the adrenal besides its extra-adrenal formation from cortisol.