Article Date: 10 Oct 2011 - 0:00 PDT
"A new study from the Centre for Addiction and Mental Health has found evidence that a specific gene is linked to suicidal behaviour, adding to our knowledge of the many complex causes of suicide. This research may help doctors one day target the gene in prevention efforts.
In the past, studies have implicated the gene for brain-derived neurotrophic factor (BDNF) in suicidal behaviour. BDNF is involved in the development of the nervous system.
After pooling results from 11 previous studies and adding their own study data involving people with schizophrenia, CAMH scientists confirmed that among people with a psychiatric diagnosis, those with the methionine ("met") variation of the gene had a higher risk of suicidal behaviour compared to those with the valine variation. . . " Read More
Article Date: 05 Aug 2011 - 0:00 PDT
" Fatal overdoses involving prescribed opioids tripled in the United States between 1999 and 2006, climbing to almost 14,000 deaths annually - more than cocaine and heroin overdoses combined. Hospitalizations and emergency room visits related to prescription opioid pain medicines such as oxycodone (brand name Oxycontin) and hydrocodone (Vicodin) also increased dramatically in the same period.
Now a report in the August issue of Health Affairs describes a major initiative at Group Health to make opioid prescribing safer while improving care for patients with chronic pain. Health Affairs is the nation's premier health policy journal, and its August issue focuses on substance abuse.
In the Group Health initiative's first nine months, clinicians at the Seattle-based integrated health system developed and documented care plans for almost 6,000 patients - 85 percent of those receiving long-term opioid therapy for chronic non-cancer pain.
Group Health's initiative was implemented well before the White House Office of Drug Control Policy, the Food and Drug Administration, and the Drug Enforcement Administration announced a national action plan in April 2011 to stem the epidemic of prescription drug abuse. Scientists from Group Health Research Institute are evaluating the initiative's effects on care, hoping Group Health's experience can help guide national efforts.
Use of prescription opioids has increased sharply since the 1980s. Excluding people with cancer and those in end-of-life care, about 4 percent of U.S. adults now use prescription opioids long term. Pharmaceutical industry advocacy and education have fueled increased opioid prescribing for chronic non-cancer pain - despite limited scientific evidence supporting the drugs' long-term effectiveness for chronic non-cancer pain.
In January 2010, Group Health Research Institute Senior Investigator Michael Von Korff, ScD, and colleagues published the first-ever study on overdose risk by dose among patients receiving prescribed opioids for chronic non-cancer pain. That study, published in the Annals of Internal Medicine, linked higher risk of fatal and nonfatal overdose to higher daily dose prescribed. His research also showed that Group Health, like other health systems nationwide, had been prescribing more opioids for chronic non-cancer pain over time - a twofold increase from 1997 to 2005.
Group Health launched a major primary care-based initiative to enhance opioid prescribing safety later in 2010. Led by Group Health Medical Director of Primary Care Claire Trescott, MD, the initiative aims to standardize use of opioids for chronic non-cancer pain, without creating undue restrictions on clinically appropriate opioid prescribing."
Many adverse events can be prevented, providing what a patient safety expert calls "humongous opportunities for improvement."
By Kevin B. O'Reilly, amednews staff. Posted April 18, 2011.
"One-third of hospital patients experience adverse events and about 7% are harmed permanently or die as a result, according to a study that detected patient safety problems at a far higher rate than other methods.
The study, in April's Health Affairs, echoes two reports issued in November 2010 that showed rates of adverse events hovering near 25% among hospitalized Medicare patients nationwide and at 10 North Carolina hospitals.
The findings draw attention to the safety troubles that have lingered in U.S. hospitals in the 12 years since the Institute of Medicine's headline-grabbing report "To Err is Human." The study cited research estimating that up to 98,000 patients die each year due to preventable medical errors.
"This is one of the best studies that now gives us a sense of how much harm is happening to patients in American hospitals," said Robert Wachter, MD, chief of the medical service at the University of California, San Francisco Medical Center, who was not involved in the research. "There is a tremendous amount of harm befalling patients who are admitted to hospitals and humongous opportunities for improvement."
