Based on the assumption that postmortem cerebrospinal fluid (CSF) is contaminated depending on the chosen sampling technique in the forensic setting resulting in bloody or at least hemolytic CSF samples, we systematically documented a total of 183 postmortem CSF samples. These samples were all assessed for their quality and color, regardless of the cause of death or the postmortem interval. The investigations were carried out through subjective assessment of color and turbidity, as well as objective measurements of the optical density (OD) of the CSF supernatants after centrifugation of each sample, with standardized photographic documentation. The observations revealed that in 28 cases the CSF was absolutely (crystal-) clear and transparent. Most of our samples showed color changes ranging from xanthrochromic to rose. Intensive staining of the supernatants was only found in a small proportion of the examined collective. We found that postmortem CSF has no uniform appearance but rather a diverse range of color spectra, and the color, as well as the OD of the CSF, correlates significantly with the postmortem interval (p < 0.001) when sampled using the proposed standard procedure.

According to the Federal Statistical Office 178,425 cases of poisoning were treated in German hospitals in 2016. Immediate clinical interventions include procedures to prevent further toxin absorption. The use of activated charcoal is considered the decontamination method of first choice after peroral poisoning. A 14-year-old girl had taken several tablets of amitriptyline with questionable suicidal intent. At the hospital where she was treated first, she had been given an unknown amount of activated charcoal via a stomach tube; however, due to the endotracheal malpositioning of the gastric tube, the activated charcoal was applied endotracheally. After this had happened, the patient was transferred to a maximum care hospital. Despite intensive care medical treatment, the girl died after 18 days of acute respiratory failure following massive aspiration of activated charcoal. The court-ordered autopsy and the subsequent microscopic examination revealed both a heterogeneous distribution of variably dense accumulations of activated charcoal in the intra-alveolar spaces of all pulmonary lobes as well as acute and chronic inflammatory changes in the lung parenchyma. Furthermore, activated charcoal was detected within the liver sinusoids and also in the tubules of the renal parenchyma.

Zusammenfassung Laut Statistischem Bundesamt wurden 2016 in Deutschland 178.425 Vergiftungsfälle im Krankenhaus behandelt. Zu den klinischen Sofortmaßnahmen gehören Verfahren zur Verhinderung weiterer Giftresorption. Die Anwendung von Aktivkohle wird dabei als Dekontaminationsverfahren der ersten Wahl nach peroralen Vergiftungen angesehen. Ein 14 Jahre alt gewordenes Mädchen habe in fraglich suizidaler Absicht mehrere Tabletten Amitriptylin eingenommen. Im erstbehandelnden Krankenhaus sei ihr eine unbekannte Menge an Aktivkohle über eine Magensonde verabreicht worden. Aufgrund der Fehllage der Magensonde wurde die Aktivkohle jedoch endotracheal appliziert. Danach erfolgte die Verlegung an ein Krankenhaus der Maximalversorgung. Trotz intensivmedizinischer Therapie sei das Mädchen nach 18 Tagen an einem akutem Lungenversagen nach massiver Aspiration von Aktivkohle verstorben. Bei der gerichtlichen Obduktion und der anschließenden mikroskopischen Untersuchung fielen sowohl eine heterogene Verteilung der intraalveolär gelegenen, variabel dichten Ansammlungen der Aktivkohle in allen Lungenlappen als auch mehrzeitige, akute sowie chronische entzündliche Veränderungen im Lungenparenchym auf. Darüber hinaus konnte Aktivkohle innerhalb der Lebersinusoide sowie in den Tubuli des Nierenparenchyms nachgewiesen werden.

In forensic science determination of the origin and sex of skeletal remains is an important task for identification purposes. In this study we investigated the krotaphion-sphenion distance (K‑S distance) in the pterion region of German, Euro-American, African-American and Rwandan skulls of modern individuals from the nineteenth to the twenty-first century to look for statistically significant differences in sex and ancestry. We found a statistically significant sex-specific difference in the K‑S distance, which was greater in male skulls than in female skulls for both sides of the skull. Our study also showed that there is a statistically significant difference in the K‑S distance between the four populations studied. Landmarks and morphometric parameters measured in our investigations, which were not used for the present examination were provided to the software program Fordisc for its reference data to enhance the range of its usability for identification of unknown skulls or partial skulls of European individuals.

