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Delayed homicides and the proximate cause.

Peter Lin1, James R Gill

  • 1Department of Forensic Medicine, New York University School of Medicine, New York, NY, USA.

The American Journal of Forensic Medicine and Pathology
|November 11, 2009
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Summary
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Delayed homicides, often resulting from remote injuries, pose investigative challenges. Establishing a pathophysiologic link is crucial for certifying these deaths, with infections and neurological complications being common causes.

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Area of Science:

  • Forensic Pathology
  • Medical Toxicology
  • Public Health

Background:

  • Delayed homicides arise from complications of injuries inflicted significantly earlier.
  • Investigating these cases presents challenges including reporting, documentation, and jurisdictional issues.
  • Certifying delayed deaths requires demonstrating a pathophysiologic link between the initial injury and the eventual demise.

Purpose of the Study:

  • To analyze delayed homicide cases in New York City over a two-year period.
  • To identify common causes of death and long-term complications in delayed homicide victims.
  • To discuss the role of proximate cause in death certification for delayed deaths.

Main Methods:

  • Retrospective analysis of 1211 homicide deaths in New York City over two years.
  • Identification of cases where death occurred more than one year after the initial injury.
  • Review of immediate causes of death and patterns of long-term complications.

Main Results:

  • 42 out of 1211 homicides (3.5%) were delayed deaths, with survival intervals from 1.3 to 43.2 years.
  • Most common immediate causes of death included infections (22), seizures (7), and intestinal obstructions/hernias (6).
  • Spinal cord injuries led to paraplegia (14 cases) and quadriplegia (8 cases), with infections being a frequent cause of death, especially in catheterized patients.

Conclusions:

  • Delayed deaths from remote injuries are a significant forensic challenge requiring careful pathophysiologic linkage.
  • Infections and complications from spinal cord injuries are common in delayed homicide fatalities.
  • The evolving legal landscape and the definition of proximate cause impact the certification and prosecution of delayed homicides.