To judge from a survey released March 31, patients are scared of medical mishaps. Nearly 60% of adults polled by the Consumer Reports National Research Center believe medical errors are common in hospitals, and nearly half said serious harm is common. Nearly 80% of patients said they feared contracting an infection in a hospital, 71% were worried about medication errors and 65% were scared of surgical mistakes. . . " Read More
20 April 2011 Last updated at 05:00 ET
"The deaths of 14 elderly residents in a care home blaze could have been prevented by a "suitable" fire safety plan, an inquiry has concluded.
The fire at Rosepark care home in Uddingston, South Lanarkshire, broke out in a cupboard on 31 January 2004 and ripped through the building.
A fatal accident inquiry said some residents may have been saved if the fire service had been called sooner.
The local health board was criticised for not detecting fire risks.
The residents who died in the blaze were Dorothy McWee, 98, Tom Cook, 95, Isobel MacLachlan, 93, Julia McRoberts, 90, Annie Thompson and Helen Crawford, both 84, Margaret Lappin, 83, May Mullen, Helen Milne, Anna Stirrat, and Mary McKenner, all 82, Robina Burns, 89, Isabella MacLeod, 75, and Margaret Gow, 84. . . " Read More
LOS ANGELES – "The doctor charged in the death of Michael Jackson tried to change his story about his actions involving the pop star, telling his own experts in the upcoming trial a different story than he told police, prosecutors said Monday. Deputy District Attorneys David Walgren and Deborah Brazil filed a motion asking a judge to bar new claims made by defendant Dr. Conrad Murray. They said he apparently made the new assertions in conversation with two doctors who will testify on his behalf in the case. The accounts were revealed in letters from the experts, Dr. Paul White, an anesthesiologist, and Dr. Joseph Haraszti, a psychiatrist and hospital director. Prosecutors believe Murray spoke to the experts after a preliminary hearing in January that focused on his statements to police after Jackson's death in June 2009. The motion quoted Murray as telling the experts he left Jackson's bedroom to make a phone call, even though he initially said he left Jackson to go to the bathroom.
LOS ANGELES – "The doctor charged in the death of Michael Jackson tried to change his story about his actions involving the pop star, telling his own experts in the upcoming trial a different story than he told police, prosecutors said Monday.
Deputy District Attorneys David Walgren and Deborah Brazil filed a motion asking a judge to bar new claims made by defendant Dr. Conrad Murray.
They said he apparently made the new assertions in conversation with two doctors who will testify on his behalf in the case.
The accounts were revealed in letters from the experts, Dr. Paul White, an anesthesiologist, and Dr. Joseph Haraszti, a psychiatrist and hospital director.
Prosecutors believe Murray spoke to the experts after a preliminary hearing in January that focused on his statements to police after Jackson's death in June 2009.
The motion quoted Murray as telling the experts he left Jackson's bedroom to make a phone call, even though he initially said he left Jackson to go to the bathroom.
Experts also said Murray claimed to have experience using propofol — the powerful anesthetic that killed Jackson — as a sedative, even though Murray didn't make such a claim in police interviews. . . " Read More
For a review, check out my initial report/opinion on Michael Jackson's death in archive pages to the left.
Bob Probert knew the fierce pounding he dished out and received over 16 seasons as an NHL enforcer was taking its toll as he got older. That's why he wanted his brain to be analyzed once he died. Even though heart failure ultimately ended his life last July at age 45, Probert also was living with a damaged brain. Researchers at Boston University said Thursday that Probert had the degenerative brain disease Chronic Traumatic Encephalopathy. The disease was found through analysis of brain tissue donated by Probert.
He is the second hockey player from the program at the Center for the Study of Traumatic Encephalopathy to be diagnosed with the disease after death. Reggie Fleming, a 1960s enforcer who played before helmets became mandatory, also had CTE.
