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非法医学专家对枪伤的错误解读:一起涉及罕见火器伤“克伦莱因枪击伤”的刑事调查误导案例报告

Misinterpretation of a Gunshot Injury by a Non-forensic Medicine Expert: A Case Report of Misguidance in a Criminal Investigation Involving the Unusual Firearm Injury 'Kronlein Shot'.

作者信息

Wankhade Toshal, Kumar Binay

机构信息

Forensic Medicine, All India Institute of Medical Sciences, Patna, Patna, IND.

Forensic Medicine & Toxicology, All India Institute of Medical Sciences, Patna, Patna, IND.

出版信息

Cureus. 2024 Feb 6;16(2):e53724. doi: 10.7759/cureus.53724. eCollection 2024 Feb.

Abstract

In India, the majority of postmortem examinations are conducted by medical professionals who lack expertise in the field of forensic medicine. Medicolegal autopsy services that are done by forensic experts are primarily confined to tertiary care centers, although a significant portion of medicolegal postmortem examinations occurs in non-tertiary healthcare setups. In this context, postmortem examination reports occasionally fail to encompass essential medicolegal features, resulting in dissatisfaction among both crime investigators and the deceased's relatives. As the doctors managing these postmortem examinations are not experts in the field of forensic medicine, if a case involves an unusual pattern of injury, the situation becomes further complicated. The absence of proper forensic assessments heightens the risk of the crime investigation heading in the wrong direction. Firearm injuries are well known for their varied pattern of injury. The present case reports one of the unusual patterns of firearm injury where a gunshot injury with close contact on the head resulted in the bursting of the skull, which is commonly referred to as a Kronlein shot. Such injuries involve extreme skull mutilation. Unlike typical contact gunshot injuries, in cases of extensive facial and cranial destruction, locating the entry wound and detecting other typical features of firearm injury become challenging. This complexity confused the autopsy surgeons of this case who were not experts in forensic medicine and mis-framed the opinion regarding the causative weapon which in turn confused the police official in the crime investigation. The case was later on referred to our institute for forensic medicine expert opinion and opinion was given after consideration of postmortem examination findings mentioned in the postmortem report, photographs of the deceased, circumstantial evidence gathered by police, and correlating all these facts with standard published literature. The case underscores the essential role of forensic experts in decoding complex medicolegal mysteries and ensuring accurate justice delivery. The case also highlights the importance of the need for comprehensive forensic examinations and considering circumstantial evidence in drawing various conclusions in a medicolegal autopsy.

摘要

在印度,大多数尸检由缺乏法医学专业知识的医学专业人员进行。法医专家进行的法医学尸检服务主要局限于三级医疗中心,尽管相当一部分法医学尸检是在非三级医疗设施中进行的。在这种情况下,尸检报告偶尔未能涵盖基本的法医学特征,导致犯罪调查人员和死者亲属都不满意。由于进行这些尸检的医生并非法医学领域的专家,如果案件涉及不寻常的损伤模式,情况会变得更加复杂。缺乏适当的法医评估会增加犯罪调查走向错误方向的风险。火器伤以其多样的损伤模式而闻名。本病例报告了一种不寻常的火器伤模式,即头部近距离枪伤导致颅骨爆裂,这通常被称为克伦莱因枪击伤。此类损伤涉及严重的颅骨毁损。与典型的接触性枪伤不同,在面部和颅骨广泛破坏的情况下,确定入口伤口和检测火器伤的其他典型特征变得具有挑战性。这种复杂性使本案中并非法医学专家的尸检外科医生感到困惑,并错误地对致伤武器做出了判断,这反过来又使犯罪调查中的警察感到困惑。该案件后来被提交到我们研究所寻求法医学专家意见,在考虑了尸检报告中提到的尸检结果、死者照片、警方收集的间接证据,并将所有这些事实与已发表的标准文献进行关联后给出了意见。该案件强调了法医专家在破解复杂的法医学谜团和确保准确司法交付方面的重要作用。该案件还凸显了在法医学尸检中进行全面法医检查以及在得出各种结论时考虑间接证据的必要性的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/039b/10919443/fe8b9e254529/cureus-0016-00000053724-i01.jpg

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