Forensic-medical examination of cases that died as a result of electric shock at the Council of Forensic Medicine, Van Regional Office

Yıl 2023, Cilt: 37 Sayı: 3, 115 - 121, 18.12.2023

Abdullah Benna Sarın

https://doi.org/10.61970/adlitip.1323118

Öz

Objective: Despite improvements in product safety, injuries due to electric shock are an important cause of mortality and morbidity. The aim of this study, examine the sociodemographic data, clinical characteristics, scene of the crime, electrical input-output wound characteristics and the pathological effects of electric shock on the body of the cases who underwent autopsy as a result of electrical injury.

Materials and Methods: A total of 2574 autopsies performed at the Council of Forensic Medicine, Van Regional Office between January 1, 2015 and July 1, 2022 were examined. Fifteen cases exposed to electric current were identified. The files of these cases were reviewed retrospectively.

Results: It was determined that 0.58% of medicolegal autopsies as a result of elektrocute. 73.3% of the cases were male, 26.7% were female, and the mean age was 28.27. All cases were accidental deaths, of which 53.3% occured in home and 46.7% occured in work. 80% of the injuries were low voltage injuries and 20% were high voltage injuries. Most deaths occurred during the summer season. While fluid conductivity was not observed in work accidents, it was found to be effective in 37.5% of home accidents. The most frequent deaths of places were the construction site, the house and its annexes. Electric shock was most commonly caused by electrical wires, cables and electrical appliances. Electric entry wound was detected in 80% of the cases, and exit wound in 26.7%. These wounds were accompanied by skin burns and general body trauma findings with a frequency that could not be ignored.

Discussion and Conclusion: In electric shocks almost entirely of accident origin; crime scene investigation detailed configuration should be delivered to the autopsy specialist immediately. The risk of electric shock should be kept in mind in the autopsy procedure for deaths occurring as a result of home and work accidents.

Anahtar Kelimeler

electrical injury, crime scene, home accident, work accident, medicolegal autopsy

Van Adli Tıp Grup Başkanlığı’nda Elektrik Çarpması Sonucu Ölen Olguların Adli- Tıbbi İncelemesi

Öz

Amaç: Ürün güvenliğinde iyileşmeler olmasına rağmen, elektrik çarpmasına bağlı yaralanmalar mortalite ve morbiditelerin önemli bir nedenidir. Bu çalışmanın amacı, elektrik yaralanması sonucu otopsi yapılan olguların sosyodemografik verileri, klinik özellikleri, olay yeri, elektrik giriş-çıkış yara özellikleri ve elektrik çarpmasının vücut üzerindeki patolojik etkilerinin incelenmesidir.

Materyal ve Metod: Van Adli Tıp Grup Başkanlığı’nda 1 Ocak 2015-1 Temmuz 2022 tarihleri arasında gerçekleştirilen toplam 2574 otopsi incelendi. Elektrik akımına maruz kalan 15 olgu tespit edildi. Bu olguların dosyaları retrospektif olarak incelendi.

Bulgular: Yapılan medikolegal otopsilerin %0.58’inin elektrik yaralanması sonucu öldüğü belirlendi. Olguların %73.3’ü erkek, %26.7’si kadın, yaş ortalaması 28.27 idi. Orijin tüm olgularda kaza olup %53.3’ü ev kazası, %46.7’si iş kazasıydı. Yaralanmaların %80’i düşük voltaj, %20’si yüksek voltaj yaralanmasıydı. Ölümler en sık yaz mevsiminde gerçekleşmişti. Sıvı iletkenliği iş kazalarında görülmezken ev kazalarının %37.5’inde etkili olduğu tespit edildi. Ölümlerin en sık inşaat alanı, ev ve ekleri olduğu belirlendi. Elektrik çarpmasına en sık elektrik teli, kablo ve elektrikli ev aletleri neden olmuştu. Olguların %80’inde elektrik giriş yarası, %26.7’sinde çıkış yarası tespit edilmişti. Bu yaralara ciltte yanık ve genel beden travması bulgularının göz ardı edilmeyecek sıklıkta eşlik ettiği belirlendi.

