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FALL FROM HEIGHT-A CASE REPORT Dr Dayanand G Gannur Associate Professor Department of Forensic medicine Shri B M Patil Medical College ,Bijapur Karnataka
The potential risk of serious injury and death resulting from a fall from a height has been recognized for thousands of years. 1 • In more modern times, studies have demonstrated that the risk of death following a high fall depends to a large extent upon the distance fallen, although other factors such as the age of the victim, the position of the body on landing and the surface landed upon can play a considerable role. 2–6
However, despite the relatively soft landing and associated slow deceleration by a landing into water, the experience gained from studying very high falls into water demonstrates that they are consistently associated with very serious injury .7,8
In the absence of witnesses or an suicide note, it is usually very difficult to determine whether a fatal fall from a height was the result of an accident, suicide, or homicide.
A CASE REPORT • A 55-year-old male, 162 cms tall and weighing 62 kg, while working at a top of the 2nd story building , was seen to fall from the top floor , onto the base of a vertical cliff, wedged head first in a deep cavity formed by large rocks at the base of the cliff. • He was immediately brought to a hospital emergency unit by ambulance. • The clinical diagnosis was a ‘small abrasion’ in the left zygomatic region, and ‘traumatic intracerebral hemorrhage, and subarachnoid hemorrhages’ of unknown origin
Later his death was confirmed. • Following an external examination by police officers, a forensic autopsy was ordered to clarify the cause and manner of death,
he had suffered extensive impact injuries to his head and upper body, but there were no injuries to the lower part of the body and there was no damage to shoes or clothing below the waist
Imprint abrasion seen over the left side of the face (zygomatic region), measuring 6x4cm • Imprint abrasion seen over chin on right side , measuring 4x1 cm
A split lacerated wound seen over the parieto-frontal region on left side, measuring 7x2 cm
ON FURTHER DISSECTION • A scalp hematoma seen ,measuring 20x16 cm • Comminuted Fracture seen over the temporo- parietal region
Subdural hemorrhage is seen over left parietal and temporal region • Contusion of brain seen over occipital region ofBoth the lobes • Contusion seen over the right arm ,3x4 cm • Internal organs shows-pallor
Examination of the scene of crime should include exact recording of where the body came to lie to rest and its position (in particular the horizontal distance away from the building/bridge or cliff edge), as this may provide later clues as to the height from which an individual fell, and whether or not he/she fell, jumped or ran and jumped.
Later in the course of police investigations and autopsy, additional information may come to light which provides further clues as to the reason for the death. • The pattern of injuries may enable a judgment as to whether an individual fell feet or head first. 10
At horizontal launch speeds less than about 2 m/s, it may even be impossible to distinguish between a jump, push, throw, dive, or accidental fall. • Shaw and Hsu showed how horizontal distance and height information can be used to determine the initial launch speed and concluded that an initial launch speed exceeding 2.70 m/s would indicate suicide (9)
a rare case of fatal facial–intracranial injury accompanied by a subdural hemorrhage that involved cerebral injury connected with a comminuted skull-fracture in an accidental fall from a height, and discussed the significance of forensic autopsy in traumatic death to determine the cause of death and manner of death.
prevention may be the most effective method of reducing pre hospital deaths. • It is widely accepted that the incidence of falls can be decreased by developing prevention mechanisms targeted to the population at risk.
To decrease the occurrence of injuries caused by falls, strategies should include awareness campaigns, parent’s education about the mechanisms of falls, increase parental supervision during playing activities, and legislative measures to ensure the safety
REFERENCES 1. Holy Bible New Testament. Matthew chapter 4; verses 5–6. 2. de Haven H. Mechanical analysis of survival in falls from heights of fifty to one hundred and fifty feet. War Medicine 1942; 2: 586–596. 3. Snyder RG. Human tolerances to extreme impacts in free-fall. Aerospace Medicine 1963; 34(8): 695–709. 4. Warner KG, Demling RH. The pathophysiology of free-fall injury. Ann Emerg Med 1986; 15: 1088–1093.
Steedman DJ. Severity of free-fall injury Injury 1989; 20: 259–261. • Risser D, Bönsch A, Schneider B, Bauer G. Risk of dying after a free fall from a height. Forensic SciInt 1996; 78: 187–191. 7. Lukas GM, Hutton JE Jr, Lim RC, Mathewson C Jr. Injuries sustained from high velocity impact with water: an experience from the Golden Gate Bridge. J Trauma 1981; 21: 612–618. 8. Li L, Smialek JE. The investigation of fatal falls and jumps from heights in Maryland (1987–1992). Am J Forensic Med Pathol 1994; 15: 295–299.
Shaw K-P, Hsu SY. Horizontal distance and height determining falling pattern. J Forensic Sci 1998;43(4):765–71.
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