CSTE is a collaboration between Boston University Medical School and the Sports Legacy Institute that is attempting to address what it calls the "concussion crisis" in sports. The group has been at the forefront of research into head trauma in sports, and has received a $1 million gift from the NFL, which it has pushed for better treatment of concussions.
The family of former Bears safety Dave Duerson agreed to donate his brain to the study after he committed suicide last month at the age of 50.
During his years as one of the most feared players in the NHL, Probert had 3,300 penalty minutes — fifth on the league's career list. He was the toughest and most prolific fighter of his time. Probert, who struggled to overcome drinking problems during his time in the NHL, played for the Detroit Red Wings from 1985-94 and the Chicago Blackhawks from 1995-2002.
"We are only beginning to appreciate the consequences of brain trauma in sports," said Chris Nowinski, the Sports Legacy Institute's co-founder and chief executive officer. "Early evidence indicates that the historical decision not to discourage contact to the head was an enormous mistake, and we hope aggressive changes continue to be made to protect athletes, especially at the youth level." Read More
Article Date: 05 Mar 2011 - 17:00 PST
"Lack of adequate supervision was a contributing factor in more than 70 per cent of fatal child drownings across Australia, according to a study in the latest Medical Journal of Australia.
Researchers from the University of Ballarat used the National Coroners Information System (NCIS) database to investigate accidental drowning deaths of children aged 0-14 years between July 1, 2000 and June 30, 2009. Of the 339 deaths in that period, supervision was ruled out as a factor in only 29 cases (8.5 per cent), which were the result of events such as cars being swept off the road during flash flooding or boats overturning in rough conditions.
"Supervision was identified as a contributing factor in almost three-quarters (71.7 per cent) of all unintentional cases of child drowning, although the level of explicit identification of supervision varied across age groups," lead researcher Ms Lauren Petrass said.
"Indeed, with deeper interrogation of coroners' findings, absent or inadequate supervision might be associated with as many as 88.8 per cent of child drownings, because in 58 cases (17.1 per cent), inadequate detail was provided in text documents to determine whether supervision was a contributing factor." . . " Read More
An important research study below centers on fatal cardiac injuries sustained in motor vehicle accidents. It's important to note that fractured sternum in a driver can occur even while wearing a seat belt.
March 14-16, 2011 Chicago, IL
Each participant in the bootcamp will participate as a testifying or consulting expert in a trial involving expert testimony. Participants will learn the art of delivering effective testimony and how to withstand grueling cross examination.
Our consulting expert participants will learn how to dissect and critique the reports and opinions of the testifying experts, and how to prepare counsel for the expert segments of trial. Each participant will be coached and guided by members of our faculty of seasoned experts and trial attorneys.
The bootcamp culminates in a courtroom setting during which each testifying expert presents and defends his or her own expert opinions on the witness stand.
After completing the Bootcamp, participants will be able to:
For details on program content, learning objectives, continuing education, and registration: click here
Here's an interesting study of a very rare type of suicide:
Journal of Forensic & Legal Medicine, Nov. 2009,Volume 16, Issue 8, Pages 492-493 (November 2009)
Abstract: “Atypical Suicidal” cut throat injury – A case report
"Suicide is one of the leading causes of death in the world. The incidence and pattern of suicide vary from country to country. Cultural, religious and social value plays a vital role.
Hanging, poisoning, drowning are the common methods of committing suicide. Suicide by incising one’s own throat without hesitation marks remains a rare, and only few cases have been reported in the forensic literature.
We present here an unusual and rare case of self-inflicted cut throat injury of a 45-year old ex-military man without tentative cuts over the neck, which has resulted from a curved sharp weapon."
BY Jonathan Lemire
DAILY NEWS STAFF WRITER
Friday, November 26th 2010, 4:00 AM
"The Staten Island teenager who was baby-sitting her boyfriend's 2-year-old son when he died was arrested Thursday - and the child's father also could face charges, police sources said.
Dubois, 18, admitted she shook Josiah but claims she did so only after the child stopped breathing, police said.
