Background/Objectives: Forensic DNA phenotyping (FDP), the inference of externally visible characteristics from biological trace evidence, has become an operational investigative tool, yet its implications for criminal justice systems remain poorly understood outside specialist forensic circles. This study examines the scientific foundations, operational utility, and regulatory context of FDP, and situates its findings within a criminological framework that forensic science literature has largely overlooked. Methods: A narrative review of scientific and legal literature was conducted across six electronic databases, covering publications up to 2026. This was complemented by a structured analysis of publicly documented criminal investigations in which FDP was operationally applied, incorporating both successful outcomes and documented failure contexts drawn from peer-reviewed validation studies. Results: Pigmentation traits are predicted with substantial reliability by validated systems; accuracy declines markedly for complex traits and non-European populations. Casework evidence suggests that FDP can contribute to the reactivation of stalled investigations when combined with complementary methods but is insufficient for identification in isolation. Among the nine European jurisdictions examined, several lack explicit legal frameworks governing phenotyping deployment, with Spain serving as a representative example. Conclusions: The disconnect between forensic science and criminal justice practice is itself a governance problem. FDP has shown investigative potential and, in some documented cases, restorative value—particularly in cold cases—but its responsible deployment requires simultaneous progress in scientific validation, regulatory reform, and the professional training of legal practitioners who currently lack the knowledge to deploy or oversee it effectively.
Background/Objectives: The pituitary gland is highly susceptible to hypoxic–ischemic injury because of its distinctive vascular architecture, yet its forensic significance in non-traumatic deaths remains poorly defined. This study aimed to compare pituitary histopathology across deaths caused by different mechanisms of systemic hypoxia. Methods: This retrospective observational study investigated pituitary histopathology in 30 forensic autopsies performed between 2019 and 2025, including suicidal hanging (n = 10), fatal heroin intoxication with respiratory failure (n = 10), and sudden cardiac death controls (n = 10). Hematoxylin–eosin-stained sections were systematically evaluated for hemorrhagic, ischemic, and necrotic changes and their anatomical distribution. Results: Neurohypophyseal hemorrhage was detected in 6/10 hanging cases and 8/10 heroin-related deaths, but in no controls. Adenohypophyseal ischemic–necrotic lesions occurred in 2/10 hanging cases and 6/10 heroin cases and were absent in controls. Lesions were generally more extensive in heroin intoxication, where hemorrhage often coexisted with vascular congestion and coagulative necrosis. The preferential involvement of the posterior lobe by hemorrhage and the anterior lobe by ischemic–necrotic injury is consistent with their different vascular supplies. Conclusions: These exploratory findings require validation. Hypoxia duration and residual perfusion were not measured. Pituitary sampling may be a complementary tool worth investigating in selected forensic cases; its routine utility was not assessed. Because all sections were stained with hematoxylin–eosin only, these findings are preliminary and require confirmation.
Background/Objectives: 3,4-Methylenedioxy-alpha-pyrrolidinohexanophenone (MDPHP) is a pyrrolidinophenone synthetic cathinone whose post-mortem interpretation is particularly difficult when advanced decomposition prevents blood-based toxicology. This case report examined instrument-derived semiquantitative MDPHP values in solid tissues and necrophagous larvae and assessed the complementary evidential value of larval matrices. Methods: Post-mortem computed tomography, complete autopsy, histology, and liquid chromatography–high-resolution mass spectrometry (LC-HRMS) were performed in an adult decedent found in advanced decomposition. Brain, liver, kidney, and four separately collected larval groups were analyzed using a procedure previously validated in blood but not validated in tissues or larvae. Results: No fatal traumatic lesion was identified. Pulmonary edema and myocardial fibrofatty replacement were documented. Instrument-derived semiquantitative MDPHP values were 0.45 ng/mg in brain, 0.75 ng/mg in liver, and 2.44 ng/mg in kidney; the four larval groups yielded <0.06, 0.43, 1.58, and 0.22 ng/mg, respectively. These values are exploratory and semiquantitative because matrix-specific validation data are unavailable. The Larvae III extract also showed signals tentatively assigned to M3.1, M5.2, and M9.1. Conclusions: Necrophagous larvae preserved evidence of MDPHP exposure and phase-I metabolite signals. The findings do not establish validated quantitative concentrations, a lethal threshold, or a tissue-to-larva relationship. In the integrated medicolegal context, MDPHP intoxication remained a plausible contributor, but causal interpretation was limited by the single-case design, decomposition, underlying myocardial pathology, absence of conventional matrices, and lack of tissue- and larva-specific method validation.
Cardiac tamponade due to iatrogenic cardiac perforation is a rare but potentially fatal complication of central venous catheterization, with relevant clinical and forensic implications. Its onset may be sudden, and the exact mechanism may remain unclear without post-mortem examination. We report two autopsy-based cases of fatal hemopericardium following central venous catheter placement. The first involved a 65-year-old man undergoing guidewire-assisted replacement of a tunneled hemodialysis catheter in the right internal jugular vein. During the procedure, sudden hypotension and loss of consciousness occurred, followed by recurrent cardiac arrest, pericardial drainage, emergency sternotomy, and death. The second involved a 94-year-old woman who developed cardiac arrest immediately after placement of a central venous catheter in the right subclavian vein for prolonged intravenous therapy. In both cases, autopsy revealed hemopericardium and a full-thickness perforation of the right ventricular apex. The findings were most consistent with an acute mechanical injury, with transient excessive guidewire advancement during catheter insertion considered the most plausible mechanism. These cases highlight that an apparently appropriate final catheter position does not necessarily exclude an insertion-phase cardiac injury.
Background: Health assessment in custodial settings represents a core medico-legal function, particularly when clinical changes may influence detention compatibility and judicial decisions. Objective documentation of disease progression during incarceration is essential to ensure respect for the principle of healthcare equivalence and the protection of fundamental rights. Methods: A retrospective descriptive medico-legal analysis was conducted on 37 male inmates referred for forensic evaluation. Standardized assessments included anamnesis, physical and psychiatric examination, evaluation of medical records, and comparative evaluation of pre-detention and detention-period health status. Results: Pre-existing conditions accounted for 73% of pathologies, while 27% developed during imprisonment. Clinical deterioration occurred in 35.1% of inmates (13 cases). Psychiatric disorders were frequent (27%, 10 inmates), predominantly depressive. Conclusions: The findings indicate that imprisonment may constitute a setting that contributes to the progression of medical and psychiatric conditions, highlighting structural and organizational challenges within penitentiary healthcare. Strengthening standardized medico-legal assessment protocols, improving multidisciplinary collaboration, and ensuring continuity of care between prison and community health services are crucial steps toward protecting inmates’ health. This study provides an exploratory assessment of health conditions in a cohort of inmates within the Italian correctional system, emphasizing the central role of healthcare in custodial settings. Since many Italian correctional facilities are equipped with well-developed healthcare services and appropriate diagnostic and therapeutic resources, numerous acute and chronic medical conditions can be effectively managed within the prison setting, ensuring continuity of care while limiting the need for transfer to external healthcare facilities.
