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Discriminating factors in fatal blunt trauma from low level falls and homicide

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Abstract

Purpose

Determination of the manner of death is a major issue in forensic practice. Differentiating the injuries caused by falls from a low height from injuries due to the deliberate application of a blunt object can be difficult. A few studies suggested the use of certain criteria, such as the hat brim line rule, to help in differentiating between falls and blows. Unfortunately they are not consistent.

Methods

All autopsy cases from a 16-year period (1996–2012) were analyzed retrospectively. Three groups were defined: homicide cases (n = 31), sudden natural deaths involving a fall (n = 103), and accidental fall cases (n = 30). The three groups were statistically compared across a wide range of parameters including general characteristics, presence, and characteristics of different types of wounds (lacerations, deep bruises, fractures, intracranial trauma, and defense injuries) as well as their respective anatomical site.

Results

There were marked differences in wounds between homicide and fall cases, e.g., wounds were more numerous and larger in homicides. We did not confirm the hat brim line rule as a reliable discriminating parameter. A simple and highly effective multivariate model was found, which included the presence of lacerations, deep bruises, and intracranial trauma.

Conclusion

This study underlines the importance of autopsy findings in providing an indication of the manner of death. Conversely, the limitations of the hat brim line rule have been highlighted.

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Abbreviations

AUC:

Area under the curve

References

  1. Fischer J, Kleemann WJ, Tröger HD. Types of trauma in cases of homicide. Forensic Sci Int. 1994;68:161–7.

    Article  CAS  PubMed  Google Scholar 

  2. Hartshorne NJ, Harruff RC, Alvord EC Jr. Fatal head injuries in ground-level falls. Am J Forensic Med Pathol. 1997;18:258–64.

    Article  CAS  PubMed  Google Scholar 

  3. Robinovitch SN, Feldman F, Yang Y, Schonnop R, Leung PM, Sarraf T, et al. Video capture of the circumstances of falls in elderly people residing in long-term care: an observational study. Lancet. 2013;381:47–54.

    Article  PubMed Central  PubMed  Google Scholar 

  4. Thierauf A, Preuß J, Lignitz E, Madea B. Retrospective analysis of fatal falls. Forensic Sci Int. 2010;198:92–6.

    Article  PubMed  Google Scholar 

  5. Venkatesh VT, Kumar MVP, Jagannatha SR, Radhika RH, Pushpalatha K. Pattern of skeletal injuries in cases of falls from a height. Med Sci Law. 2007;47:330–4.

    Article  CAS  PubMed  Google Scholar 

  6. Mazzolo GM, Desinan L. Sharp force fatalities: suicide, homicide or accident? A series of 21 cases. Forensic Sci Int. 2005;147:S33–5.

    Article  PubMed  Google Scholar 

  7. Karlsson T. Multivariate analysis (‘forensiometrics’)—a new tool in forensic medicine. Differentiation between sharp force homicide and suicide. Forensic Sci Int. 1998;94:183–200.

    Article  CAS  PubMed  Google Scholar 

  8. Karger B, Niemeyer J, Brinkmann B. Suicides by sharp force: typical and atypical features. Int J Legal Med. 2000;113:259–62.

    Article  CAS  PubMed  Google Scholar 

  9. Rogde S, Hougen HP, Poulsen K. Homicide by sharp force in two Scandinavian capitals. Forensic Sci Int. 2000;109:135–45.

    Article  CAS  PubMed  Google Scholar 

  10. Ormstad K, Karlsson T, Enkler L, Law B, Rajs J. Patterns in sharp force fatalities-a comprehensive forensic medical study. J Forensic Sci. 1986;31:529–42.

    CAS  PubMed  Google Scholar 

  11. Ambade VN, Godbole HV. Comparison of wound patterns in homicide by sharp and blunt force. Forensic Sci Int. 2006;156:166–70.

    Article  PubMed  Google Scholar 

  12. Kremer C, Sauvageau A. Discrimination of falls and blows in blunt head trauma: assessment of predictability through combined criteria. J Forensic Sci. 2009;54:923–6.

    Article  PubMed  Google Scholar 

  13. Kremer C, Racette S, Dionne CA, Sauvageau A. Discrimination of falls and blows in blunt head trauma: systematic study of the hat brim line rule in relation to skull fractures. J Forensic Sci. 2008;53:716–9.