The city medical examiner ruled Josiah's death a homicide. Dubois, who was initially arrested for endangering the welfare of a child, could face additional charges, the police sources said.
The autopsy also revealed that Josiah had suffered injuries over an extended period of time.
Dubois blamed the boy's father, her boyfriend, whom she claimed had been beating the child, the sources said. Police were questioning the dad, 28-year-old Darrell Taylor, late yesterday.
Taylor told cops he was at work when the toddler lost consciousness, but investigators are trying to determine whether he - or another adult - previously injured the child, the sources said.
Dubois is to be arraigned today in Staten Island Criminal Court."
12:00 AM CDT on Saturday, September 18, 2010
By JENNIFER EMILY / The Dallas Morning News
"The Texas Forensic Science Commission rebelled Friday against its head commissioner, refusing to accept his draft report clearing arson investigators of misconduct or negligence in a 1991 fatal fire where flawed science was used to determine the blaze was intentionally set.
Cameron Todd Willingham was executed in 2004 for killing his three children by setting that blaze. Texas may have executed an innocent man on Gov. Rick Perry's watch if the fire was accidental.
"There's a lot of work to be done still," Tarrant County Medical Examiner Nizam Peerwani, a member of the commission, said after the meeting. "That's why the commission didn't approve the draft."
The commission instead plans to question arson experts at a future meeting about investigation standards at the time of the fire and will look into whether the investigators knew or should have known the science that led them to assume the fire was caused by arson was flawed. . . "
"Jarrod Polston, 18, an Indiana University freshman from Greenwood, was visiting Ball State with friends who also graduated from Center Grove. Investigators think Polston passed out about 3 a.m. Saturday inside a room in Studebaker West after consuming alcohol and drugs. . . Delaware County Coroner Jim Clevenger said Polston vomited while unconscious, which blocked his airway, and said others in the room with Polston were unaware anything was wrong with him until they woke up later that morning. . . An autopsy Sunday revealed alcohol and methadone in Polston's system, officials said at a news conference." Read More
Point of View
Well, it's that time of year again, Folks. The start of a new freshman year at college, along with the usual partying, heavy drinking, and drugs is upon us. And now another young freshman student is dead from alcohol and drugs. According to an article on about.com, "73% of college students drink on campus ... some 159,000 of the nation’s current freshmen will drop out of school because of alcohol or drug use .."
In fact, according to a survey by the National Collegiate Athletic Association, only 56 percent of full-time first year students graduate within 6 years. The National Center for Education Statistics (1998), state that nearly one-third of all undergraduates will leave college within the first year.
Studies have shown that many will have developed alcohol or drug related problems before the first year is out. Studies also show that about 43% of all students report drinking in a high-risk manner at some point in the college career. Twenty percent of students report drinking in a high-risk manner often.
Here is an excellent article, entitled, Today's First-Year Students and Alcohol, by M. Lee Upcraft, PhD, comparing our college students of today with those from the 1960's and 1970's. As the article states, " Joe College doesn't live here any more." College Drinking - Changing the Culture
The number of sexual assault complaints, coming from college students, tend to increase during September and October. And as many warnings as there are about GHB date rape drugs, the truth is, I've rarely ever had to send a specimen out for testing. That's because it's mostly voluntary excessive drinking on the part of both male and female students.
As a nurse, with 35 years of diverse experience in the health care field, I've always been a big believer in being proactive. I've seen the difference it made in my patients' health and their enjoyment of life.
As a forensics nurse, I'm an even bigger believer. The old saying, Prevention is worth a pound of cure, is as true when dealing with most sexual assaults, as it is when dealing with generalized health issues.
As I've told others many times, While I certainly have the right to go walking alone down a dark city street at 3 am, I'm also not about to do it either. To me, that's being proactive. I'm preventing myself from being placed in harm's way from the start. I view excessive college drinking the same way. Be proactive, protect yourself, and substantially decrease your chances of being harmed, or of harming someone else.
To say that sexual assault is a horrible experience to go through would be the understatement of the year. Why then would we not take steps to try to prevent it ? Stranger rape is actually very rare. Most sexual assaults are aquaintance type assaults. And often the females don't remember or aren't sure.
