Related Experiment Video
Updated: May 22, 2026
Setup and Execution of the Rapid Cycle Deliberate Practice Death Notification Curriculum
Published on: August 5, 2020
["Natural" death of a person under the care of a custodian]
Kurt Trübner1, Manfred Kleiber, Steffen Heide
1Institut für Rechtsmedizin der Universität Essen.
Insights
A second external examination revealed fatal blunt force injuries missed in the initial assessment, leading to a murder charge for the woman's caretakers. This highlights the critical importance of thorough post-mortem examinations.
Area of Science:
- Forensic Pathology
- Medical Law
Background:
- Initial death certificate cited cardiac arrest and psycho-organic brain syndrome.
- A mandatory second external examination is required before cremation.
Observation:
- Extensive hematomas were noted on the thorax, face, and forehead during the second examination.
- The initial autopsy revealed serial rib fractures and a fractured skull.
Findings:
- Forensic autopsy determined the cause of death as fat embolism due to massive blunt force trauma to the thorax.
- The trauma resulted in serial rib fractures and a hematopneumothorax.
Implications:
- The adopted son and his wife, the woman's caretakers, were charged with murder following contradictory statements.
- This case underscores the critical role of thorough post-mortem examinations in uncovering potential foul play and correcting initial diagnostic errors.
Abstract:
An ambulance service doctor was called to the death of a 76-year-old woman and attested cardiac arrest and psycho-organic brain syndrome as the cause of death on the death certificate. At the second external examination mandatory before cremation, extensive hematomas were detected on the right thorax and multiple haematomas in the face and on the forehead. The autopsy initially ordered by the public health officer revealed serial rib fractures and a fractured skull. After notifying the prosecutor, a forensic autopsy was ordered and death was found to have been caused by fat embolism following massive blunt force to the thorax with serial rib fractures and haematopneumothorax. After that, the adopted son, who had been appointed care custodian for the woman, and his wife were suspected, because they had given contradictory explanations for the injuries. At first, they were only suspected of failure to render assistance, but in the end they were both charged with murder. Only because of the second external examination prescribed by the law still in force could the errors of the improper first external examination be corrected.
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