Tartışma ve Sonuç: Tamamına yakını kaza orijinli olan elektrik çarpmalarında; olay yeri incelemesi ayrıntılı yapılarak otopsi uzmanına ivedilikle ulaştırılmalıdır. Ev ve iş kazaları sonucu meydana gelen ölüm olgularına yapılacak otopsi işleminde elektrik yaralanması ihtimali akılda bulundurulmalıdır.

Anahtar Kelimeler

elektrik yaralanması, olay yeri, ev kazası, iş kazası, medikolegal otopsi

Kaynakça

• Knight B, Saukko PJ. Knight’s forensic pathology. 3rd ed. London, England: Arnold; 2003. pp. 326–38. https://doi. org/10.1201/b13642
• Saleem N, Akhtar J, Ahmed S, Aziz A. Aetiology and outcome of paediatric burns. J Surg Pakistan. 2001;6:26–8.
• Oruç M, Dündar AS, Okumuş H, Dengeşik Ö, Altın İ, Şamdancı ET, Celbiş O. Autopsy findings and scene of incident examination in deaths resulting from electrical injury. Aust J Forensic Sci. 2021:1-12. https://doi.org/10.108 0/00450618.2021.1973098
• DiMaio VJ, DiMaio D. Electrocution. In: Forensic Pathology, 2nd ed. Boca Raton, FL. CRC Press LLC; 2001. pp. 409-18.
• Aghakhani K, Heidari M, Tabatabaee SM, Abdolkarimi L. Effect of current pathway on mortality and morbidity in electrical burn patients. Burns. 2015;41(1):172–6. https://doi.org/10.1016/j.burns.2014.06.008
• Maghsoudi H, Adyani Y, Ahmadian N. Electrical and lightning injuries. J Burn Care Res. 2007;28(2):255–61. https://doi.org/10.1097/BCR.0B013E318031A11C
• Singerman J, Gomez M, Fish JS. Long-term sequelae of low voltage electrical injury. J Burn Care Res. 2008;29(5):773–7. https://doi.org/10.1097/BCR.0b013e318184815d
• Tuğcu H, Kaya A, Ulukan MÖ, Tuğcu İ, Celasun B. Death due to high-voltage electrical injury: two case reports. Gülhane Med J. 2004;49(4):335–9.
• Bernal E, Arnoldo BD. Electrical injuries. In: Herndon DNMDF, editor. Total Burn Care. 2018;2:396–402. https:// doi.org/10.1016/B978-0-323-47661-4.00037-X
• Mukherjee B, Farooqui JM, Farooqui AAJ. Retrospective study of fatal electrocution in a rural region of western Maharashtra, India. J Forensic Leg Med. 2015;32:1–3. https://doi.org/10.1016/j.jflm.2015.02.002
• Duff K, McCaffrey RJ. Electrical injury and lightning injury: a review of their mechanisms and neuropsychological, psychiatric and neurological sequelae. Neuropsychol Rev. 2001;11:101–16. https://doi.org/10.1023/A:1016623318049
• Reddy A, Balaraman R, Sengottuvel P. Accidental electrocution fatalites in Puducherry: a 3-year retrospective study. Int J Med Sci Public Health. 2015;4:48–52. https://doi. org/10.5455/ijmsph.2015.0828201411
• Behera C, Sikary AK, Rautji R, Gupta SK. Electrocution deaths reported in South Delhi, India: a retrospective analysis of 16 years of data from 2002 to 2017. Med Sci Law. 2019;59(4):240–6. https://doi.org/10.1177/0025802419860288
• Korkmaz M, Uysal C. Evaluation of the death cases due to electric current being performed autopsies between 2007 and 2014 years in Diyarbakır. Bull Legal Med. 2021;26(1):27–32. https://doi.org/10.17986/blm.1473
• Turkmen N, Eren B, Fedakar R, Durak D. Deaths from electrical current injuries in Bursa city of Turkey. Ulus Travma Acil Cerrahi Derg. 2008;14:65–69.
