Entomological and Cardiologic Evidence of Time Since Death in Short Postmortem Intervals

Ondruschka, Benjamin; Babian, Carsten; Neef, Martin; Zwirner, Johann; Schwarz, Maik

doi:10.1111/1556-4029.14010

Cited by 5 publications

(3 citation statements)

References 11 publications

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“…Also, palliative care specialists encounter them during end-of-life decisions ( 3 , 4 ). In the postmortem field, IcarDs can be employed to estimate time since death ( 5 , 6 ), identify unidentified bodies ( 7 , 8 ), or to clarify the cause of death ( 5 , 9 ). Additionally, the legal medicine experts contribute to the work-up of IcarD-associated deaths [e.g., ( 10 )] including IcarD associated suicides [e.g., ( 11 )].…”

Section: Introductionmentioning

confidence: 99%

Forensic, legal, and clinical aspects of deaths associated with implanted cardiac devices

Federspiel,

Potente,

Abeln

et al. 2023

Front. Psychiatry

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As the population ages, the prevalence of heart failure and individuals wearing an implanted cardiac device is increasing. The combination of different underlying pathophysiologies and (the combination of) implanted cardiac devices can become a challenge with regard to the determination of cause and manner of death in such individuals. Additionally, heart disease is frequently associated with mental disease, ranging from anxiety and depression to suicidality and suicide (attempts). At the same time, the correct diagnosis of cause and manner of death is the basis for quality assurance, further therapeutic advances, legal safety, and suicide prevention. By that, an interdisciplinary field between legal medicine, clinicians, and law enforcement opens up. In this field, the different participants can simultaneously benefit from and need each other. For example, legal medicine experts need investigatory results and clinical expertise for the interpretation of readout data of implanted cardiac devices in order to correctly determine the cause of death. A correctly determined cause of death can assist law enforcement and help clinicians to further improve various therapeutic approaches based on correct mortality data collection. In addition, it is the basis for identification of suicides of device carriers, allowing psychological and psychiatric experts to better understand the burden of mental disease in this particular cohort. Against this interdisciplinary background, this manuscript summarizes information about psychiatric comorbidities and suicidality while being on a device. Thereby, basic information on complications and malfunctions of implanted cardiac devices, device-associated deaths with particular emphasis on device manipulation is displayed as basic information needed for correct determination of the cause of death. Also, legal and ethical issues in this field are outlined. The final result is a proposal of an interdisciplinary assessment workflow for a conjoint approach to improve the diagnosis of deaths associated with implanted cardiac devices. It will allow for a differentiation between an individual who died with or due to the device.

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Section: Introductionmentioning

confidence: 99%

Forensic, legal, and clinical aspects of deaths associated with implanted cardiac devices

Federspiel,

Potente,

Abeln

et al. 2023

Front. Psychiatry

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“…There are only a few specific cases wherein the time since death is determined exactly in the absence of witnesses, e.g. when evaluating the readings of cardiac implantable electronic devices [ 7 ]. Utilising changes in biomechanical properties of certain tissues after death is yet to be explored for forensic time since death estimations.…”

Section: Introductionmentioning

confidence: 99%

The use of brain tissue mechanics for time since death estimations

Zwirner,

Devananthan,

Docherty

et al. 2023

Int J Legal Med

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Time since death estimation is a vital part of forensic pathology. Despite the known tissue degradation after death, the efficacy of using biomechanical tissue properties to estimate time since death remains unexplored. Here, eight brain tissue localizations were sampled from the frontal lobe, parietal lobe, anterior and posterior deep brain, superior colliculi, pons, medulla, and cerebellum of 30 sheep; were then stored at 20 °C; and subsequently subjected to rheometry tests on days zero to four after death. Overall, the measured tissue storage modulus, loss modulus, and complex shear modulus decreased after death for all of the tested regions in a site-specific manner. Day zero to day one changes were the only 24-h interval, for which statistically significant differences in tissue mechanical moduli were observed for some of the tested brain regions. Based on receiver operator characteristic analyses between day zero and the pooled data of days one to four, a post mortem interval of at least 1 day can be determined with a sensitivity of 90%, a specificity of 92%, and a positive likelihood ratio of 10.8 using a complex shear modulus cut-off value of 1461 Pa for cerebellar samples. In summary, biomechanical properties of brain tissue can discriminate between fresh and at least 1-day-old samples stored at 20 °C with high diagnostic accuracy. This supports the possible value of biomechanical analyses for forensic time since death estimations. A striking advantage over established methods to estimate the time since death is its usability in cases of disintegrated bodies, e.g. when just the head is found.

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“…Clinically used TBI biomarkers provide information on the diagnosis, prognosis, and treatment efficiency of TBIs [ 14 ]. In contrast, forensic pathologists expect additional objective data on TBI survival time estimations or time since death estimations [ 15 , 16 ]. Ante-mortem, TBI biomarkers are determined in blood or cerebrospinal fluid (CSF), which are sampled from living individuals under aseptic conditions [ 17 ].…”

Section: Introductionmentioning

confidence: 99%

Forensic biomarkers of lethal traumatic brain injury

et al. 2022

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Traumatic brain injury (TBI) is a major cause of death and its accurate diagnosis is an important concern of daily forensic practice. However, it can be challenging to diagnose TBI in cases where macroscopic signs of the traumatic head impact are lacking and little is known about the circumstances of death. In recent years, several post-mortem studies investigated the possible use of biomarkers for providing objective evidence for TBIs as the cause of death or to estimate the survival time and time since death of the deceased. This work systematically reviewed the available scientific literature on TBI-related biomarkers to be used for forensic purposes. Post-mortem TBI-related biomarkers are an emerging and promising resource to provide objective evidence for cause of death determinations as well as survival time and potentially even time since death estimations. This literature review of forensically used TBI-biomarkers revealed that current markers have low specificity for TBIs and only provide limited information with regards to survival time estimations and time since death estimations. Overall, TBI fatality-related biomarkers are largely unexplored in compartments that are easily accessible during autopsies such as urine and vitreous humor. Future research on forensic biomarkers requires a strict distinction of TBI fatalities from control groups, sufficient sample sizes, combinations of currently established biomarkers, and novel approaches such as metabolomics and mi-RNAs.

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Entomological and Cardiologic Evidence of Time Since Death in Short Postmortem Intervals

Cited by 5 publications

References 11 publications

Forensic, legal, and clinical aspects of deaths associated with implanted cardiac devices

Forensic, legal, and clinical aspects of deaths associated with implanted cardiac devices

The use of brain tissue mechanics for time since death estimations

Forensic biomarkers of lethal traumatic brain injury

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