Ballard Mark, Bull Anthony M J, Clasper Jonathan C, Hepper Alan E, Kirkman Emrys, Mahoney Peter F
Royal Centre for Defence Medicine, Level 2 QEHB, Mindelsohn Way, Edgbaston, Birmingham, B15 2WB, United Kingdom.
Centre for Injury Studies, Imperial College London, Sir Michael Uren Hub, White City Campus, London W12 0BZ, United Kingdom.
Forensic Sci Int Synerg. 2025 Aug 11;11:100634. doi: 10.1016/j.fsisyn.2025.100634. eCollection 2025 Dec.
An expert panel was assembled to report on whether either earlier or different medical treatment could have allowed any of the 22 fatalities of the Manchester Arena Bomb to survive. The aim of this paper is to report on the methodology used by the panel, and to make recommendations for future forensic analyses of explosive events. The panel comprised individuals with a broad range of expertise who received relevant materials from the Inquiry Solicitors. The methodology used was iterative and comprehensive with the panel meeting together at regular points to: sequentially review all the material; conduct detailed analyses on the material; review the outputs of the analyses; reconcile and address any inconsistencies or points of debate; strictly define the following terms: unsurvivable, unlikely to be survivable, and potentially survivable; and report to the Inquiry. A second level of iteration was overlayed on this due to: early reporting being requested by the Solicitors to the Inquiry prior to all information being provided; and the expert panel conclusions being contested by the family of one of the casualties and the medical experts appointed by their legal teams, resulting in further analyses being conducted by the panel. The following detailed analyses were conducted for each fatality: injury scoring; injury visualisation and mapping; forensic three-dimensional post-mortem CT scan analysis; ballistic injury analysis; blood loss analysis; tourniquet use; blast lung injury; and categorisation and survivability. The panel concluded that 21 individuals suffered unsurvivable injuries and one suffered potentially survivable injuries. In order to complete their tasking, the panel found that: no one piece of evidence and expertise on its own was sufficient; post-mortem CT imaging to assess anatomical damage and body worn video to analyse physiological response were key; and lack of detailed information on survivors hindered the panel's work. The clarity of outputs provided by the panel with only the conclusion regarding one of the fatalities being contested highlights the robustness of this panel approach. The following recommendations are made that, in addition to the information that was provided to the panel during this Inquiry, the following information be provided during any future forensic analyses of explosive events: the location of survivors, and uninjured; medical records of the survivors; the three-dimensional plans of the location; structural damage records; and building records and construction technique.
一个专家小组被召集起来，以报告更早或不同的医疗救治是否能让曼彻斯特竞技场爆炸案中的22名遇难者中的任何一人幸存下来。本文的目的是报告该小组所采用的方法，并为未来爆炸事件的法医分析提出建议。该小组由具有广泛专业知识的人员组成，他们从调查律师那里收到了相关材料。所采用的方法是反复且全面的，小组成员定期会面，以便：依次审查所有材料；对材料进行详细分析；审查分析结果；协调并解决任何不一致或有争议的问题；严格定义以下术语：无法存活、不太可能存活和有可能存活；并向调查委员会报告。由于以下原因，在此基础上又进行了第二层反复：律师在所有信息尚未提供之前就要求向调查委员会进行早期报告；一名遇难者的家属及其法律团队指定的医学专家对专家小组的结论提出了质疑，并导致小组进行了进一步分析。对每名遇难者都进行了以下详细分析：损伤评分；损伤可视化与绘图；法医三维尸检CT扫描分析；弹道损伤分析；失血分析；止血带使用情况；爆震性肺损伤；以及分类和可存活性。该小组得出结论，21人遭受了无法存活的损伤，1人遭受了有可能存活的损伤。为了完成其任务，该小组发现：没有任何一项单独的证据和专业知识足以说明问题；用于评估解剖损伤的尸检CT成像和用于分析生理反应的随身视频是关键；幸存者缺乏详细信息阻碍了小组的工作。该小组提供的结果清晰度很高，只有关于一名遇难者的结论受到质疑，这凸显了这种小组方法的稳健性。现提出以下建议，即在未来对爆炸事件进行任何法医分析时，除了在本次调查期间提供给该小组的信息之外，还应提供以下信息：幸存者和未受伤者的位置；幸存者的医疗记录；事发地点的三维平面图；结构损坏记录；以及建筑记录和施工技术。
