Orensic Pathology Case Study: The Multiple Fatality Traffic Accident”

Read the below case study and answer the questions that follow:

Two guys, ages 27 and 17, met 2 girls, aged 16, at a lakeside resort, asking if the girls would like to take a ride in their jeep. Welcoming the opportunity the girls jumped in, not knowing or not caring that the fellas had been drinking all afternoon.

Driving around curving mountain roads at a high rate of speed, the jeep went off a cliff, coming to rest some 100 feet below.

The 2 males were dead at the scene, the 2 females unconscious but alive.

En route to the hospital by ground ambulance, one of the females suffered cardiorespiratory arrest approximately 20 minutes before arriving in the Emergency Department.

A resuscitative effort of 1 hour, including CPR and Advanced Cardiovascular Life Support in the ambulance, was to no avail.

At autopsy, both males were found to have distended urinary bladders (a potential indication of their state of intoxicationa alcohol is a diuretic, thus the full bladder; alcohol is also an anesthetic, thus the reason the bladder was not emptied via urinationa voluntrary or otherwise!).

The first body is that of a 17-year-old male, with no obvious external trauma. Examination of the body is essentially negative. Examination of the skull and brain reveals intracranial hemorrhage.

The second body is that of a 27-year-old-male with no obvious external trauma. Examination of the body reveals 1) atrioventricular bisection of the heart, without significant blood loss, and 2) traumatic rupture of the spleen, again without significant blood loss. Examination of the skull and intracranial contents reveals a hinge fracture of the skull base, extending from one ear to the other, and minimal evidence of intracranial bleeding.

The third body is that of a 16-year-old female. She is noted to have ecchymosis of the Right eye, and a deep scalp laceration extending from the hair line to just above the Right eyebrow, however there is no intracranial pathology demonstrable on post mortem examination of the head. Examination of the body reveals a complete tear through the liver, with approximately 3600 ml of blood suctioned from the abdominal cavity (someone her size probably had a total blood volume of approximately 4000 ml). Her bladder was empty.

a) Please write, in appropriate format, cause of death statements for each of these decedents, and explain your reasoning.

b) Based on the findings reported, can you state where the decedents were likely seated in the jeep? How would you further investigate these deaths to make definite that determination? What other findings of significance would you search for?

c) The bladder of the female was not distended with urine. Does that mean she did not drink a significant amount the day of the Motor Vehicle Collision? Why or why not?