Nasogastric feeding tubes are commonly used in medical practice to provide nutritional support to patients who cannot take in an adequate amount of food orally. Although rare, nasogastric tubes errantly placed into the respiratory tract may cause serious complications, including death. We present an unusual autopsy case of a fatal hydrothorax that consisted of the enteric feeding solution following placement of a small-bore feeding tube into the left lung, despite no perforation of the tracheobronchial tree or esophagus. Alternative mechanisms for the formation of an enteral nutritional hydrothorax in the absence of a perforation from a feeding tube can be explained by the properties of the fluid, increased alveolar permeability, and underlying lung damage.

Often, medical staff and sometimes their attorneys mistakenly believe that HIPAA prevents disclosure of medical records to medical examiner and coroner offices. Medical examiner and coroner government offices are not covered entities. Moreover, HIPAA specifically allows disclosure to law enforcement, public health, and medical examiner and coroners. However, state and Joint Commission requirements may further impact disclosures.

In the wake of second wave of coronavirus disease (Covid-19), an increased number of mucormycosis cases were reported by the Ministry of Health and Family Welfare in India. A total of 45 432 cases of mucormycosis were reported till mid-July 2021, with 4252 fatalities. Mucormycosis and other fungal infections are most commonly seen as an opportunistic infection. They are found in those with low underlying immunity either due to a diabetes, cancers particularly hematological malignancies, and so on, or as a side effect of prolonged/irrational use of certain drugs like steroids, immunosuppressive drugs for management of other disorders including Covid-19. The Health Authorities in India stated that although it is not a new disease, its true incidence during the beginning of the second wave was unknown as it was not a notifiable disease. As per reports, the most common presentations of mucormycosis included rhinocerebral (77.6%), cutaneous (4.3%), and pulmonary (3.0%). We present a case of pulmonary mucormycosis and pneumonitis in a Covid-19 positive patient brought for autopsy. The patient was an under trial prisoner sent for treatment to our facility who was reported Covid positive.

Intentional or accidental cardiothoracic injuries caused by needles and pins are rare and commonly reported in individuals with psychiatric conditions or intravenous drug users. Although rare, these cases could result in serious injury during the performance of an autopsy and highlight the importance of post-mortem radiology. Therapeutic complications with cardiac perforation have been reported due to pericardiocentesis and acupuncture. The majority of reported cases were not fatal and some had a prolonged asymptomatic period of weeks or even years after insertion. Needles or other sharp objects can reach the cardiovascular system directly through the chest wall, indirectly from any segment of the gastrointestinal tract after swallowing needles, or through migration of broken needles from distant injection sites in intravenous drug users. We report a case of rapidly fatal cardiopulmonary injuries following "self-treatment" to "pop" a cyst with a piercing needle. The scene, autopsy, computed tomography, and digital x-ray findings of this unique case are discussed with a review of selective literature. In this case, the right lung and heart showed multiple perforations, possibly resulting from heartbeats or respirations pushing the organs against the needle. To our knowledge, perforations in this setting of "self-treatment" have not been previously reported in the literature.

Violence with physical assault is a common cause of morbidity and mortality prevalent but not limited to underdeveloped countries. The opinion of the forensic expert is often indispensable in such cases to determine the penalties. This study was planned to describe the pattern of presentation of the victims and evaluate the strengths and limitations in formulating a scientific medicolegal opinion based on the findings of the victim. A retrospective descriptive study based on the case records of the victims of assault admitted to Colombo North Teaching Hospital, Ragama, Sri Lanka, was conducted for four years. Out of the 400 victims, the majority (72% n = 290) were males and of the age-group of 21 to 40 (n = 216). The reason for assault in the majority was sudden provocation (n = 99, 25%), followed by previous long-duration enmity (n = 89, 22%). The majority (83%) had isolated blunt force trauma, and the injuries were nongrievous (74%). Defense injuries were significantly associated with attempted defense (p = 0.000) and sharp force trauma (p = 0.002). The underlying reason for the assault was not significantly associated with the causative weapon (p = 0.228) or body region injured (p = 0.195). Even though the presentation and the pattern of injures are definitely of value in formulating a scientific opinion, the study identified the limitations of the forensic experts, and the need for a holistic approach at the investigations was highlighted.

