SUICIDAL INJURIES FROM HEIGHT FALLS

  • Goran Pavlovski Institute of Forensic Medicine, Criminalistic and Medical Deontology, Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, North Macedonia
  • Aleksandar Stankov Institute of Forensic Medicine, Criminalistic and Medical Deontology, Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, North Macedonia
  • Zlatko Jakjovski Institute of Forensic Medicine, Criminalistic and Medical Deontology, Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, North Macedonia
  • Natasha Bitoljanu Institute of Forensic Medicine, Criminalistic and Medical Deontology, Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, North Macedonia
  • Viktorija Belakaposka Srpanova Institute of Forensic Medicine, Criminalistic and Medical Deontology, Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, North Macedonia
  • Ljupco Cakar Institute of Forensic Medicine, Criminalistic and Medical Deontology, Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, North Macedonia
  • Ana Ivcheva Institute of Forensic Medicine, Criminalistic and Medical Deontology, Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, North Macedonia
  • Verica Poposka Institute of Forensic Medicine, Criminalistic and Medical Deontology, Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, North Macedonia

Abstract

According to the manner of death, falls from height can be accidental, homicidal and predominantly suicidal. The type of injuries in suicidal falls from height depend to a large extent on the height of the fall, the part of the body that landed and suffered the first impact, the age and the body weight of the victim, clothes worn and body composition. Although with prospect, the research is an average study of the Institute for Forensic Medicine in Skopje, conducted on 80 victims of fatal falls from different heights, through forensic-medical autopsy. The data for all examined cases have been taken from the forensic-medical autopsy reports. The study analyses the cases which appear to be suicides, according to the manner of death. The injuries inflicted from the falls are analysed according to the height in three groups: small height up to 7 meters, middle height from 7 to 10 meters and big heights above 20 meters. Study results have shown that 25% of the analysed cases are suicides. The analysis of the number and severity of the injuries in relation to the height of the fall prove that the fractures of the hipbone and legs were most frequent injuries found in the victims who have fallen from 7 to 20 meters. In the victims of height falls up to 7 meters, most frequent injuries were the fractures of the ribs and the spine. In falls from height above 20 meters, all organs were equally damaged. In suicides from falls from height, most frequent injuries of the skeleton were fractures of the ribs and spine, while the liver was the most affected organ among the internal organs. However, the type of injuries determined with the autopsy is not a sufficient indicator for successful assessment of the manner of death in fatal falls from height.


Key words: fall from height, type of injury, suicide.

