Forensisch-medizinische Untersuchungen von Tatverdächtigen. Eine Analyse von 270 Gutachten aus den Jahren 2006 bis 2018

Hintergrund

Zu den Aufgaben in der rechtsmedizinischen Praxis gehören zunehmend forensisch-medizinische Untersuchungen von Lebenden. Im Gegensatz zu Studien über Gewaltopfer findet sich in der Fachliteratur allerdings ein erhebliches Defizit an Ergebnissen über systematische rechtsmedizinische Untersuchungen von Tatverdächtigen.

Fragestellung

Welche relevanten Daten können aus einer retrospektiven Analyse von forensisch-medizinischen Untersuchungen von Tatverdächtigen erhoben und welche Rückschlüsse für die rechtsmedizinische Praxis gezogen werden?

Material und Methode

Es wurden insgesamt 270 Gutachten nach forensisch-medizinischen Untersuchungen von Tatverdächtigen aus dem Einzugsgebiet des Instituts für Rechtsmedizin der Universitätsmedizin Rostock der Jahre 2006 bis 2018 nach vorab definierten Kriterien ausgewertet.

Ergebnisse

Die vorgeworfenen Straftaten waren am häufigsten Körperverletzungen (n = 88 = 30,7 %), gefolgt von vorsätzlichen Tötungen (n = 63 = 22,0 %) und Sexualdelikten (n = 49 = 17,1 %). Von den begutachteten Personen waren 236 (87,4 %) männlich und 34 (12,6 %) weiblich. Die Mehrzahl der Tatverdächtigen (n = 175 = 65,5 %) war in einem Lebensalter von 18 bis 40 Jahren.

Im Hinblick auf die Aussage der rechtsmedizinischen Ergebnisse in Bezug auf den vorgeworfenen Straftatbestand wurden 126 (46,7 %) Gutachten als für den Tatverdächtigen belastend, 13 (4,8 %) als entlastend und 131 (48,5 %) als frei von Be- oder Entlastungsaussagen eingestuft.

Zu den 270 Gutachten über Tatverdächtige gab es 209 (77,4 %) korrespondierende Opferuntersuchungen. Von diesem Teilkollektiv mit Täter-Opfer-Begutachtungen wurden in 193 Fällen (92,3 %) Tatverdächtige und Opfer von demselben Gutachter untersucht.

Schlussfolgerungen

Für die Rekonstruktion eines Tatgeschehens sind rechtsmedizinische Untersuchungen des Opfers und des Tatverdächtigen wertvoller als die nicht selten beobachtete Untersuchung der geschädigten Person allein. Befunde mit belastenden Tendenzen für den Tatverdächtigen werden häufiger festgestellt als solche, die zu einer Entlastung des Beschuldigten führen. Da es in der Fachliteratur im Vergleich zu den Opfern von Gewalttaten ein Defizit an Ergebnissen über systematische forensisch-medizinische Untersuchungen von Tatverdächtigen gibt, sollten weitere Studien folgen.

Enterokolitis als Ursache eines akuten unerwarteten Todes eines Orang-Utans in Zoohaltung

Es wird von einem 13 Jahre alt gewordenen weiblichen Orang-Utan berichtet, der 4 Tage vor dem Tod an einer akuten Enterokolitis erkrankte. Die tierärztliche Ultraschalluntersuchung einen Tag vor dem Tod erbrachte den Nachweis von vermehrter Flüssigkeit im Zäkum und einer abschnittsweise verdickten Kolonwand. Nach dem für die Veterinärmediziner und die Zoomitarbeiter unerwarteten Todeseintritt erfolgte eine Obduktion durch Rechtsmediziner der Universitätsmedizin Rostock mit Unterstützung von Ärzten weiterer Fachrichtungen. Dabei wurde als Todesursache eine akute Escherichia-coli-Enterokolitis mit massiver Blutung in den Darm festgestellt. Begünstigend oder ursächlich für die letale Enterokolitis dürften wahrscheinlich zahlreiche rezidivierende Durchfallerkrankungen in der Anamnese des Orang-Utans als Folge eines Verweigerns des Stillens durch die Mutter nach der Geburt gewesen sein.

Lesions and characteristic injury patterns caused by high-voltage fault arcs

Exposure to high-voltage electric arcs as a result of an accident or by means to commit suicide can affect people's health and cause death. There are characteristic external findings that can be found on external examination. These include extensive skin burns, periorbital recesses or "crow's feet," vapor deposition of conductor material, known as metallization, and tightly spaced, roundish, crocodile skin like burns. The Institute of Legal Medicine of the Rostock University Medical Center recorded 16 deaths caused by exposure to electricity between 1990 and 2018. Six of these deaths were caused by exposure to high-voltage electric arcs and five of these deaths (83 %) showed crocodile skin like burns and one had periorbital recesses burns on the face as a result of a fault arc. To our knowledge, the present paper is the first report describing the frequent occurrence of crocodile skin like burns due to high-voltage fault arcs.