Medicolegal death investigation systems, which generally fall within one of three types-medical examiner, coroner, or law-enforcement-led systems-investigate deaths that are unnatural or suspicious. The current quality of cause of death statistics on deaths investigated within medicolegal death investigation systems globally limits effective public health response. A starting point to strengthening global medicolegal death investigation systems and improving the quality of cause and manner of death reported to civil registration systems is through a strong legal framework. Two resources, the United Nations Statistics Division Guidelines on the Legislative Framework for Civil Registration, Vital Statistics and Identity Management and the Global Health Advocacy Incubator Legal and Regulatory Toolkit for Civil Registration, Vital Statistics and Identity Management, present recommendations and provide guidance to country stakeholders in reviewing and revising their medicolegal death investigation legal frameworks. Physician determination of cause and manner of death, defined criteria for case referral to the medicolegal death investigation system, an amendment process, and investigation collaboration are four core considerations for medicolegal death investigation system legal frameworks. A strong medicolegal death investigation legal framework is a necessary starting point, but it is not sufficient for ensuring the timely, accurate, and complete reporting of cause and manner of death in national vital statistics.

Established in 1929, Northwestern University's Scientific Crime Detection Laboratory (SCDL), America's first independent forensic crime laboratory, undertook a wide range of scientific case work during the 1930s, including toxicology, firearms identification, polygraph testing, the analysis of questioned documents and bacteriology; its mission being to provide Chicago with a world-class forensic science service. Alongside this mission, however, a key ambition of the SCDL's founders was to forensically educate police officers, legal professionals, and the general public. Convinced that American police were largely ignorant of scientific aids to crime detection and that the public's lack of forensic awareness led to the destruction and contamination of crime scenes, the SCDL attempted to fashion itself as a "school for manhunters." But, while the laboratory's ambitious program of public talks, scientific demonstrations, detective schools, expositions, and radio programs were intended to foster the creation of both a scientifically savvy public and policemen on par with those to be found in Europe, the SCDL encountered a number of significant hurdles to achieving these goals, including the hostility of some high-ranking police officials.

Growing attention to the philosophy of forensic science in recent decades has sometimes included the question: "what kind of science is forensic science"? Yet there has been little discussion of how that question has been differently construed in terms of period, place, and prevailing anxieties. Following an examination of the unique character this question must have in an American legal context, this article reviews three modes/phases of response, rooted successively in individual authority, comprehensive method, and institutions of flexible problem-solving. The conclusion applies this complex legacy in two ways: first to clarify areas of incoherence and tension in recent attempts to underwrite forensic sciences, and second to supply a fuller framework for Max Houck's argument for the essentially historical character of forensic science.

South Africa is burdened by both an exceptionally high crude death rate and a very high non-natural death rate. Efficient death investigation may greatly aid in identifying and addressing public health issues, while also being a prerequisite for the administration of justice. To improve the quality and consistency of death investigation in a country or region, it will help to have an understanding of relevant historical developments as well as the current sociopolitical, legislative, and organizational perspectives which may shape and underpin the forensic medical and scientific investigation of death. This review aims to provide the reader with some insights in this regard.

Injury patterns in pedestrians struck by motor vehicles were described in medical literature first published almost a half century ago. "Classical" triads of injury distribution were described for adults (skull-pelvis-extremity) and subsequently applied to children (head-hip or pelvis-distal femur/knee joint). Notably, these classical triads were derived from two publications reporting clinical observations of only 11 patients, all of whom were adults. A systematic literature review was conducted using Medline, CINAHL, EMBASE, and Cochrane to determine the evidence-base for motor vehicle collision (MVC)-pedestrian injury "triads" and other trauma patterns described for pedestrians in the adult and pediatric age groups. Of the 1540 full-text articles identified in the review, 56 articles published in English met the inclusion criteria, that is, motor vehicle-pedestrian collision resulting in specific, fatal injuries determined by postmortem examinations. There were variations in injury patterns that differed from the "classical" triads. These differences likely stem from advances in vehicle design and safety features which have affected the nature and distribution of injuries. Further research on the correlation of specific injuries sustained by pedestrians of different ages with various types of vehicles and impacts are needed to assess the validity of previously observed injury patterns in relation to the current motor vehicle fleet. Delineation of injury patterns can assist health care teams in trauma management. Vehicle manufacturers and government regulators can better assess whether the introduction of advanced driver assistance features designed to protect pedestrians when struck will be effective in reducing severe injuries. In forensic pathology practice, knowledge of pedestrian injury patterns based on data representative of impacts involving modern vehicles can provide MVC death investigators the means to determine MVC dynamics and pedestrian kinematics.