ZusammenfassungIntrakranielle Blutungen sind im Säuglingsalter seltene, aber lebensbedrohende Ereignisse. Neben Gefäßmissbildungen, Stoffwechseldefekten sowie Störungen der Blutgerinnung kommen v. a. nichtakzidentielle Traumata, Schütteltrauma in Betracht. Die klinische Diagnostik umfasst hinsichtlich der Blutungsgenese neben Sonographie und MRT als apparatives Verfahren auch eine Fundoskopie sowie laborchemische Analysen, insbesondere der Gerinnungsparameter. Für die Blutgerinnung ist das fettlösliche Vitamin K essenziell: Frühe, klassische und späte Vitamin-K-Mangel-Blutungen werden dabei unterschieden. Um ein gehäuftes Wiederauftreten von Vitamin-K-Mangel-Blutungen bei Neugeborenen und jungen Säuglingen zu verhindern, bedarf es einer hinreichenden Aufklärung der Eltern. Eine Verweigerung der Prophylaxe scheint Folge einer weltanschaulich begründeten Ablehnung der Schulmedizin und ein zunehmendes Phänomen in wohlhabenden Industrieländern zu sein.

During the investigative process that typically follows a criminal act, it may prove necessary to work with and analyze evidence that is not recent but old. This could become necessary, for example, when a crime is discovered some time after it was committed or when a cold case is reopened. Due to this need, the present study focused on the detection and visualization of 2-year-old biological traces. To do so, an alternative light source and different filters were used. The optical behavior of 2-year-old samples of blood, semen, urine, saliva, and sweat located on 19 different materials was documented, analyzed, and compared with the optical behavior of the same samples when they were recent [1].

An einem Novembermorgen traten bei einem Arzt und seiner Lebensgefährtin kurze Zeit nach dem Genuss ihres Frühstückskaffees anticholinerge Symptome in unterschiedlicher Intensität auf. Der Kaffee war in dem Kaffeevollautomaten des Geschädigten zubereitet worden. Toxikologische Untersuchungen konnten sowohl im Asservat des Wassertanks als auch im Urin der Geschädigten Atropin und Scopolamin nachweisen. Es kam der Verdacht auf, dass die ehemalige Lebensgefährtin des Geschädigten diesen mit Extrakten der Engelstrompete habe vergiften wollen. Im Rahmen des Ermittlungsverfahrens wurden Versuche durchgeführt, inwieweit Atropin und Scopolamin aus Engelstrompetenblüten extrahiert werden können und in welchem Umfang diese Substanzen nach dem Brühvorgang im Vollautomaten auch im Kaffee vorhanden sind. Die Versuche zeigten, dass der Brühvorgang zu einem Abfall der Konzentrationen, jedoch nicht zum vollständigen Verlust der Giftsubstanzen führt.

Whenever blunt or sharp forces are used in a crime, analysis of bloodstain pattern distribution may provide important information for the reconstruction of happenings. Thereby, attention should be paid to both the crime scene and the clothes of everyone involved in the crime. On dark textiles, though, it is difficult or even impossible for the human eye to detect bloodstains because of the low contrast to the background. However, in the near infrared wavelength range, contrast is considerably higher. Many textiles reflect light beyond a wavelength of 830 nm and thus appear light-colored, whereas blood absorbs the light and appears dark. In our studies, a D7000 NIKON reflex camera modified for infrared photography produced high-resolution photographs visualizing even very small spatter stains on dark textiles. The equipment can be used at any crime scene or lab and provides immediately available and interpretable images. Thus, important findings can be obtained at an early stage of police investigations, as two examples (homicide and attempted homicide) illustrate.

