RESUMEN
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.
Asunto(s)
Traumatismos Craneocerebrales , Balística Forense/métodos , Traumatismos del Cuello , Cráneo , Suicidio , Heridas por Arma de Fuego/patología , Adulto , Autopsia/métodos , Traumatismos Craneocerebrales/etiología , Traumatismos Craneocerebrales/patología , Armas de Fuego , Humanos , Masculino , Traumatismos del Cuello/etiología , Traumatismos del Cuello/patología , Cráneo/lesiones , Cráneo/patologíaRESUMEN
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.
Asunto(s)
Servicios de Salud Dental , Responsabilidad Legal , Mala Conducta Profesional , Servicios de Salud Dental/legislación & jurisprudencia , Servicios de Salud Dental/normas , Humanos , Mala Conducta Profesional/legislación & jurisprudencia , Mala Conducta Profesional/estadística & datos numéricos , Mejoramiento de la Calidad , Federación de RusiaRESUMEN
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.
Asunto(s)
Médicos Forenses , Morgue , Exposición Profesional/prevención & control , Patólogos , Autopsia/normas , Humanos , Administración de la Seguridad/organización & administración , Reino Unido , Precauciones Universales/métodosRESUMEN
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.
Asunto(s)
Causas de Muerte , Abuso de Ancianos/mortalidad , Medicina Legal/métodos , Anciano , Abuso de Ancianos/prevención & control , Testimonio de Experto/métodos , HumanosRESUMEN
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.
Asunto(s)
Simulación por Computador , Medicina Legal , Cómputos Matemáticos , Fenómenos Biomecánicos , Medicina Legal/métodos , Medicina Legal/tendencias , Humanos , Imagenología Tridimensional/métodosRESUMEN
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.
Asunto(s)
Piel , Suicidio , Heridas por Arma de Fuego , Adulto , Armas de Fuego/clasificación , Balística Forense/métodos , Humanos , Masculino , Piel/lesiones , Piel/patología , Heridas por Arma de Fuego/diagnóstico , Heridas por Arma de Fuego/patologíaRESUMEN
The objective of the present study was to analyze the experience of the coroners and pathologists in the Great Britain based on the results of the coroner's autopsies and recommendations of the experts involved in the activities carried out in the framework of the National Confidential Enquiry into Patient Outcome and Death program (NCEPOD). The recommendations are designed to reform the country's medical examiner system, improve the equipment of the mortuary facilities, and optimize funding for the autopsy studies. The authors consider in the chronological order the following issues of the coroners and pathologists' activities: organization of their work and its procedural aspects, ordering coroner's autopsies, preparation for their performance, analysis of the relevant documentation (autopsy reports) and medical case histories (discharge summaries). Also discussed are the recommendations of the NCEPOD experts for the improvement of the said studies with the detailed analysis of the causes underlying the aforementioned problems and concise comments of the authors.
Asunto(s)
Autopsia , Médicos Forenses/organización & administración , Patólogos/organización & administración , Autopsia/métodos , Autopsia/normas , Humanos , Competencia Profesional , Reino UnidoRESUMEN
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).
Asunto(s)
Autopsia , Médicos Forenses , Autopsia/métodos , Autopsia/normas , Médicos Forenses/economía , Médicos Forenses/organización & administración , Médicos Forenses/normas , Diagnóstico , Apoyo Financiero , Humanos , Evaluación de Necesidades , Cambios Post Mortem , Estudios Retrospectivos , Reino UnidoRESUMEN
The article presents the results of a commission inspection of the results of the forensic medical expertise performed by the specialists of a state-owned forensic medical bureau in connection with the civil case concerning the judicial appeal of the 58 year-old suitress S. against a private plastic surgery clinic. It is shown that the carelessness of the surgeons with the fact of chronic diseases in the patient and the application of the vasoconstrictor medications during the surgical treatment (blepharoplasty) resulted in optic nerve atrophy in the immediate postoperative period with the complete loss of vision in the only seeing eye. The expertise has revealed a number of additional defects as well as diagnostic and surgical errors in the actions of the surgeons of this private clinic considered to be responsible for the resultant disablement of the patient.
