[Postmortem computed tomography of the frozen corpse]. / Posmertnaya komp'yuternaya tomografiya oledenevshego trupa.

The purpose of the work is to identify the possibilities of computed tomography in establishing postmortem changes in the bones of the skeleton and internal organs during in a frozen corpse. The article describes a case from thanatological practice with the performance of a pre-sectional computed tomography of a corpse of a young woman found in a forest in a state of complete freezing. As a result of the study, CT images of frozen internal organs were obtained, which are never found in clinical practice. Significant changes in the CT pattern were revealed due to a decrease in the density of the frozen zones. The use of pre-sectional computed tomography enabled to identify postmortem changes in internal organs formed during freezing of the corpse; the position of the corpse during its glaciation and the uniformity of the freezing process.

[The notion and classification of expert errors].

The author presents the analysis of the legal and forensic medical literature concerning currently accepted concepts and classification of expert malpractice. He proposes a new easy-to-remember definition of the expert error and considers the classification of such mistakes. The analysis of the cases of erroneous application of the medical criteria for estimation of the harm to health made it possible to reveal and systematize the causes accounting for the cases of expert malpractice committed by forensic medical experts and health providers when determining the degree of harm to human health.

[Errors made by experts when implementing the Medical Criteria for the estimation of the severity of harm to human health].

This paper is devoted to the analysis of expert errors made in the course of implementation of the Medical Criteria for the estimation of the severity of harm to human health. In 2010, the Moscow Regional Bureau of Forensic Medical Expertise issued 11 180 primary expert judgments and acts of forensic medical examination of the total number of 26 196 expertises performed (43%). They include 2797 cases of severe harm to health, 2881 cases of moderate and 5502 cases of mild harm to health. Only 74 (1.3%) of the 5678 cases of severe and moderate harm to health were misinterpreted by the experts. Thirty three (0.6%) judgments were considered as doubtful. Sixty one of the 74 cases of harm to health were erroneously described as severe and 13 ones as moderate. The main source of the errors was misapplication of the respective articles of the Medical Criteria for the estimation of the severity of harm to human health. Only 20 (0.4%) of the 5502 cases estimated as mild harm to health proved erroneous. Fifty four (1%) judgments were recognized to be doubtful. A total of 264 forensic medical expertises were performed by expert commissions during 2010 of which 118 (45%) were designed to estimate the harm to human health. In more than two thirds of the cases, the errors of primary expertise of the severity of harm to human health due to the misapplication of the Medical Criteria were either revised or corrected; the remaining one third of the judgments were left unaltered (i.e. the results of the primary expertise were confirmed).

[The application of the medical criteria for the harm to health: expert and law-enforcement practice].

This paper is devoted to the practical application of the medical criteria (MC) for the harm to health (HH) put into force on September 16, 2008. The authors undertook the analysis of procedures of forensic medical expertises for the estimation of the harm to health during the periods before and after putting MC into action (between 2007 and 2010). The results of this analysis were compared with the number of documented criminal actions that caused harm to health and the number of subjects convicted of such crimes. It is shown that the frequency of crimes leading to the serious harm to health has increased (by 22%) in parallel to the roughly similar decrease in the frequency of crimes responsible for the moderate harm. These trends are unrelated to the changes in the number of subjects convicted of such crimes. The frequency of intentional infliction of the serious harm to health decreased by 12% and the number of subjects convicted of the crimes that caused serious (Criminal Code of the Russian Federation, parts 1-3, article 111) and moderate (Criminal Code, article 112) harm to health decreased in 2010 by 5% compared with 2007. The rise in the frequency of the crimes responsible for the serious harm to health (Medical Criteria, pp. 6.11.1-6.11.11) revealed during forensic medical expertises is unrelated to the number of documented crimes and subjects convicted of them under parts 1,2, article 264 of the Criminal Code. The number of documented crimes and subjects convicted of them after the new medical criteria had been put into force (2009 and 2010) decreased by 23% and 15% respectively. It is concluded that putting into effect the new regulations and medical criteria did not result in a substantial change in the relative frequency of the serious and moderate harm to health. Nor did the law enforcement practice gives evidence of any change in the relationship between cases of moderate and serious harm to health and in the number of grave crimes causing the harm to health. The new medical criteria allowed to put in order and present in a structured fashion the data on the harm to health depending on the degree of its severity.

