Recommendations for victim survivability assessment methodology based on the Manchester Arena Bombing Inquiry

Area of Science:

• Forensic pathology
• Trauma analysis
• Explosive event investigation

Background:

• The Manchester Arena Bomb resulted in 22 fatalities.
• An expert panel was convened to determine if earlier or different medical treatment could have altered survival outcomes.
• The panel's findings are crucial for understanding survivability in mass casualty events.

Purpose of the Study:

• To report on the methodology used by an expert panel in analyzing fatalities from the Manchester Arena Bomb.
• To make recommendations for future forensic analyses of explosive events.
• To assess the potential impact of medical treatment on survival.

Main Methods:

• An iterative and comprehensive methodology was employed by a multidisciplinary expert panel.
• Detailed analyses included injury scoring, 3D post-mortem CT scans, ballistic analysis, and blood loss assessment.
• Key data sources included post-mortem CT imaging and body-worn video, with survivability categorized as unsurvivable, unlikely to be survivable, or potentially survivable.

Main Results:

• The expert panel concluded that 21 of the 22 fatalities sustained unsurvivable injuries.
• One fatality was categorized as having potentially survivable injuries.
• The panel emphasized that no single piece of evidence was sufficient; a combination of expertise and data was essential.

Conclusions:

• The panel's robust approach led to clear outputs, with only one fatality's outcome contested.
• Lack of detailed information on survivors and the event location hindered the comprehensive analysis.
• Recommendations for future investigations include providing survivor data, medical records, and detailed site information.