References

1. Türkoğlu A, Sehlikoğlu K, Tokdemir M. A study of fatal falls from height. J Forensic Leg Med. 2019;61:17-21.
2. Kafadar S, Kafadar H. The medico-legal evaluation of injuries from falls in pediatric age groups. Journal of Forensic and Legal Medicine 2015;31: 52-5.
3. Peng TA, Lee CC, LinJCC, Shun CT, Shaw KP, Weng TI. Fatal falls from height in Taiwan. J Forensic Sci 2014; 59 (4): 978-82.
4. Gelbard R, Inaba K, Okoye OT. Falls in the elderly: a modern look at an old problem. Am J Surg 2014; 208 (2): 249-53.
5. Behera C, Janani S, Murty OP. Fatal fall from heıght in south Delhi (1996-2005): a retrospectıve study. Journal of Forensic Medicine and Toxicology 2014; 31 (2): 23-6.
6. Turk EE. Fatal falls from height. Forensic pathology reviews. 2008; 5:25-38.
7. Jain V, Jain S, Dhaon B.A Multi Factorial Analysis of the epidemiology of Injuries from Falls from Heights.Int J Crit Illn Inj Sci. 2014;4(4):283-7.
8. Dusan Zecevic i saradnici. Sudska medicina i deontologija. Zagreb: Medicinska naklada; 2004.
9. Abrams RC, Marzuk PM, Tardif K, Leon AC. Preference of fall from hight as a method of suicide by eldery residents of New York City. Am J Public Health. 2005; 95: 1000-2.
10. Schoenfisch A, Lipscomb H, Cameron W, Adams D, Silverstein B.Rates of and circumstances surrounding work-related falls from height among union drywall carpenters in Washington State, 1989-2008. J Safety Res. 2014;51:117-24.
11. Turk EE, Tsokos M. Pathologic features of fatal falls from height. Am J Forensic Med Pathol. 2004; 25:194-9.
12. Cetin G, Gunay Y, Fincanci SK, OzdemirKolusayin R. suicides by jumping from Bosporus Bridge in Istanbul. Forensic Sci Int. 2001; 116:157-62.
13. Gill JR. fetal descent from height in New York City. J Forensic Sci. 2001; 46:1132-7.
14. Wischhusen F, Patra S, Brauman M, Turk EE, Puschel K. Analysis of jumping/falling distance from a height. Forensic Sci Int. 2006; 156:150-3.
15. Chao TC, Lau G, Teo CES. Falls from a height: the pathology of trauma from vertical deceleracion. In: Mason JK, Purdue BN, editors. The pathology of trauma, 3rd ed. London: Arnold; 2000.
16. Arbes S, Berzlanovich A. Injury pattern in correlation with the height of fatal falls.Wien Klin Wochenschr. 2015 J;127(1-2):57-61.
17. Nordell E, Jarnlo GB, Jetsén C, Nordström L, Thorngren KG. Accidental falls and related fractures in 65-74 year olds: a retrospective study of 332 patients. Acta Orthop Scand. 2000;71(2):175-9.
18. Kohli A, Banerjee KK. Pattern of injuries in fatal falls from buildings. Med Sci Law. 2006;46:335–41.
19. Kent A, Pearce A. Review of morbidity and mortality associated with falls from heights among patients presenting to a major trauma centre. Emerg Med Australas. 2006;18:23–30.
20. Atanasijevic TC, Savic SN, NikolicSD, Djokic VM. Frequency and severity of injuries in correlation with height of fall. J Forensic Sci. 2005; 50:608-12.
21. Garman CR, Franck CT, Nussbaum MA, Madigan ML.A bootstrapping method to assess the influence of age, obesity, gender, and gait speed on probability of tripping as a function of obstacle height.J Biomech. 2015 Feb 3. pii: S0021-9290(15)00047-0. doi: 10.1016/j.jbiomech.2015.01.031. [Epub ahead of print]PMID:25683521
22. Alizadeh SS, Mortazavi SB, Sepehri MM.Building a model using bayesian network for assessment of posterior probabilities of falling fromheight at workplaces.Health Promot Perspect. 2014;4(2):187-94
23. Auñón-Martín I, Doussoux PC, Baltasar JL, Polentinos-Castro E, Mazzini JP, Erasun CR. Correlation between pattern and mechanism of injury of free fall.Strategies Trauma Limb Reconstr. 2012;7:141–5.
24. Gulati D, Aggarwal AN, Kumar S, Agarwal A. Skeletal injuries following unintentional fall from height.Ulus Travma Acil Cerrahi Derg. 2012;18:141–6.
25. Roccia F, Boffano P, Bianchi FA, Zavattero E.Maxillofacial Fractures due to Falls: does Fall Modality Determine the Pattern of Injury?J Oral Maxillofac Res. 2014;5(4):e5.
26. Clavijo-Alvarez JA, Deleyiannis FW, Peitzman AB, Zenati MS. Risk factors for death in elderly patients with facial fractures secondary to falls. J Craniofac Surg. 2012;23(2):494-8.
27. Salonen EM, Koivikko MP, Koskinen SK. Acute facial trauma in falling accidents: MDCT analysis of 500 patients. Emerg Radiol. 2008;15(4):241-7.
28. Van den Bergh B, Karagozoglu KH, Heymans MW, Forouzanfar T. Aetiology and incidence of maxillofacial trauma in Amsterdam: a retrospective analysis of 579 patients. J Craniomaxillofac Surg. 2012;40(6):e165-9.
29. Turk EE, Tsokos M. Blunt cardiac trauma caused by fatal falls from height: an autopsy-based assessment of the injury pattern. J Trauma. 2004; 57: 301-4.
30. Fang BR. Kuo LT, Li CT, Chang JP. Isolated right atrial tear following blunt chest trauma: report of three cases. Jpn Heart J. 2000; 41:535-40.
31. Moulin A. Cardiac contusion diagnosed by cardiac tropin. Am J Emergency Med. 2002;20:382-3.
Published
2022-12-29
How to Cite
PAVLOVSKI, Goran et al. SUICIDAL INJURIES FROM HEIGHT FALLS. Journal of Morphological Sciences, [S.l.], v. 5, n. 3, p. 129-138, dec. 2022. ISSN 2545-4706. Available at: <http://jms.mk/jms/article/view/vol5no3-21>. Date accessed: 28 mar. 2024.
Section
Articles