Sagittal liver transection--an injury from improperly worn shoulder harness seatbelts: a report of two cases.

We have identified two cases which exemplify the typical injury caused by the under-the-arm placement of a shoulder harness (without the associated lap belt) in frontal collisions, namely, fatal liver laceration in the sagittal plane. Trauma care personnel should be alert for this type of rapidly fatal abdominal injury that occurs even in low-speed impacts. A prominent warning label on these belts regarding proper placement and the need for use of the associated lap belt may be appropriate.