[The application of the videographic images as samples for the comparative craniofacial study].

The results of analysis of 181 forensic medical examinations for craniofacial personality identification are presented. Video snapshots of materials used in the practical forensic medical work and specimens prepared for experimental stdies are shown to be of a higher informative value than conventional photographs. The use of life-time video snapshots for the purpose of comparison significantly improves the efficacy of craniofacial identification by providing much wider opportunities for studying the signs of descriptive portraits, comparing skull measurements and life-time video snapshots obtained at different head rotations and camera angles, and making use of specific characteristics of the stomatological status.

[Forensic medical evaluation of the severity of harm to the health in the cases of a fracture of the zygomaticoorbital complex complicated by ophthalmological disorders].

Expert reports of the cases of a fracture of the zygomaticoorbital complex are presented along with their comprehensive assessment based on the available investigative, clinical, and anamnestic data. The analysis included 71 patients, materials of forensic medical examination and other medical documentation, civil, criminal, and administrative proceedings. It was shown that forensic medical evaluation of the severity of harm to the health in the cases of a fracture of the zygomaticoorbital complex including those complicated by ophthalmological disorders is possible both in terms of the total duration of health impairment and in terms of the persistent loss of ability to work (on a percentage base). It is concluded that the degree of harm to the health in the cases of a fracture of the zygomaticoorbital complex complicated by ophthalmological disorders can be categorized as mild, moderate, and severe depending on the total duration of health impairment and percentage loss of ability to work. In case of irreparable facial disfigurement, the moderate harm to the health can be re-evaluated by the court as a severe one.

[The data on statistical surveillance of recording forensic medical expertises of the harm to human health collected by the Bureau of Forensic Medical Expertise (BFME) in Central Health Department of the Moscow region].

This publication deals with the analysis of application of the "Medical criteria for the harm to human health" put into force on September 16, 2008, as exemplified by the work of the Bureau of forensic medical expertise (BFME), Central Health Department of the Moscow region, during the period from 2007 and 2010. The data were borrowed from the materials of departmental statistical reporting (F.42) on forensic medical examinations of the harm to human health carried out during the period between 2007 and 2010. In addition, the statistical report of BFME on the application of the medical criteria in 2010 was used. The number of forensic medical expertises for the estimation of the degree of harm to human health was shown to decrease by 9% but remain 3% higher than the average across the country. The number of expertises of severe harm to the health increased by 15% as in the whole of the country with the concomitant 20% reduction in the number expertises of mild and moderate harm. These trends are unrelated ether to the changes in the frequency of crimes leading to the serious harm to the health or to the number of subjects convicted of such crimes. It was found that p.p. 6.1.1 - 6.1.30 of the "Medical criteria" that list life-threatening injuries are most frequently (in 58% of the cases) used to document facts of severe harm to the health. The same is true of p.p. 6.11. - 6.11.11 listing the injuries responsible for the persistent loss of occupational capacity (by at least one third). The frequency of application of concrete paragraphs of the (Medical criteria, is determined within each group. The largest number of expert errors (3.2%) were committed while estimating serious harm to the health based on the paragraphs listing the injuries responsible for the persistent loss of occupational capacity (by at least one third). The minimal number of such errors (1%) were committed while estimating serious harm to the health from life-threatening injuries.

[Forensic medical criteria for the assessment of severity of harm to the health in subjects with zygomatic bone fractures].

Expert reports concerning subjects with zygomatic bone fractures were analysed and comprehensively evaluated using investigatory, clinical and anamnestic data. A total of 704 forensic medical reports were available for the purpose including 225 (32%) isolated and 479 (68%) combined fractures. It was shown that most complications of zygomatic fractures develop late in the post-traumatic period which requires repeated examination of the patients within at least one month after the injury. It is emphasized that such examination must involve neuropathologist, ophthalmologist, and maxillofacial surgeon to adequately evaluate harm to the health in patients with isolated zygomatic fractures. The main causes of discrepancy between results of estimation of harm to the health during primary and subsequent forensic medical examination of subjects with zygomatic fractures are considered.