Asunto(s)
Blefaroplastia , Ceguera , Errores Médicos , Complicaciones Posoperatorias/diagnóstico , Trastornos de la Visión/diagnóstico , Blefaroplastia/efectos adversos , Blefaroplastia/métodos , Ceguera/diagnóstico , Ceguera/etiología , Testimonio de Experto/métodos , Femenino , Medicina Legal , Humanos , Errores Médicos/efectos adversos , Errores Médicos/legislación & jurisprudencia , Persona de Mediana EdadRESUMEN
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.
Asunto(s)
Accidentes de Tránsito/prevención & control , Extremidad Inferior/lesiones , Peatones , Heridas y Lesiones , Medicina Legal , Humanos , Modelos Anatómicos , Proyectos de Investigación , Índices de Gravedad del Trauma , Heridas y Lesiones/clasificación , Heridas y Lesiones/diagnóstico , Heridas y Lesiones/etiologíaRESUMEN
The clinical and expert evaluation of the unfavourable consequences of the provision of the inadequate dental implantation treatment has demonstrated the ever increasing number of justified complaints and civilian lawsuits instituted annually in connection with the infringements of health associated with the poor quality of the medical care provided to the patients. The authors present the results of commission forensic medical expertise performed on account of the civilian lawsuits instituted by a 74 year-old patient K. against a private stomatological polyclinic. It was shown that the medical personnel of the polyclinic disregarded the objective contraindications for the surgical treatment of the patient on the day of her application for the medical assistance. It is concluded that the advanced age of the patient and well apparent atrophy of the alveolar part of the lower jaw required preliminary substantiation of the necessity of the surgical intervention. However, the diagnostic and treatment errors in the form of incomprehensive examination and the application of the inadequate implantation technique resulted in postoperative complications including severe disturbances of the masticatory function and painful sensations. The commission forensic medical expertise reported in the present article has failed to reveal any objective factors that might have been responsible for the above diagnostic and treatment errors and established the immediate cause-and-effect relationship between them and the resultant unfavourable consequences of the treatment. The opinion of the commission was recognized to be well-substantiated by the court and provided a basis for the judicial judgement in favour of patient K.
Asunto(s)
Atención Odontológica , Implantación Dental/efectos adversos , Mala Praxis/legislación & jurisprudencia , Anciano , Atención Odontológica/legislación & jurisprudencia , Atención Odontológica/métodos , Testimonio de Experto/métodos , Femenino , Medicina Legal/métodos , Humanos , Federación de RusiaRESUMEN
The authors discuss the modern possibilities and prospects for the application of photogrammetry (FM) in forensic medical traumatology based on the results of the analysis of the many-year experience reported in the foreign periodicals with special reference to road traffic injuries, gunshot wounds, and animals' bites. The examples of objective difficulties and promising prospects for the further application of the FM techniques in the practical work of forensic medical experts and medical criminalists are considered with reference to the use of various FM-based methods and equipment including 3D laser scanners, chambers, stereoscopic mounting attachments, etc. Special attention is given to the contribution of the current scientific and technical progress to the solution of the practical problems facing forensic medical experts with reference to the unique opportunities provided by the modern computed technologies enabling the specialists to considerably improve the quality of expert examination.
Asunto(s)
Medicina Legal , Fotogrametría , Traumatología , Accidentes de Tránsito , Mordeduras y Picaduras , Humanos , Imagenología Tridimensional , Heridas y Lesiones , Heridas por Arma de FuegoRESUMEN
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.
