Homicide and canicide with analogous killing pattern and agonal decapitation.

Killings of human beings involving animals have rarely been described in the forensic literature. In the present case, the decapitated corpse of a woman as well as the decapitated, castrated and partially disemboweled corpse of a dog were found together. Both bodies also exhibited analogous, distributed massive sharp-force traumas. The approximately same pattern of actions as well as findings consistent with an exaggerated killing are particularly noteworthy. The perpetrator was found to be the son of the victim and had long exhibited psychological abnormalities. He was acquitted of the charge of manslaughter due to mental incapacity and was subsequently placed in a psychiatric hospital.

Liquid chromatography-tandem mass spectrometry detection of the quaternary ammonium compound mebezonium as an active ingredient in t61.

Quaternary ammonium compounds pose an analytical challenge. Mebezonium, a muscle-relaxing agent contained in veterinary euthanasia solution T61, was analyzed in body fluids, organs, and injection sites of a veterinarian by liquid chromatography-tandem mass spectrometry (LC-MS-MS) method. Additionally, embutramide and tetracaine, which are two other active ingredients contained in T61, methadone, xylazine, and analgesics were detected by LC-MS-MS and high-performance liquid chromatography-ultraviolet detection methods. For detection of mebezonium a solid-phase extraction (SPE) combined with ionpairing reagent heptafluorobutyric acid was developed. Separation was achieved on Phenomenex Synergi Hydro RP C(18) column combined with ammonium formate buffer and acetonitrile (pH 3.5). To enrich other drugs, liquid-liquid extraction procedures were used. Most of these drugs were separated on a Restek Allure PFP Propyl column using the mentioned mobile phase. Mebezonium and embutramide were detected in femoral vein serum in concentrations of 10.9 and 2.0 mg/L, respectively. The concentration of xylazine and methadone in serum was 2.0 and 0.4 mg/L, respectively. The LC-MS-MS method with SPE combined with an ion-pairing reagent allowed the quantitation of mebezonium. Methadone was detected in toxic concentrations and was, in combination with xylazine and T61, considered to be the cause of death.

Unusual suicides of young women with tentative cuts and fatal neck injuries by chain saw and circular saw.

Suicides with chain saws and circular saws are extreme exceptions, in particular with regard to females and concerning the neck region. We report two of such rare cases involving young women. A 30-year-old female with a known schizoaffective psychosis killed herself with an electric chain saw. The autopsy revealed a deep saw cut of the neck and shoulder with partial transection of the cervical spine. Several tentative saw cuts were present on the right lower jaw. A 29-year-old woman suffering from depression committed suicide by use of a circular saw. She inflicted herself fatal neck injuries with at least three separate cutting procedures. Our cases were characterized by the following features: female sex, young adulthood, no occupational experience with saws, psychiatric disorders, absence of alcohol or drugs, use of an aggressive method of suicide, focus of saw injuries on the right side of the neck, detection of tentative saw cuts or several trials, identical causes of death (exsanguination and blood aspiration).

[Homicides by sharp force with nearly complete penetration of the weapon]. / Tötungsdelikte durch scharfe Gewalt mit nahezu vollständigem Eindringen des Tatwerkzeuges.

Despite a large number of publications on sharp force injuries, there are no specific reports on homicides with nearly complete penetration of the weapon into the body of the victim. We present three cases in which the crime was committed in this unusual way. The victims were males aged between 28 and 71 years. They were killed by multiple sharp force. The weapons used were knives with a total length of up to about 20 cm, which penetrated into the body (almost) completely including the handle. Involved body regions were the front and back of the chest and the neck. In one case, two different sharp weapons were found in the trunk. The injuries inflicted on the internal organs by the penetrating knives caused massive bleeding and were the leading cause of death. Additional remarkable features were complex patterns of injury by further sharp and blunt force and, in one case, tying. The victims were highly intoxicated (by alcohol and, in one case, illegal drugs), which made them nearly incapable of acting. All perpetrators were male, between 23 and 33 years of age, strongly influenced by alcohol and loosely acquainted with the victims. The kind of committing the offence seems to be explainable only against the background of an absolute will to annihilate ("overkill").

[Uncovering an undetected homicide by exhumation]. / Aufdeckung eines verkannten Tötungsdeliktes durch Exhumierung.