[Analysis of the structure and specific features of maternal and infant mortality according to the data of Forensic Medical Examination Bureau and Pathologic Anatomy Bureau for 2002-2006].

The present analysis of maternal and infant (under 1 year of age) mortality is based on the data for the period from 2002 to 2006 that have come to the address of the All-Russia scientific and practical conference "Topical issues of forensic medical examination of the human corpse" (5-6 June 2008, Sankt-Peterburg). The materials were collected using a standard questionnaire form distributed among regional forensic-medical examination bureaus an pathologic anatomy departments. The questionnaire comprised over 50 questions. The study revealed a steady tendency toward a decrease in maternal and infant mortality in the Russian Federation as a whole and in its different regions. The study included analysis of similarities and differences in the mortality rates reported by forensic-medical examination bureaus and pathologic anatomy departments of the country and in the technical approaches practiced by them.

[Evaluation of injection signs in drug-users in forensic medical practice].

The study was designed to obtain the morphological picture of post-injection lesions in drug-addicts. The most frequent localization of the signs of non-medical injections was established. Special attention was given to concrete signs having special informative value for the evaluation of the prescription of post-injection lesions. The possibility of using these data for the confirmation of non-medical origin of such lesions was assessed. It is concluded that the results of the study may be useful for the substantiation of diagnosis of acute and chronic narcotic intoxication and for the post-mortem examination in the course forensic medical investigation.

[Forensic medical identification of the immediate causes of death from acute radiation injury].

The objective of the present study was to perform retrospective thanatological analysis of reports on acute radiation disease in liquidators of the consequences of the accident at the Chernobyl nuclear power plant. It is shown that hemorrhagic syndrome was the main cause of death among the liquidators exposed to ionizing radiation.

[Organizational problems of disaster victim identification in mass casualties as exemplified by Tu 154-M and Airbus A310 passenger plane crashes].

Managerial experience is described that was gained during the large-scale work on victim identification following mass casualties in the Tu 154-M and Airbus A310 passenger plane crashes. The authors emphasize the necessity to set up a specialized agency of constant readiness meeting modern requirements for the implementation of a system of measures for personality identification. This agency must incorporate relevant departments of the Ministries of Health, Defense, and Emergency Situations as well as investigative authorities and other organizations.

[On the criteria for the forensic medical appraisal of harm to the human health from thermal injuries].

"Rules for forensic medical determination of the severity of bodily injures" currently used in practical expertise are at some variance with the Criminal Code and the Criminal Procedure Code of the Russian Federation. Their analysis taking into account the available clinical reports and the results of our original studies of archive materials made it possible to propose and substantiate additional criteria for the assessment of harm to the human health from thermal injuries.

[Clinical, laboratory, and morphological manifestations of fatal and non-fatal poisoning with surrogate alcoholic beverages].

Clinical and morphological signs of poisoning with surrogate alcoholic beverages and their effect on human internal organs are described. Acute respiratory failure is believed to be the key element in patho- and tanatogenesis of alcoholic intoxication, the immediate cause of death being hepatic and/or renal insufficiency. Histologic examination revealed marked dystrophic changes in all internal organs of the affected subjects.

[Forensic-medical evaluation of toxic hepatitis associated with surrogate alcohol poisoning].

Medical cards of 1,116 inpatient victims of surrogate alcohol poisoning and 242 cases of its fatal outcome associated with jaundice were available for analysis form Irkutsk Region and other regions of the Russian Federation in the second half of 2006 and early 2007. The study revealed differences in hepatic lesions depending on the chemical nature of toxicants. Mixtures containing guanidine derivatives caused highly specific irreversible disturbance of bile transport in hepatocytes and biliary capillaries in the absence of cholestasis at the level of biliary ducts. Changes in hepatocytes of different type and genesis appear to be due to other toxic components and may be of use for the establishment of causal relation between hepatic lesions and concrete toxic mixtures.

[Criteria of estimation of state forensic-medical expert activity administration].

Criteria of estimation of state forensic medical activity administration were systematized and their content was considered. New integral index of administration efficiency - index of technological efficiency - was developed and proved.