It seems our American culture lately stresses the importance of being proactive in just about everything we do. Everything except possibly preventing ourselves from either being victimized, victimizing someone else, while under the influence of alcohol or drugs, or being falsley accused.
Or, as in the case above, from being found dead from alcohol poisoning or a drug overdose in a college dorm.
That's why Harford Medlegal Consulting, provides free presentations to our local high schools, churches, community centers, and colleges. It's our way of helping our community and its students to be proactive and protect themselves.
My husband and I are parents of a college freshman too. Prior to sending our youngest off to college this semester, my husband and I discussed both the fun and the danger he's likely to encounter his first year away from home. And we didn't shy away from any potential sexual assault issues either. Not only was he warned about excessive drinking but about the consequences as well.
Will he listen to us ? At this point, having led by example, we can only hope the good sense we taught him sticks.
USA Today newspaper conducted an analysis of college student deaths in the United States over a five year period beginning January 1, 2000. The analysis found that the number of deaths among freshmen was disproportionately high. Therefore, more colleges are becoming proactive towards trying to decrease student drinking on and around campus.
"The following are examples of the strategies many colleges and universities are implementing that can have a positive influence on the campus culture regarding alcohol and other drug use:
" Daniel Reardon's nightmare began at 5:30 a.m. with a call from the University of Maryland police. His 19-year-old son, Danny, had taken part in a fraternity drinking ritual and was unconscious . . .
LOS ANGELES - "Prosecutors investigating Michael Jackson’s death plan to file a criminal complaint charging the singer’s doctor with involuntary manslaughter rather than seek a grand jury indictment, The Associated Press learned Tuesday, a strategy shift that will give an eager public an earlier look at evidence.
While there is no public timetable for charges to be filed against Dr. Conrad Murray, there are strong indications the move is imminent. Murray and lawyer Edward Chernoff have traveled to Los Angeles from Houston, where Murray practices, and the attorney said his client is prepared to turn himself in.
“If they tell him to surrender in 10 minutes, he’ll go surrender,” said Chernoff, who spent several hours meeting with other members of Murray’s defense team Tuesday. “He’s never hidden, he’s always been available.”
David Walgren, the deputy Los Angeles County district attorney handling the case, declined to comment.
Jackson, 50, hired Murray to be his personal physician as he prepared for a strenuous series of comeback performances in London. His stunning death on June 25 in Los Angeles came after Murray, tending to Jackson in the star’s rented mansion, administered the powerful anesthetic propofol and two other sedatives to get the chronic insomniac to sleep, according to the Los Angeles County coroner’s office, which ruled the death a homicide. . . " Read More
Hope Witsell, 13, took her own life
Dec. 2: In a TODAY exclusive, the mother of a 13-year-old Florida girl who committed suicide after explicit cell phone photos were revealed to her classmates talks with TODAY’s Meredith Vieira.
But one impetuous move robbed Hope of her childhood, and eventually, her life. The 13-year-old Florida girl sent a topless photo of herself to a boy in hope of gaining his attention. Instead, she got the attention of her school, as well as the high school nearby.
The incessant bullying by classmates that followed when the photo spread put an emotional weight upon Hope that she ultimately could not bear.
Hope Witsell hanged herself in her bedroom 11 weeks ago.
Her death is only the second known case of a suicide linked to bullying after “sexting” — the practice of transmitting sexual messages or images electronically. In March, 18-year-old Jesse Logan killed herself in the face of a barrage of taunts when an ex-boyfriend forwarded explicit photos of her following their split. . . " Read More
According to Fox News today, "Michael Jackson still had a faint pulse and his body was warm when his doctor found him in bed and not breathing, a lawyer for the doctor told The Associated Press on Sunday. . . Chernoff told the AP that Murray was at the pop icon's rented mansion on Thursday afternoon when he discovered Jackson in bed and not breathing. The doctor immediately began administering CPR, Chernoff said."