The problems of postmortem examinations and the associated dark figure of undetected homicides are well known and have been repeatedly discussed in Germany. The article deals with the case of a 73-year-old woman whose death was initially certified as being natural ("sudden cardiac death"). When secondary suspicious circumstances turned up, an exhumation was ordered three weeks after the burial. At autopsy, signs of multiple blunt force to the occiput, the thorax and the upper extremities as well as compression of the neck were found. The findings proved foreign intervention and suggested death due to suffocation. In the court trial, the accused pleaded an accidental event (fall down stairs). He was sentenced to life imprisonment for murder. The presented case of homicide remained undetected at first, as due to the deceased's advanced age a natural death had been falsely assumed. An obviously very superficial external postmortem examination by the physician was probably the main reason for the misjudgement. The factors "advanced age" and "homicide leaving few external traces and no visible injuries" seem to present special problems and essentially contribute to the dark figure of undetected homicides. Physicians performing postmortem examinations and the general public should be made aware of the problem by regular further education and discussion.

[Excessive use of fentanyl patches as the only means of suicide]. / Exzessiver Fentanylpflastergebrauch als alleiniges Suizidmittel.

Due to the increasing prescription there are more and more cases of abuse and accidents related to fentanyl patches. The use of fentanyl patches (e.g. Durogesic) for committing suicide is rare, however. In our case, we describe a suicide with an amount of fentanyl patches never mentioned in the literature before. A depressive 63-year-old man was found dead in his apartment. On the body of the decedent 20 nearly symmetrically arranged fentanyl patches (Durogesic) of different strength with a total dose of 1350 microg/h were found. According to the results of the police the fentanyl patches were part of the pain therapy of his late wife, who had died one year before. Neither the autopsy nor the histological examinations revealed a cause of death. The chemical-toxicological investigation showed the following fentanyl concentrations: 94.9 ng/g (femoral vein blood), 45.9 ng/g (blood of the left heart), 74.8 ng/g (blood of the right heart), 101 ng/mL (urine), 468 ng/mL (bile), 745 ng/mL (stomach contents), 78.4 ng/mL (cerebrospinal fluid), 133 ng/mL (vitreous humor). The blood concentrations were in the upper range of the concentrations found in similar cases published. Hints for a postmortem increase of the fentanyl concentration because of the long postmortem interval of nearly 8 days were found.

"I am flying to the stars"--suicide by aircraft in Germany.

In 2006, 67 persons were killed in aircraft accidents in Germany and involving German aircrafts abroad. In spite of extensive investigation of each aircraft accident, there are no reliable data as to the number of suicides by aircraft. We report on a 50-year-old man who committed suicide by willfully crashing his Beech "Sierra" aircraft minutes after take off from an airport close to the town of Rendsburg, Germany. Before killing himself, the intoxicated pilot had sent an SMS announcing his suicide plans to a friend. The findings of the medico-legal investigation and the results of a review of aircraft accident reports by the German Federal Bureau of Aircraft Accidents Investigation (BFU) regarding suicidal plane crashes are presented.

[Unusual circumstances in a fourfold complex suicide]. / Ungewöhnliche Umstände eines 4-fach kombinierten Suizids.

Complex suicides are defined as suicides using more than one method, which may sometimes suggest homicide. We present the case of a 27-year-old man who killed himself by using four different methods. The man was known as a loner and sufferd from bipolar psychosis. An eyewitness saw him afire and falling out of a window on the 4th floor of a hotel. He was wearing a judo dress with the belt wound twice around his neck. He died in a hospital about two hours later. The autopsy showed signs of neck compression typical of (self)-strangulation, several stab and cut wounds in the thoracic and abdominal region from sharp force, extensive first- to third-degree burns caused by the effect of heat, contusions of internal organs, serial rib fractures and several bone fractures of the extremities as signs of blunt force. The CO-Hb value in the blood amounted to 7%; the other toxicological tests were negative. Death was found to be due to exsanguination from a deep stab wound in the abdomen and multiple trauma caused by the fall from a great height in the course of a suicide. Homicide could be excluded due to the circumstances of the case, which demonstrated again that both the medical findings and the investigation results of the police are indispensable for the differentiation between suicide and homicide.

[Fatal electrocution in prison]. / Stromtod in der Haftanstalt.

The clarification of deaths from electric current can be difficult when electric skin marks are missing or overlooked. In the following, the fatal electric accident of a 21-year-old man in prison is reported with a scene which primarily seemed to be inconspicuous. The autopsy disclosed typical electric marks in the skin of the left thumb and the corresponding part of the left index finger. A second inspection of the jail room, which was large enough for three men, but occupied by the deceased alone, led to the finding of widely spread utensils (two forks with signs of corrosion and deformation of the prongs, radio cable with socket, water container) for the self-construction of a kind of "immersion heater" for the heating of water. The man must have suffered electrocution when touching the prongs of the forks. Death supposedly occurred due to disturbances of the cardiac rhythm after a longer interval of maintained ability to act. The case again proves the difficulties in the detection and examination of possible electric deaths in which unusual sources of electricity must be considered.

Demands on scientific studies: vitality of wounds and wound age estimation.

