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Fatal descent from height in New York City
1New York City Office of Chief Medical Examiner, NY 10016, USA.
Journal of Forensic Sciences
|September 25, 2001
Summary
Deaths from falls were analyzed, revealing that most suicides (86%) involved psychiatric illness. Accidental falls also showed significant substance use, impacting injury assessment.
Area of Science:
- Forensic Pathology
- Toxicology
- Psychiatry
Background:
- Descent from height is a significant cause of death.
- Autopsy findings can be variable depending on the circumstances of the fall.
- Psychiatric history and toxicology are crucial in determining manner of death.
Purpose of the Study:
- To review deaths due to descent from height.
- To examine scene and autopsy findings, psychiatric history, and toxicology.
- To discuss investigation methods and death certification criteria.
Main Methods:
- Retrospective review of autopsy cases from the Manhattan Office of Chief Medical Examiner (1997-1999).
- Analysis of scene findings, autopsy results, psychiatric history, and toxicology.
- Categorization of deaths by manner: suicide, accident, undetermined, homicide.
Main Results:
- 120 deaths were reviewed: 77 suicides, 36 accidents, 5 undetermined, 2 homicides.
- Psychiatric illness was present in 86% of suicide cases.
- Substance use (ethanol and illicit drugs) was detected in 29% of suicides and 36% of accidents.
- Accidental falls by women constituted less than 3% of all manners.
Conclusions:
- High prevalence of psychiatric illness in suicide by fall.
- Significant substance use in both suicide and accidental falls.
- Autopsy findings alone are insufficient to determine fall height; investigation is key.
- Water entry deaths may present with minimal external but severe internal injuries.
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