Asunto(s)
Huesos , Quemaduras/patología , Fracturas Óseas/patología , Traumatismos de los Tejidos Blandos/patología , Autopsia/métodos , Huesos/lesiones , Huesos/patología , Cadáver , Patologia Forense/métodos , Humanos , Tomografía/métodosRESUMEN
The study of blood stains retained at the scene of the crime is of crucial importance for the preliminary inquiry. The present article is focused on the analysis of the possibilities and prospects for the use of photogrammetry (PM) as exemplified by the foreign expert practice of the blood stains examination at the site of the event. It is shown that the results of the application of digital photogrammetry in addition to the traditional methods of morphological investigations enables the forensic medical experts to reconstruct a number of unique features and circumstances that accompanied the commission of a crime at the site of the event. Such PM techniques supplemented by the ballistic analysis of the blood splatter and droplet trajectories provides additional evidence that allows the forensic medical experts to reconstruct the scene of the crime including the pose and position of the victim at the moment of causing injury. Moreover, these data make it possible to determine the maximum number and the sequence of injurious impacts (blows). The authors discuss the advantages and relative disadvantages of the application of the photogrammetric technique in the routine practical expert work. It is emphasized that the published decision making algorithms provide the specialists in various disciplines and professional experts with the ready-made technological tools for obtaining the additional criteria for the objective improvement of the quality of the studies they carry out and for the enhancement of the value of expert conclusions. It is concluded that the application of the modern photogrammetric technologies can be recommended for the solution of the applied forensic medical problems and conducting the relevant expert research.
Asunto(s)
Manchas de Sangre , Crimen/legislación & jurisprudencia , Medicina Legal/métodos , Fotogrametría/métodos , HumanosRESUMEN
The objective of the present study was to analyze the results of research reported in the theses for the degree in "forensic medicine" defended in different dissertation committees during the 5 year period (from 2010 till 2014) and to summarize and compartmentalize the main research areas in which the authors carried out their study and thereby make the data obtained more readily available for the wide circles of readers. A total of 55 theses for the scientific degree in "forensic medicine" (14.03.05) were defended during the period from 2010 till 2014 including 18 (32.7%) ones for the degree in two disciplines, the second being either "pathological anatomy" (n=6) or "stomatology" (n=4). Despite the great variety of the problems resolved in the studies conducted during the five year period, the subject matter of most research was on the whole consistent with the main lines of activities of the institutions with which the degree-seeking workers were affiliated. The same refers to the choice of the tutors and scientific advisers. the authors emphasize the necessity of centralized planning of research in compliance with the list of priority investigations having practical significance and coordination of cooperative studies carried out based on the state bureau of forensic medical expertise (SBFME) and departments of forensic medical expertise of medical universities.
Asunto(s)
Medicina Legal/métodos , Investigación/organización & administración , Humanos , Federación de RusiaRESUMEN
The present article deals with the problem of forensic medical diagnostics of the injuries inflicted inside the passenger car compartment during motor vehicle accidents. The authors place special emphasis on the fact of a significant increase in the number of road traffic accidents (RTA) with such consequences throughout the world. The modern automobile industry pays much attention to the enhancement of the car safety features by significantly improving the design of passenger compartments. It accounts for a change in the traditional character of the injuries to both the driver and the passengers resulting from motor vehicle accidents. This, in turn, creates difficulties for the forensic medical experts as regards personality identification of the subjects who happened to be inside the car at the moment of the collision especially in the case of unascertainable circumstances of the accident and/or the involvement of several victims. The authors describe peculiarities of the injuries inflicted inside the passenger car compartment during road traffic accidents including such that result from bringing the driver and the passengers closer to the construction elements of the car (stage I), their direct contact with these elements (stage II), and subsequent displacement (stage III).