Research on vitality and wound age estimation belongs to the classic fields in forensic medicine. Despite large literature data there is still considerable demand of further research and practical transfer of knowledge and techniques to daily casework. Scientific studies must fulfil basic criteria as to appropriate methods, selection of case material, analysis of results and quality control. Nowadays, immunohistochemistry, biochemical tests and molecular biological techniques are mainly used studying questions of vitality and wound age. Investigations can be based on human tissue samples (autopsy material, vital specimens) or animal experiments. The possibilities, advantages and disadvantages of these study designs are described. Indispensable is the use of appropriate control groups or control samples and a sufficient case number which permits statistical analysis. Main strategy is to minimize variations due to methods and investigators as the unavoidable biological variation of vitality processes and wound repair is large enough.

Time-dependent immunohistochemical detection of proinflammatory cytokines (IL-1beta, IL-6, TNF-alpha) in human skin wounds.

UNLABELLED: The proinflammatory cytokines interleukin-1beta (IL-1beta), interleukin-6 (IL-6) and tumour necrosis factor-alpha (TNF-alpha) hold important functions in the early and late courses of inflammation, trauma and wound healing. In the present study, human skin wounds due to sharp force (n = 105) were collected during surgery and autopsy. The wound age mainly varied from several minutes to 5 h, some specimens aged up to 6 weeks. Control specimens from uninjured skin were available in each case. After preparation of cryostat sections, immunohistochemistry was performed according to the APAAP technique, using monoclonal and polyclonal antibodies. The results were evaluated semiquantitatively. All markers were weakly expressed in normal human skin constitutively. However, the staining pattern changed significantly in vital wounds concerning epidermal layers, subepidermal cells, vessels and sweat glands. IL-1beta and IL-6 showed enhanced expression after 15 and 20 min at the earliest (increase of epidermal reactivity). After 30-60 and 60-90 min, respectively, marked expression was observed with these markers. Similar alterations were detectable with TNF-alpha after 15 and 60-90 min. The reactivity of all three markers persisted over several hours, then decreased to basal levels again and sometimes reappeared after days and in granulation tissue. Leukocytes reacting with IL-1beta and IL-6 appeared after approximately 2 h. CONCLUSION: proinflammatory cytokines can serve as a useful tool for the estimation of vitality and wound age, in particular in the early post-traumatic interval prior to leukocyte reaction. Autolysis did not play a role in the samples investigated (postmortem interval up to 8 days). Problems could sometimes rise from constitutive expression. Therefore, it is recommended to examine control samples from the same individual and to compare the reactivity with wound specimens.

[Modern variant of hanging: use of a time-programmed winch]. / Eine moderne Variante des Erhängens: Einsatz einer zeitprogrammierten Seilwinde.

Hanging is one of the most frequent types of suicide. Descriptions of unusual ligatures can be read about again and again. The paper reports the suicide of a 41-year-old electrician, who, using an electric winch, hung himself in nearly free suspension. The winch that was secured to the timberwork of the attic had been programmed by an electric time clock, the toggle switch of the remote control was fixed in the on-position using adhesive tape. The man had handcuffed his hands behind his back against any attempts to save himself. The noose was partly cushioned with a bike tube with the obvious aim of reducing the pain. Due to the state, in which he was found and the results of the post-mortem examination, a third party responsibility was excluded. The case shows that not only certain types of knots and nooses can be associated with various occupational groups, but the choice of a special strangulation device can possibly also come from the occupational sphere. As a modern variation of hanging, the presented casuistry can partly complete the familiar documentation of historical cases with the use of block and tackle and similar constructions.

[Suicide with exit bags: circumstances and special problem situations in assisted suicide]. / Suizide mit Exit Bags: Umstände und besondere Problemlagen bei Sterbebegleitungen.

So-called exit bags are voluminous, transparent plastic bags, each with a collar to go round the neck, and a Velcro fastening. In conjunction with the consumption of sleeping pills, the bags are recommended as an aid to commit suicide by organizations in favour of "humane death". It is reported on four such suicides by elderly people between 79 and 87 years of age. In two of these cases, there was assistance in committing suicide, one corresponding to a suicide protocol from the Swiss organization for euthanasia, EXIT. In two cases, detailed instructions for committing suicide were found. The morphological findings were not very specific in any of the cases. If the plastic bags are removed by a third party, this type of suicide may remain undetected even after performance of an autopsy. Exit bags tend to be used by older people with either real or feared life-threatening illnesses, in suicides which have usually been planned for some time. From the criminological point of view, the possible active participation of other persons in pulling the covering over the head can often not be proved. Assisting a suicide, in the sense of giving instructions on how to accomplish it, is not punishable in German law.