OK, I have a slight problem with this info . . . and more than a few questions. First off, if the physician was the one who found Michael Jackson, why wasn't he the one who called 911? Was someone else in the room when the physician found him and was that person asked to call 911?
If so, how many minutes passed between the time the physician found him, "warm and with a slight pulse," and the unidentified person called 911 saying that he had no pulse, wasn't breathing, and that the physician was performing CPR?
What did his pupils look like? The classic sign of an overdose with narcotics is pin point pupils. After checking a patient's breathing and heart rate, the next thing would be checking the pupils. It can all be done in a matter of seconds.
And why in the world would a cardiologist not know what any first time CPR trainee is taught - that you have to have a hard surface beneath the patient or CPR won't work? A bed is way too soft.
I once arrived to visit a home health care patient, only to find him in complete arrest (after a "night of partying"). The first thing I did, after assessing his respiratory, cardiac and pupil status, and asking the family to call 911, was pull him to the floor and begin CPR. Geezz, how long has it been since this guy renewed his CPR certification? We're required to renew every year.
According to Fox news, "Dr. Murray has never prescribed nor administered Demerol to Michael Jackson," Chernoff said. "Not ever. Not that day. ... Not Oxycontin (either) for that matter."
Well, that's all fine and good. But did the good doctor know about the drugs? It's one thing to practice in an office, and the patient not tell you they are taking drugs, quite another to be living in residence with that patient and not know what was going on.
Whether he actually wrote any prescriptions, or actually gave any narcotics, or any other drugs, to Michael Jackson or not, it was still that physician's responsibility to know what was going on with his patient and what drugs that patient was taking.
Did he give any to Michael Jackson at any time? Sometimes drugs can react negatively with each other and increase the effects of other drugs, especially if there are other conditions, like kidney or liver disease, whereby the drugs couldn't be cleared properly from the body. This could possibly cause a build up of drugs in his system.
In other words, Demerol, being a respiratory depressant, could increase the effects of any other meds, built up in his system, which would also have a respiratory depressive effect. Together, they could severely depress the respiratory system by acting on the respiratory center of the brain which controls breathing. The combined effect could also decrease the patient's heart rate, blood pressure, and circulation, potentially causing a cardiac arrest.
Whether Dr. Murray prescribed Demerol or not, if he was aware that Michael Jackson was taking it, long term, he should also have been aware that Demerol, or any other narcotic, is not an appropriate treatment for chronic back pain and, most definitely, not appropriate treatment for a fractured leg that reportedly had occurred years before. It was his job to know these things. I did check his name and license out on the CA Medical Board website. It stated, "No records returned." Although it's possible to obtain a temporary licensure, according to the research, it's usually reserved for visiting professors or to complete continuing educational requirements in a different state from which the original license was obtained.
Narcotics are Schedule II drugs used for pain relief of acute injury only and its use is severely restricted by law under the Control Substances Act. NSAIDS (Non-steroid anti-inflammatory drugs) are usually the appropriate choice for chronic back pain, not narcotics.
If Michael Jackson was actually being given Demerol, or any other narcotic, long term, as reported, then the investigation should determine who prescribed the narcotic, who obtained it, and who gave it. Someone had to have done so. IMO, the facts, as they are coming out, just don't pass the smell test at the moment.
Much has been made by the media over the tragic death of David Carradine who was found hanging in his Bangkok hotel room. The initial report, indicating a suicide, was later replaced with the news that he died of possible autoerotic asphyxia; meaning, possibly an accidental death, rather than intentional suicide.
Either way, it's still a tragedy for Mr. Carradine's family, made much worse by the intense scrutiny of the news media. My heart goes out to them. While David Carradine was a well known celebrity, he was still a human being, with a family who loved him, and they should be afforded a certain amount privacy.
Having said that, because of that intense scrutiny, I feel it's important to post some facts about this unusual manner of death in order to get the word out to the public and, hopefully, prevent copy cat deaths from occurring.