In medico-legal literature, only a small number of publications deal with lethal injuries caused by shots with modified guns. This might lead to the conclusion that such cases are extremely rare. However, there are cases again and yet again. During the investigation process, the modified gun is of particular importance since it can show an unusual ballistic behaviour. The present paper reports on a suicide of a 60-year-old man, committed with a modified revolver and a lead bullet. The man had a single gunshot wound with entrance at the right temporal bone. Autopsy revealed that the bullet had fragmented into two major parts. The smaller one stood outside the cranial cavity and pushed its way alongside between the cranial bone and scalp to its end position in the left temporal area. The bigger part entered the cranial cavity and ended in the left parietal lobe. In shots on ballistic soap and on a head-model, the ballistics of the weapon and lead bullet were characterized. The angle necessary for bullet fragmentation was determined by shots on ballistic soap and turned out to be 55°–60° at a velocity of around 200 m/s. This knowledge was transferred to contact shots on a head-model consisting of a layered polyurethane sphere filled with 10 % ballistic gelatine and covered with a skin-like cap almost all around. The resulting injury pattern corresponded to the one of the suicide person. The bigger bullet part entered the skull while the smaller part pushed its way alongside between skin and skull causing an outer contour shot. Furthermore, the revolver was documented firing off two bullets by one trigger pull—a phenomenon of importance for forensic casework the authors have not found reported in forensic literature.

The aim of this study was to figure out a new practically applicable method to distinguish between historical and recent human skeletal remains. Therefore, the optical behavior of bone cross sections was investigated using the combination of two methods: a modification of an already established test (UV-induced fluorescence) and a new method (490 nm-induced fluorescence). We evaluated the areal extent of fluorescence of 30 bone cross sections with known postmortem interval (PMI) using ultraviolet light and 490 nm light. For analysis, the areal extend of fluorescent surface was determined using photos of the samples and an image editing software. The results prove that there is a correlation between PMI and the areal extent of fluorescent surface in both tests. Furthermore, the combination of both methods is a good indicator to distinguish within the forensic relevant post mortem interval between PMI < 30 years and PMI > 30 years.

During the autopsy of fire victims, one often sees intensive reddening of the inner vascular layers resembling changes due to putrefaction. To determine the frequency of this phenomenon and the circumstances under which it occurs, in particular the presence of putrescence, signs of vitality and the extent of destruction by the fire, the fire fatalities autopsied at the Institutes of Legal Medicine in Freiburg, Halle and Würzburg were analyzed. In the concrete study, 259 fire deaths were investigated retrospectively and 21 prospectively. The study material included 191 males and 68 females aged 0 to 93 years. Vital exposure to the fire was found in 70%, perimortal exposure in 23 % and postmortem exposure in 7% of the cases. Red discoloration of the intima of the central vessels was seen in 106 victims (41%). This finding is most likely caused by postmortem heat-induced hemolysis, which occurs when the temperature in the body rises above 52 °C due to the effect of external heat. Therefore, a reddish discoloration of the intima cannot be regarded as sign of vitality.

Because biological traces often play an important role in the investigation process of criminal acts, their detection is essential. As they are not always visible to the human eye, tools like a forensic light source or infrared photography can be used. The intention of the study presented was to give advice how to visualize biological traces best. Which wavelengths and/or filters give the best results for different traces on different fabrics of different colors? Therefore, blood (undiluted and diluted), semen, urine, saliva, and perspiration have been examined on 29 different materials.