    Article  PubMed  Google Scholar 

  14. Guyomarc’h P, Campagna-Vaillancourt M, Kremer C, Sauvageau A. Discrimination of falls and blows in blunt head trauma: a multi-criteria approach. J Forensic Sci. 2010;55:423–7.

    Article  PubMed  Google Scholar 

  15. Ehrlich E, Maxeiner H. External injury marks (wounds) on the head in different types of blunt trauma in an autopsy series. Med Law. 2002;21:773–82.

    PubMed  Google Scholar 

  16. Richter M. Gerichtsärztliche Diagnostik und Technik. Leipzig: Hirzel; 1905.

    Google Scholar 

  17. Kratter J. Lehrbuch der gerichtlichen Medizin: mit Zugrundelegung der deutschen und österreichischen Gesetzgebung und ihrer Neuordnung. Stuttgart: F. Enke; 1921.

    Google Scholar 

  18. Walcher PD. Über„stumpfe“Kopfverletzungen. Dtsch Z ges Gerichtl Med. 1931;17:22–9.

    Google Scholar 

  19. Fracasso T, Schmidt S, Schmeling A. Commentary on: Kremer C, Racette S, Dionne CA, Sauvageau A. Discrimination of falls and blows in blunt head trauma: systematic study of the hat brim rule in relation to skull fractures. J Forensic Sci. 2008;53:716–9. J Forensic Sci. 2011;56:1662.

    Article  PubMed  Google Scholar 

  20. Knight B. Forensic pathology. London: Edward Arnold; 1991.

    Google Scholar 

  21. Sharkey EJ, Cassidy M, Brady J, Gilchrist MD, NicDaeid N. Investigation of the force associated with the formation of lacerations and skull fractures. Int J Legal Med. 2012;126:835–44.

    Article  CAS  PubMed  Google Scholar 

  22. Vincent ML, Moreau TM. Accidental falls: causes, prevention and intervention. New York: Nova Science; 2008.

    Google Scholar 

  23. Kuhns JB, Maguire ER. Drug and alcohol use by homicide victims in Trinidad and Tobago, 2001–2007. Forensic Sci Med Pathol. 2012;8:243–51.

    Article  PubMed  Google Scholar 

  24. Kuhns JB, Wilson DB, Clodfelter TA, Maguire ER, Ainsworth SA. A meta-analysis of alcohol toxicology study findings among homicide victims. Addiction. 2011;106:62–72.

    Article  PubMed  Google Scholar 

  25. Carson HJ. Patterns of ecchymoses caused by manner of death and collateral injuries sustained in bruising incidents: decedent injuries, profiles, comparisons, and clinicopathologic significance. Forensic Sci. 2010;55:1534–42.

    Article  Google Scholar 

  26. Chattopadhyay S, Tripathi C. Skull fracture and haemorrhage pattern among fatal and nonfatal head injury assault victims—a critical analysis. J Inj Violence Res. 2010;2:99–103.

    Article  PubMed Central  PubMed  Google Scholar 

  27. Mohanty S, Mohanty MK, Panigrahi MK, Das SK. Fatal head injury in homicidal victims. Med Sci Law. 2005;45:244–8.

    Article  PubMed  Google Scholar 

  28. Brunel C, Fermanian C, Durigon M, de la Grandmaison GL. Homicidal and suicidal sharp force fatalities: autopsy parameters in relation to the manner of death. Forensic Sci Int. 2010;198:150–4.

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Forensic Medicine and Pathology, Raymond Poincaré Hospital, AP-HP, UVSQ, 104 Boulevard Raymond Poincaré, 92380, Garches, France

    Thomas Lefèvre & Geoffroy Lorin de la Grandmaison

  2. Department of Pharmaco-Toxicology, Raymond Poincaré Hospital, AP-HP, UVSQ, 104 Boulevard Raymond Poincaré, 92380, Garches, France

    Jean-Claude Alvarez

Authors
  1. Thomas Lefèvre
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  2. Jean-Claude Alvarez
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  3. Geoffroy Lorin de la Grandmaison
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Correspondence to Thomas Lefèvre.

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Lefèvre, T., Alvarez, JC. & Lorin de la Grandmaison, G. Discriminating factors in fatal blunt trauma from low level falls and homicide. Forensic Sci Med Pathol 11, 152–161 (2015). https://doi.org/10.1007/s12024-014-9651-7

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