Axel Gehl

Skin and soft tissue artifacts due to postmortem damage caused by rodents.

Five cases of postmortem bite-injuries inflicted by rodents are presented (five males between 41 and 89 years; three cases caused by mice, one case by rats, one case of possible mixed rodent activity by rats and mice). The study presents a spectrum of phenomenological aspects of postmortem artifacts due to rodent activity to fresh skin and soft tissue: the majority of the injuries have a circular appearance. The wound margins are finely serrated with irregular edges and circumscribed 1-2 mm intervals within, partly showing protruding indentations up to 5 mm. Distinct parallel cutaneous lacerations deriving from the biting action of the upper and lower pairs of the rodents incisors are diagnostic for tooth marks of rodent origin but cannot always be found. No claw-induced damage can be found in the skin beyond the wound margins. Areas involved in the present study were: exposed and unprotected parts of the body, such as eyelids, nose and mouth (representing moist parts of the face); and the back of the hands. Postmortem rodent activity may occasionally be expected on clothed and therefore protected parts of the body. The phenomenon of postmortem rodent activity to human bodies can be found indoors especially under circumstances of low socioeconomic settings; outdoors this finding is particularly observed among fatalities among homeless people.

Skin tension and cleavage lines (Langer's lines) causing distortion of ante- and postmortem wound morphology.

The assessment of individual wounds at autopsy may be complicated by the superimposition of a number of injuries or damage to tissues that occurred after death, either of which has the potential to distort the morphology of the initial injury. Additional factors that may change the shape of wounds are (1) the relationship of the wound to the so-called skin cleavage lines (Langer’s lines) and (2) tension placed on the skin. Three autopsy cases are reported to demonstrate once more how wound morphology may be altered by such factors. In case 1, rectangular stab wounds to the base of the neck in a 53-year-old man, which suggested that a square or rectangular tool may have caused the injuries, were altered to more typical knife stab wounds once skin tension had been released at autopsy. The uppermost wounds, however, continued to gape due to the effects of skin cleavage lines. In case 2, slit-like wounds resembling stab wounds in the neck of a 54-year-old woman found in a river were shown to be circular once skin tension had been released. In case 3, the effects of either cleavage lines or skin tension could be demonstrated on excised wounds from a 43-year-old man whose body had also been found in a river; tensile forces easily changed circular into slit-like wounds. Tension and/or skin cleavage lines may transform round skin defects into slit-like wounds resembling knife stab wounds, round out genuine stab wounds and artefactually lengthen stab wounds. These factors must be taken into consideration carefully when wounds are assessed at the death scene prior to autopsy.

Intersecting fractures of the skull and gunshot wounds. Case report and literature review

When two fracture lines of a solid surface (ice, glass, eggshell, etc.) intersect, it is always possible to tell which one has been made first. Indeed pre-existing damage of the surface arrests all the fracture lines produced by subsequent impacts. This well-known principle (established by Puppe in 1903) has been largely used in glass fracture analysis, but can be applied also to the examination of skull fractures. It can help sequencing blunt force or gunshot injuries determining the direction of fire and differentiating entrance from exit wounds in the absence of specific distinguishing features (i.e., internal/external beveling of the skull or overlying skin indicators). In this context, we report the case of a 76-year-old man who shot himself in the mouth with a Walther PPK 7.65 handgun and highlight the utility of the application of both Puppe’s Rule and Multislice Computed Tomography (MSCT) in the examination of gunshot wounds to the skull.

Digitale forensische Fotodokumentation

ZusammenfassungDie digitale Fotografie hat die analoge Fotografie in Rechtsmedizin und Kriminaltechnik genauso wie im Privatleben nahezu vollständig abgelöst. Die neue Technik bringt zweifellos zahlreiche Vorteile. Die scheinbare Einfachheit hat jedoch dazu geführt, dass die forensische Fotodokumentation nicht mehr von hauptberuflichen Fotografen durchgeführt wird, sondern beispielsweise von den Sachbearbeitern der Kriminalpolizei oder den in der Rechtsmedizin tätigen Ärzten. Die Erfahrung hat gezeigt, dass es im professionellen Einsatz nicht ausreicht, sich auf die Automatikfunktionen der Kamera zu verlassen, ohne diese zu hinterfragen.AbstractJust as in private life, digital photography has almost completely replaced the use of analog photography in forensic medicine and the forensic sciences. This new technology undoubtedly offers numerous advantages. However, the apparent ease with which it can be used has led to forensic photographs no longer being taken by professional photographers butby police officers or forensic pathologists. Experience has shown that in a professional context it does not suffice to unquestioningly rely on the automatic functions of a digital camera.