Background HSV infections during pregnancy are generally asymptomatic and associated with high rate of neonatal morbidity and death. Differential serologic diagnosis of HSV infections in pregnancy is important for the correct assessment of the infection status. The aim of this study was to evaluate the performance of Roche Elecsys® assays for the type specific determination of HSV-1 and HSV-2 IgG antibodies. Methods A total of 800 samples obtained from sexually active adults (n = 300), pregnant women (n = 400) and herpes infection suspected patients(n = 100) were analysed using Roche Elecsys® HSV-1 and HSV-2 assays and commercially available Focus Diagnostics HerpeSelect, Radim HERPES S.V and Diasorin LIAISON type specific ELISA assays. A commercially available Western Blot assay was used for the resolution of the discrepant results. For further confirmation of the type specific detection performance of the Elecsys® HSV-1 and HSV-2 assays 310 potentially cross reactive samples for HSV-2 and 123 samples for HSV-1 were analysed. Results The Elecsys® HSV-1 IgG assay showed a relative sensitivity of 95.6 to 100%. The relative specificity was between 97.6 and 100%. The Elecsys® HSV-2 IgG assay showed a relative sensitivity of 92.6 to 100%. The relative specificity was between 98.7 and 100%. These assays exhibits excellent differentiation between HSV-1 and HSV-2 infections with no cross reactivity to other herpes viruses like CMV, VZV or EBV. Conclusion The results obtained with the type specific Roche Elecsys® HSV-1 and HSV-2 assays indicate that these assays are useful, specific and sensitive for the differential determination of HSV-1 and HSV-2 IgG antibodies in serum or plasma samples. The advantage of the Roche Elecsys® assays compared to ELISA based assays, is that these assays are rapid and can be performed in a fully automated process.

The intermittent and long-term spectroscopic observation of light reflected from livor mortis is hoped to help with the determination of the time of death or its circumstances like e.g. carbon monoxide poisoning. A mobile measurement system with a robot for the required movements has been assembled and thoroughly tested at the Offenburg University of Applied Sciences. It has been operated reliably for 36 hours continuously recording spectra and taking temperature and distance measurements every 20 minutes. The system has been delivered to the collaborating Institute of Forensic Medicine at the University of Würzburg for field studies.

An 88-year-old woman committed suicide by drinking a toxic amount of highly concentrated alcohol and setting two rooms of her flat on fire. As there was not enough oxygen, the fire went out, however. At autopsy, no thermal lesions were found on the body, but soot depositions in the airways and a COHb value of 14% pointed to the inhalation of fire fumes. The ethanol concentration in femoral blood was 6.62 per mille. The gastric mucosa was fixed by the ingested alcohol and showed hardly any autolytic changes despite a post-mortem interval of five days. Congener analysis of the gastric contents and the femoral blood indicated the uptake of a fruit distillate or its foreshot.

Das Leichenschauwesen ist in Deutschland landesgesetzlich geregelt. Gegenwärtig ist grundsätzlich jeder niedergelassene und angestellte Arzt zur Leichenschau verpflichtet. Auf Initiative der 78. Konferenz der Justizministerinnen und Justizminister wurde 2008 eine Projektgruppe eingesetzt, die Möglichkeiten einer qualitativen Verbesserung der ärztlichen Leichenschau aufzeigen sollte. In diesem Kreis wurde u. a. dafür plädiert, Todesfeststellung und Leichenschau voneinander zu trennen und die eigentliche Leichenschau nur von speziell ausgebildeten und behördlich autorisierten Ärzten vornehmen zu lassen. Dabei wird verkannt, dass eine bloß äußere Untersuchung auch dann in ihrer diagnostischen Aussagekraft beschränkt bleibt, wenn sie von spezialisierten und besonders qualifizierten Ärzten durchgeführt wird. Selbst beim Tod durch mechanische Gewalteinwirkung brauchen keine äußeren Hinweiszeichen vorzuliegen. Dies wird anhand eines Beispiels aus dem rechtsmedizinischen Obduktionsgut (Polytrauma nach Sturz aus der Höhe) belegt und diskutiert.

The post-mortem examination falls within the legislative power of the German states. Presently all general practitioners or employed physicians are obliged to perform external post-mortem examinations. On the initiative of the 78th Conference of the German Ministers of Justice a project group was formed in 2008 to study the options to improve the quality of the medical post-mortem examination. The members of this group suggested a separation of the determination of death from the post-mortem examination and to have the post-mortem examination performed by specially trained and officially authorized physicians. This proposal does not recognize that the diagnostic value of merely an external examination will also be limited even if it is performed by specialized and specifically qualified physicians. Even if death was caused by mechanical impact there are not always external signs. This is illustrated and discussed using an example from forensic autopsy material (multiple trauma after a fall from a height).