Investigation of Drowning Deaths: A Practical Review

Armstrong, Erica J.; Erskine, Kevin L.

doi:10.23907/2018.002

Cited by 47 publications

(40 citation statements)

References 92 publications

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“…However, this requires that this foam is correctly identified as a drowning sign. Similar foam developments have already been described in other causes of death such as pulmonary edema, drug intoxication, or heart failure and should not be mixed up [13,44]. However, such specificity does not apply to frothy fluid in the respiratory tract at time of obduction.…”

Section: External Signs Of Drowning: Foammentioning

confidence: 71%

Macromorphological findings in cases of death in water: a critical view on “drowning signs”

2020

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Death in water is a challenging issue in forensic pathology since from natural death to homicide all circumstances of death in water are conceivable. Therefore, the correct interpretation of all abnormal autopsy findings is important. In order to determine a death by drowning, numerous internal and external signs of drowning are already described. However, these are supposed to be influenced by various factors reducing their significance and evidence. Moreover, the autopsy of water corpses often reveals further pathological findings that should not be underestimated for determining the cause of death. The aim of this study was to set frequencies of the observed drowning signs in context to the forensic literature and to identify possible influencing factors. In this study, we observed that pathological organ changes of the cardiovascular system were significantly more common in corpses after shortened (atypical) drowning processes than in classical drowned victims. Furthermore only a complete formation of external foam, immediately after the corpse’s recovery, was exclusively found in drowning victims. All other drowning signs were either also observed in non-drowning deaths in water or no information could be provided with reasonable assurance. In addition, many of the examined drowning signs were negatively affected by prolonged postmortem intervals, putrefaction, or resuscitation attempts. It can be concluded from our analysis that morbidity is an important factor in deaths in water. Morbidity can support a death by drowning in case of incidents in water. For the examined drowning signs, no high diagnostic certainty could be observed. Nevertheless, these findings can increase their diagnostic value—if forensic physicians take influencing factors into consideration.

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Section: External Signs Of Drowning: Foammentioning

confidence: 71%

Macromorphological findings in cases of death in water: a critical view on “drowning signs”

2020

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“…Diatom test is theoretically based on the presence of diatom in the vital organs of the body such as lungs, bone marrow, kidney and brain [11], [12]. When a person tries to breathe inside water bodies such as lake, ocean and river, the diatoms along with water penetrates in the alveolar system of the human body and gets deposited in vital organs by blood circulation.…”

Section: Introductionmentioning

confidence: 99%

Diatomological Mapping of Aurangabad Region for Unrevealing Drowning Mystery

Shaikh

Ghuge

Sandeep

et al. 2021

Preprint

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Purpose:Drowning is the third unnatural cause of death in India. Drowning death is still considered as one of the most difficult to investigate, it requires the expertise in the pathophysiology and limnology. Long procedural protocol in laboratory analysis of vital organs and the site to obtain the victim and site-relation that creates a burden on the investigating agency. The presence of diatoms in the vital organs of the body helps to establish the pre- or post-mortem drowning death and the appearance of site-specific/unique diatoms for a region aids into locating the exact drowning site. The onsite identification can be solved by studying the diversity and preparing the diatoms map (D-map). Availability of D-map can help to reduce the investigation time and helps in confirmation of the drowning site.Methods:In the present study, samples were collected from the 12 water bodies in Aurangabad region M.S. India, and were acid digested, using Aqua regia solution containing HNO3: H2SO4 in 1:3 proportion in 20ml of water sample. Slides were prepared, mounted and microscopic analysis was performed using light and inverted phase microscope.Results:The D-map was generated and it featured 55 identified species, amongst the members of Nitzschia, Navicula and Cymbella were commonly found in many water bodies, while Craticula, Gomphonema, Tibetiella, Melosira, Pleurosira, and Mastogloia were restricted to only single water body. These unique diatoms can be used as site-specific indicators in drowning investigation of Aurangabad region. This study generated diatomic map for experimental water body present in Aurangabad region.Conclusion:These D-maps will be helpful in dispense a significant information about water bodies and their common as well as unique flora with a qualitative and quantitative distribution of diatoms. D- Map generated in this study can be harnessed to update knowledge of diatomology or diatoms database and generated data will aid in drowning investigation.

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“…Prolonged submersion with decomposition adds another dimension of diagnostic difficulty [ 8 ]. It is well-known that drowning is a complex process with several physical reactions, leading to acute respiratory distress syndrome, hypoxic respiratory failure, and cardiorespiratory arrest [ 8 , 9 ].…”

Section: Introductionmentioning

confidence: 99%

Proteomics in Deaths by Drowning: Diagnostic Efficacy of Apolipoprotein A1 and α-1 Antitrypsin, Pilot Study

et al. 2020

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Drowning is one of the leading causes of death worldwide. The pathophysiology of drowning is complex and, sometimes, interpretation of the circumstances of death in the autopsy becomes the main source of information in its diagnosis. New advances in medical research, such as proteomics, especially in forensic pathology, are still in the development. We proposed to investigate the application of Mass Spectrometry-based technologies, to identify differentially expressed proteins that may act as potential biomarkers in the postmortem diagnosis of drowning. We performed a pilot proteomic experiment with the inclusion of two drowned and two control forensic cases. After applying restrictive parameters, we identified apolipoprotein A1 (ApoA1) and α-1 antitrypsin as differentially expressed between the two diagnostic groups. A validation experiment, with the determination of both proteins in 25 forensic cases (16 drowned and 9 controls) was performed, and we corroborated ApoA1 higher values in the drowning group, whereas α-1 antitrypsin showed lower levels. After adjusting by confounder factors, both remained as predictive independent factors for diagnosis of drowning (p = 0.010 and p = 0.022, respectively). We constructed ROC curves for biomarkers’ levels attending at the origin of death and established an ApoA1 cut-off point of 100 mg/dL. Correct classification based on the diagnosis criteria was reached for 73.9% of the cases in a discriminant analysis. We propose apolipoprotein A1 (with our cutoff value for correct classification) and α-1 antitrypsin as valuable biomarkers of drowning. Our study, based on forensic cases, reveals our proteomic approach as a new complementary tool in the forensic diagnosis of drowning and, perhaps, in clinical future implications in drowned patients. However, this is a pilot approach, and future studies are necessary to consolidate our promising preliminary data.

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Investigation of Drowning Deaths: A Practical Review

Cited by 47 publications

References 92 publications

Macromorphological findings in cases of death in water: a critical view on “drowning signs”

Macromorphological findings in cases of death in water: a critical view on “drowning signs”

Diatomological Mapping of Aurangabad Region for Unrevealing Drowning Mystery

Proteomics in Deaths by Drowning: Diagnostic Efficacy of Apolipoprotein A1 and α-1 Antitrypsin, Pilot Study

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