Putrefaction and wound dehiscence: a potentially confusing postmortem phenomenon.

The decomposed body of a 49-year-old man was found at his home address. At autopsy, 3 incised wounds of the lower abdomen and groins were identified, raising the possibility of some form of inflicted injury. Further dissection revealed that the wounds were healing surgical incisions that had been forced open by putrefactive tissue breakdown, swelling, and gas formation. Death was due to ischemic heart disease. Putrefaction is a common problem encountered in forensic practice that may result in considerable distortion and modification of tissues. Unusual skin lesions caused by the disruption and dehiscence of healing surgical wounds may be created by decomposition. This possibility should be considered when symmetrical, cleanly incised wounds are identified.

Modellprojekt zur Implementierung eines medizinischen Kompetenzzentrums für Gewaltopfer in Hamburg

ZusammenfassungIn Hamburg erfolgt die klinisch-rechtsmedizinische Untersuchung von verletzten Gewaltopfern seit 1998 als niedrigschwelliges Angebot. Alle Opfer von Gewalt werden auf eigenen Wunsch, unabhängig von einer Anzeige bei der Polizei, im Institut für Rechtsmedizin kostenlos untersucht. Verletzungen werden dokumentiert, Spuren gesichert und rechtsmedizinische, gerichtsverwertbare Gutachten erstellt. Es werden dabei im interdisziplinären Verbund mit anderen Abteilungen der Universitätsklinik Konzepte für spezifische Opfergruppen entwickelt. Der Aspekt der Psychotraumatisierung kann durch ein im Institut für Rechtsmedizin bestehendes Angebot psychologischer Krisenintervention berücksichtigt werden. Im ersten Jahr der auf dieser Basis seit 2003 als Modellprojekt weitergeführten Ambulanz wurden 1.071 Patienten (62% Frauen, 38% Männer, ca. 21% ausländische Nationalität) untersucht, 40% von ihnen außerhalb des Institutes. Die berichtete Sachlage deutete in 26,5% der Fälle auf einen Partnerschaftskonflikt, in 17,7% auf ein Vergehen gegen die sexuelle Selbstbestimmung hin. Raubtaten wurden in 6,1%, andere Aggressionskonflikte in 30,5% der Fälle dargestellt (15% Sachlage unklar). Der Fremdtäteranteil betrug insgesamt 30%. Die als Modellprojekt konzipierte Hamburger Initiative hat das Ziel, den Versorgungsbedarf bei Gewaltopfern zu erkennen, das Angebot des rechtlichen Opferschutzes zu optimieren und Rechtsmedizin als integrierendes und vernetzendes Element im existierenden regionalen Hilfesystem zu etablieren.AbstractA medico-legal competence centre for victims of violence was established in Hamburg in 1998 where a low threshold of intervention is provided. Victims who come to the Competence Centre to have their injuries documented are not required to report the offence to the police. A forensic documentation of injuries as well as the securing of biological evidence is available for free. The service is expanded to provide victims not just with the possibility of further examination by the appropriate departments of the University Hospital Hamburg-Eppendorf, but also with in- house psychological support. In 2003, 1071 victims of violence were examined (62% females, 38% males, about 21% with foreign nationality). The underlying history was violence in intimate partnerships in 26.5% of the cases, sexual violence in 17.7%, robbery in 6.1%, and other categories of non-intimate violence in 30.5% (history unknown in 15%). The project analyses the provision of care and legal aid for acute cases and thereby contributes to an improvement in the situation of victims of violent crime by connecting existing services in the public health system in Hamburg.

Cao Gio – Kindesmisshandlung oder Heilbehandlung?