• Dirlik M, Gün B, Kallem FÇ. Evaluation of death cases connected to electric current in Aydın Province, Western Turkey. Workplace Health Saf. 2015;63(12):546–550. https://doi.org/10.1177/2165079915608403
• Massey BK, Sait MA, Johnson WL, Ripple M, Fowler DR, Li L. Deaths due to electrocution: An evaluation of death scene investigations and autopsy findings. J Forensic Sci Med. 2018;4:179–83. https://doi.org/10.4103/jfsm.jfsm_57_18
• Dündar AS, Altın İ, Aksöz C, Sarın AB, Özdemir B. Deaths associated with electric shock injuries in children and adults: A 10-year retrospective examination in Şanlıurfa, Southeast Turkey (2012-2022). J Forensic Sci. 2023. https://doi.org/10.1111/1556-4029.15351
• Shaha KK, Joe AE. Electrocution-related mortality: a retrospective review of 118 deaths in Coimbatore, India, between January 2002 and December 2006. Med Sci Law. 2010;50:72–4. https://doi.org/10.1258/msl.2010.010008
• Shih JG, Shahrokhi S, Jeschke MG. Review of adult electrical burn injury outcomes worldwide: An analysis of low- voltage versus high-voltage electrical injury. J Burn Care Res. 2017;38(1):293–8. https://doi.org/10.1097/ BCR.0000000000000373
• Sheikhazadi A, Kiani M and Ghadyani MH. Electrocutionrelated mortality-a survey of 295 deaths in Tehran, Iran between 2002 and 2006. Am J Forensic Med Pathol. 2010;31:42–5. https://doi.org/10.1097/PAF.0b013e3181c213f6
• Ozdel S, Cakıcı EK, Sayli TR. Pediatric electrical injury in Turkey: Five year retrospective hospital-based study. Pediatr Int. 2019;61:1155–8. https://doi.org/10.1111/ped.14008
• Holizki T, McDonald R, Foster V, Guzmicky M. Causes of work-related injuries among young workers in British Columbia. Am J Ind Med. 2008;51:357–63. https://doi. org/10.1002/ajim.20555
• Akçan R, Karacaoğlu E, Keten A, Odabaşı AB, Kanburoğlu Ç, Tümer AR. Electrical fatalities in Ankara over 11 years. Turk J Med Sci. 2012;42:533–8. https://doi.org/10.3906/sag- 1010-1243
• Gille J, Schmidt T, Dragu A, Emich D, Carius PH, Kremer T, Raff T, Reichelt B, Siafliakis A, Siemers F, Steen M, Struck MF. Electrical injury-a dual center analysis of patient characteristics, therapeutic specifics and outcome predictors. Scand J Trauma Resusc Emerg Med. 2018;26:43–52. https:// doi.org/10.1186/s13049-018-0513-2
• Dündar AS, Oruç M, Celbiş O, Şamdancı ET, Akatlı AN, Okumuş H, Taşkapan Ç, Özhan O, Parlakpınar H. An experimental rat model of electric shock injury with isolated electric shock and water conduction: the histopathological changes on the skin and internal organs and the effect on biochemical parameters. Int J Legal Med. 2023;137(1):215–26. https://doi.org/10.1007/s00414-022-02834-w
• Dündar AS, Sarın AB. Infant electrocution due to smartphone charge cable-a hidden public health risk. Am J Forensic Med Pathol. 2023;44(2):140–3. https://doi.org/10.1097/PAF.0000000000000826
• Xu G, Su R, Lv J, Lai X, Li X, Wu J, Hu B, Xu L, Shen R, Gu J, Yu X. Anterior wrist and medial malleolus: the optimal sites for tissue selection in electric death through hand-to-foot circuit pathway. Int J Legal Med. 2017;131:433–9. https:// doi.org/10.1007/s00414-016-1474-5
• Silver MD. Cardiovascular pathology. 2nd ed. New York: Churchill Livingstone; 1996. pp. 92–9.