Although, according to Dr. Park Dietz, co-author of Autoerotic Fatalities ( Dietz, et al., 1983), the media is "not a suitable medium to discuss this syndrome", due to copy cat behavior. It's for that very reason that I feel it's appropriate to discuss it in this blog. In fact, according to the above cited article, two fatal incidents occurred following the viewing, against Dr. Dietz' advice, of a show on autoerotic asphyxia, by persons who had viewed the show.
Autoerotic asphyxia is an unusual, though not unheard of, manner of death. It has been documented since the 1600's, for treatment of erectile dysfunction and impotence, and is described as being among the most bizarre of the "paraphilias," or abnormal sexual behaviors. It occurs primarily among adolescents and young adult males.
In the book, Autoerotic Fatalities by Hazelwood et al. (1983), the authors suggest that the most common psychological processes underlying autoerotic asphyxia ". . . are the desire for the subjective experience of hypoxia, the acting out of a masochistic fantasy that includes being abused, tortured, or executed, and the desire to be sexually aroused through risk-taking."
Autoerotic asphyxia typically begins in adolescence and most fatalities occur in this age group. According to the paper, The Autoerotic Asphyxiation Syndrome in Adolescents and Young Adult Males, "A study of five teen survivors showed "a history of choking, physical abuse, sexual abuse, other risk-taking behaviors, and pairing of sexual arousal with the choking experience.
Their behavior was found to be ritualistic and compulsive . . . physical and sexual abuse can be precursors to the abnormal sexual behavior." This behavior is often seen in introverted male teens engaging in increased sexual fantasies. The adult practice has been named "terminal sex" or "scarving". Most victims are heterosexual and there's usually no known history of deviant sexual behavior. Unfortunately, since there are few survivors, there is still too little information to determine the exact causes.
Of course, from a death investigation stand point, the first question is whether it was an intentional suicide or an accidental death? Two elements are required to conclude suicide:
(1) The intent of the victim to commit suicide
(2) A specific act which carries out the suicide. The scene of death, if left undisturbed, will usually reveal the clues.
The obvious question is what was the intent of the victim? Was it an intentional suicide or the acting out of sexual fantasies? And how do we tell? According to Dr. Mary H Dudley, Chief Medical Examiner for Sedgwick County, Wichita, KA, from whom I took my death investigator training, those investigating the death scene, "should not jump to conclusions . . . examine the scene very closely, listen to the family, and check that nothing has been moved."
This last part is very important, as family members often conceal or destroy evidence at the scene, or alter the body. "The visual memory of the death scene becomes imprinted in the family member's mind forever." It can be done for any number of reasons, including embarrassment, financial gain, religious beliefs, or the social stigma involved with suicides. In a hanging death, the knot of the ligature is the most valuable piece of evidence. It should never be altered. If the ligature has to be cut off the body, it should be cut away from the knot.
According to the media reports, David Carradine was found hanging with his hands tied behind his back. However, photographic evidence from the scene, published by Thai Rath newspaper, showed "hands apparently bound together above the head" [Carradine family upset by Thailand By: Bangkokpost.com and Agencies], which would indicate an accidental autoerotic asphyxiation death, rather than an intentional suicide.
A death investigation of suicide begins with interviewing family and friends in order to create a "psychological autopsy," followed by reviewing the victim's past medical and mental history. The medical examiner will search the body for signs of previous attempts, such as "hesitation marks". These are marks and scars along the wrists, arms, or neck, made by someone who starts to cut, then changes their minds. Multiple old scars, from such attempts, are often seen. In my work I've seen this on several females, from a few old, healed, superficial cuts along the wrist areas, to multiple scars all over their bodies.
Past history of depression is also a strong indicator. Prior attempts are seen in as much as 20-60 percent of successful suicides. While the CDC states that teen suicide was the 3rd leading cause of death among young adults and adolescents, 15 to 24 years of age, peak age for suicide by males is 55-65 and females is 60-70.