Unusual head injury by a forklift vehicle

A case of an unusual head injury by a forklift vehicle is presented.

Accidental mechanical asphyxia of children in Germany between 2000 and 2008

Accidents constitute one of the greatest risks to children, yet there are few medical reports that discuss the subject of accidental asphyxia. However, a systematic analysis of all documented cases in Germany over the years 2000-2008 has now been conducted, aiming at identifying patterns of accidental asphyxia, deducing findings, defining avoidance measures and recommending ways of increasing product safety and taking possible precautions. The analysis is based on a detailed retrospective analysis of all 91 relevant autopsy reports from 24 different German forensic institutes. A variety of demographic and morphological data was systematically collected and analysed. In 84 of the 91 cases, the sex of the victim was reported, resulting in a total of 57 boys (68 %) and 27 girls (32 %). The age spread ranged between 1 day and 14 years, with an average of 5.9 years. Most accidents occurred in the first year of life (20 %) or between the ages of 1 and 2 years (13 %). In 46 % of cases, the cause of death was strangulation, with the majority occurring in the home environment. In 31 % of all cases, the cause of death was positional asphyxia, the majority resulting from chest compression. In 23 % of cases, the cause of death was aspiration, mainly of foreign bodies. Today, accidental asphyxiation is a rare cause of death in children in Germany. Nevertheless, the majority of cases could have been avoided. Future incidence can be reduced by implementing two major precautions: increasing product safety and educating parents of potentially fatal risks. Specific recommendations relate to children's beds, toys and food.

Sudden cardiac death in a 5-year-old girl associated with parvovirus B19 infection

We report on a 5-year-old girl who suddenly collapsed and died while dancing at a family party. Histological examination of the heart including the cardiac conduction system revealed lymphocytic infiltrations of the sinu-atrial node and perivascular infiltration in the atrio-ventricular region. Additionally, foci of mononuclear infiltrates were observed in the myocardium. Consequently, myocarditis was diagnosed as cause of death. The child also had lymphocytic conjunctivis, parotitis and tracheitis. Evaluation of infections by means of nested polymerase chain reaction revealed parvovirus B19 DNA (PVB19) in tissue samples of the trachea.

Pathological changes of the heart in sudden infant death

There are more than 120 different theories on the possible causes of sudden infant death (SID). In particular, dysfunctions of the central nervous system, cardiorespiratory insufficiency due to infections including atypical immune reactions, and cardiac dysregulation have been discussed during the previous decade. Reports on disturbances of the cardiac rhythmogenic function due to LQTS were among the most speculative. Based on gross histological, immunohistochemical and molecular genetic investigations of SID cases, the most important and most frequent findings of the heart are shown. The significance of different types of myocarditis, hypoxia-related changes, disturbances of the rhythmogenic function, cardiomyopathy, and other changes is discussed with regard to the cause of death. In conclusion, most of the changes reported in the literature are not sufficient to explain the cause of death. Problems in the diagnosis are shown which influence the classification of these disturbances as well as the classification of SID.

Myocardial injury due to lightning

The report deals with a 27-year-old male who was standing in a tent and was injured by lightning as it struck a tree about 1.5 m away. He immediately lost consciousness and exhibited ventricular fibrillation when the emergency physician arrived. A clinical picture of hypoxaemic brain damage emerged after initially successful resuscitation. Brain death was diagnosed on the fifth day after injury. The discrete external findings (remaining arborescent skin marks) contrasted markedly with the severe thermal damage to the pectoral muscle and cardiac musculature found during the autopsy. The histological cardiac findings indicated severe acute myocardial infarction affecting virtually all parts of the myocardium.

Fibromuscular dysplasia of coronary arteries as a rare cause of death

A case of fibromuscular dysplasia of the coronary arteries in a 15-year-old boy is reported. After a quarrel involving no violence the boy suddenly suffered from ventricular fibrillation, collapsed and was initially successfully defibrillated. After 37 days of deep unconsciousness the boy died of bronchopneumonia. The cause of the ventricular fibrillation was clarified only after histological investigations. Fibromuscular dysplasia of the coronary arteries with narrowing was found, which has very occasionally been described in the literature. However, its localization in the A-V node artery, as described here, only seems to have been observed once.