ZusammenfassungIn einer Schule fielen bei einem 7-jährigen vietnamesischen Jungen streifige Hautrötungen unklarer Herkunft auf, die den Verdacht zunächst auf eine Kindesmisshandlung lenkten. Die Untersuchung ergab, dass es sich um feine intrakutane Blutungen handelte, die durch eine spezielle asiatische Massage-Form, Cao Gio (vietnamesisch) oder Gua Sha (chinesisch), hervorgerufen wurden. In eigenen Untersuchungen wurde belegt, dass die Methode geeignet ist, gleichartige Hauterscheinungen hervorzurufen. Von einer Kindesmisshandlung war somit nicht auszugehen. Auf die besondere Gefahr der Fehlinterpretation soll hingewiesen werden.AbstractIn an elementary school it was noticed that a 7-year-old boy had reddish streaks on his skin which raised the suspicion of child abuse. Careful examination of the case revealed that the origin of the petechial bleeding was a special Asian massage technique, cao gio (Vietnamese) or gua sha (Chinese). Tests showed that the technique is capable of causing similar skin lesions, therefore there was no cause to suspect child abuse. Health professionals need to be aware of this phenomenon in order to avoid false diagnoses and accusations.

Artenspektrum und zeitliches Auftreten von Insekten an Wohnungsleichen im Großraum Hamburg

Von Mai bis September 2000 wurden an 30 Wohnungsleichen in Hamburg Artenspektrum und Reihenfolge des Auftretens von Insekten erfasst. Es wurden 7 Fliegengattungen, in denen 5 zur Art bestimmt wurden, 2 Käferarten und eine Erzwespenart gefunden. In 28 von 30 Fällen waren die Goldfliege (Lucilia sericata) und in 21 Fällen die blaue Schmeißfliege (Calliphora vicina) anzutreffen. Die übrigen Fliegenarten traten zwischen 11- und 3-mal auf; Käfer wurden 2-mal, die Erzwespe einmal registriert. Fünf Fliegenarten gehören zu den Erstbesiedlern, die häufig bereits am Tag des eintretenden Todes an einer Leiche auffindbar sind. Als Spätbesiedler traten die übrigen Fliegen und die Käfer frühestens am dritten Tag nach Eintritt des Todes auf. Eine Sonderstellung nimmt die Erzwespe ein, da sie ihre Eier in Fliegenpuppen legt und somit erst nach der Verpuppung der Fliegen Wirte findet. Sie erscheint daher erst etwa 14 Tage nach Todeseintritt an einer Leiche.The number and the temporal occurrence of various species of insects on 30 human corpses found in domestic situations in Hamburg were registered from May until September 2000. In total, seven genera of fly were found, five of which were classified to the species level as well as two species of beetles and one wasp species. The most frequent species found was the blowfly (Lucilia sericata) on 28 followed by the blue blowfly (Calliphora vicina) on 21 corpses. Other fly species appeared in 3–11 cases, beetles in 2 cases and the wasp species were found once. In order of appearance the insects could be differentiated in “early colonizers” and “late colonizers” whereby five fly species were found on the first day after death and therefore registered as “early colonizers”. All the other insects arrived 3 days after death or later. The wasp species (Nasonia vitripennis) had an exceptional position because the eggs were laid on fly pupae, so that hosts could only be found after the flies had pupated and therefore was not found on a corpse earlier than 14 days after death.

The novel H1N1/swine-origin influenza virus and its implications for autopsy practice

As fatalities attributable to novel H1N1/S-OIV infections are currently rising, an increasing number of autopsies will have to be performed on these cases. In view of this challenge, adequate safety precautions and recommendations for autopsy procedures and the sampling and handling of specimens have to be established. Based on current literature, procedures for daily autopsy practice are proposed, particularly in regard to personal protection equipment, swab usage, and autopsy hygiene.

Blood Trace Evidence on Washed Textiles - a systematic approach

Luminol has been used for a long time for detecting latent blood traces during police investigations because it is easy to use and does not pose any health risks, while providing trace evidence for DNA analysis. It is often the method of choice for examining clothing. Clothes worn during the offense are often destroyed or washed afterwards by the offenders. The purpose of this study is to show the possibilities of blood and DNA detection on washed clothes by documenting the macroscopic results and their chemiluminescence after washing. The tests comprised different fabrics and laundry detergents including different washing and drying methods. Chemiluminescence was detected on almost all blood-marked samples (95.9%), even after all traces visible to the naked eye have been removed by washing. Evidence of a complete DNA profile or individual alleles could be confirmed in almost all of the test cases (93.3%).