Suicide Risk Signs
Sudden, unexpected mood changes - especially going from an extremely agitated state to one of "calm deliberation"
Increased depression or exalted mood
Increased fatigue and sleeping
Suddenly giving away personal belongings
Making peace with others
Suicide Death Scene Signs
A suicide note
A tape/video recording
The body is found in a locked room
Firearm residue on the hands
Evidence of prior rehearsal
Presence of the book, Final Exit or a recent membership in the Hemlock Society
Recent grief over loss or threat of losses
Recent purchase of weapons
Prior suicide attempt
Autoerotic Death Scene
Usually male, between the ages of 12-25
Is found dead of asphyxia by hanging, a plastic bag over his head, or by gas.
He is either naked or is wearing female clothing
There is usually pornographic material and a mirror found close by
He's usually found by a family member in his bedroom or other private area of the home
Appearance of solo sexual activity in conjunction with the Asphyxia
Victims often found alone or in a secluded location
Signs of suicide (see above)
Ligature will have no release mechanism
No pornographic material or mirror
Usually a note or video left behind
Accidental Autoerotic Suicide
Victims often found alone or in secluded location
No apparent suicide attempt
No obvious intent
Evidence of a physical mechanism for enhancing sexual gratification
Evidence of a safeguard mechanism
Evidence of sexual fantasy aides
May have bondage items
Evidence of prior dangerous autoerotic practice
Parents, it's important that you monitor your teen's activities both online and off. Studies have shown that many learned of this behavior through word of mouth, detective magazines, sex manuals, and pornographic literature and media - easily available on line.
Counseling, education, law enforcement, and clergy should all be used to help family and friends cope with such an extremely traumatic event. In addition, in my opinion, while they should be offered strong emotional support, they should also be allowed their privacy in which to grieve for their loved one.
Jan. 26, 2009 -- Rates of infant mortality due to accidental suffocation and strangulation in bed have quadrupled since 1984, a new study shows.
In the same period, rates of sudden infant death syndrome (SIDS) declined, while sudden unexpected infant deaths remained stagnant, shows the study, published in the February edition of Pediatrics.
The seeming contradictions in increases and declines in deaths of infants are likely due to changes in the way such tragedies are investigated and classified, researcher Carrie K. Shapiro-Mendoza, PhD, of the CDC, tells WebMD.
She credits an "impressive" decline in SIDS cases to a national "back to sleep" campaign that, among other things, urges parents to put babies to sleep on their backs.
The reason for the sharp increase in accidental suffocation and strangulation in bed, or ASSB, isn't known for sure.
"It's probably due to poor bedding, blankets in cribs, sleeping with parents or siblings, or bad habits," she tells WebMD. "Or infants getting wedged between the mattress and the wall."
Also, despite urgings from the American Academy of Pediatrics and the CDC, many parents still put babies to bed on their stomachs, which can lead to suffocation.
The decline in SIDS rates has been offset by an increase in other sudden unexplained infant deaths, a new category called SUIDs. ASSB death, a subgroup of SUIDs, is a leading cause of infant mortality, says Shapiro-Mendoza... Read More
While autopsies, blood spatter analysis and DNA research apparently make for entertaining television, Mike Osborne discovered that real forensic science is far less glamorous. It's a beautiful spring day in East Tennessee. The trees are just putting on leaves and every shrub and wildflower is in full bloom. But as you enter one of the most unusual research facilities in the world, even the sweetest smelling blossoms can't mask the stench of rotting flesh.
TV dramas that follow detectives as they investigate a crime have long been a staple of American television. But in recent years, these shows have taken a decidedly graphic turn, focusing on the forensic teams that examine the victim's body and look for evidence that can help investigators bring the killers to justice.
While autopsies, blood spatter analysis and DNA research apparently make for entertaining television, Mike Osborne discovered that real forensic science is far less glamorous.
It's a beautiful spring day in East Tennessee. The trees are just putting on leaves and every shrub and wildflower is in full bloom. But as you enter one of the most unusual research facilities in the world, even the sweetest smelling blossoms can't mask the stench of rotting flesh.
Certified Forensics Nurse Examiner and Independent Consultant