Asunto(s)
Accidentes de Tránsito/clasificación , Medicina Legal , Heridas y Lesiones/diagnóstico , Humanos , Vehículos a Motor , Heridas y Lesiones/fisiopatologíaRESUMEN
This article reports the results of the commission forensic medical expertise undertaken to evaluate the possibility of severe injury to the ankle joint resulting from the road traffic accident as exemplified by the collision of a VAS 21043 car moving backward with a pedestrian. It was shown that the injury to the victim's right lower leg included the tear of the right crural deltoid ligament, the open communicated fracture of the lower third of fibular diaphysis with the displacement of the distal fragment, the lacerated wound in the lower third of the right leg, the rupture of distal tibiofibular synedesmosis, the closed communicated fracture of the posterior edge of the tibia without displacement, and outward subluxation of the right foot. According to the classification accepted in orthopedics , this variant of the injury to the ankle joint is a combination of the classical «complete¼ Dupuytren fracture and the Destot-type fracture. The analysis of the mechanism underlying formation of such injury has shown that it was a consequence of the indirect injurious action in the absence of the primary impact without the car running over the victim's leg.
Asunto(s)
Accidentes de Tránsito , Medicina Legal , Fracturas Óseas/fisiopatología , Peatones , Humanos , Vehículos a MotorRESUMEN
This article is designed to report the results of the comprehensive forensic medical and autotechnical expertise for determining the positions of the driver and the first seat passenger of the GAS-3110 car at the moment of the frontal crash with a KAMAZ-5312 truck. The comparative analysis of the injuries in two subjects one of whom died as a result of the given accident made it possible to conclude that he had occupied the driver's seat in the car. The differential diagnosis was based on the peculiarities of the injuries to the upper extremities with the predominance of the most severe wounds at the right side of the body. Also taken into consideration were the specific conditions of the given frontal collision, design of the GAS-3110 passenger compartment, winter season, night time, and possible neglect of the passive safety means, etc.
Asunto(s)
Accidentes de Tránsito , Automóviles , Vehículos a Motor , Heridas y Lesiones , Prevención de Accidentes/métodos , Conducción de Automóvil/normas , Automóviles/normas , Patologia Forense/métodos , Humanos , Postura , Equipos de Seguridad/normas , Heridas y Lesiones/diagnóstico , Heridas y Lesiones/etiologíaRESUMEN
This paper is designed to present an example from the domestic expert practice with the successful application of the radionuclide technique to visualize the bone lesions in a victim of a traffic accident having concomitant pathology of the osseous-articular apparatus (Scheuermann-Mau disease). The use of the osteoscintigraphic method made it possible not only to confirm the injury to the spinal column and the sternum but also to ensure its differential diagnostics from the concurrent pathology. Also, the method allowed to detect the exact location of the fractures. Moreover, it proved possible to comprehensively characterize the mechanism underlying the bone fracture resulting from the car accident.
Asunto(s)
Accidentes de Tránsito , Huesos , Fracturas Óseas , Enfermedad de Scheuermann/diagnóstico , Tortura , Huesos/diagnóstico por imagen , Huesos/lesiones , Diagnóstico Diferencial , Medicina Legal/métodos , Fracturas Óseas/diagnóstico , Fracturas Óseas/etiología , Humanos , Cintigrafía , Enfermedad de Scheuermann/complicacionesRESUMEN
The results of analysis of forensic medical expertises carried out by different state institutions of forensic medical expertise of this country are presented. It was shown that the practice of standardized expertises of the injuries inflicted inside the passenger compartment of the car remains to be established. The comprehensive approach to the solution of the problem of the circumstances of the road traffic accident and the positions of its participants in the passenger compartment of the car is possible based only on the multi-faceted investigation. The definitive combined study including the analysis and comparison of the results of the autotechnical expertise, forensic medical examination of the corpses and the survivors inside the passenger car compartment, forensic biological (molecular genetic) expertises, and medico-criminalistic investigations of the traces of biological deposits and microparticles retained on the components of the passenger compartments and the clothes of the victims makes it possible to determine, with a high degree of accuracy, the position of the participants of the traffic accident inside the passenger compartment of the car at the moment of collision.