Forensic aspects of the highway crash

It can be stated that patterns of injury in highway crashes can often be related to specific design and damage features of the vehicle. The restraint systems designed to attenuate injury may also, under severe crash circumstances, produce trauma. Problems may arise as to identification of vehicular drivers. It behooves the pathologist concerned with the necropsy of crash victims and the physician responsible for treating crash victims to become familiar with the pathogenesis of injuries. Such knowledge can be utilized in the recommendation for improvement of vehicles to render them more crashworthy. Awareness of the various mechanisms of injury in vehicle crashes also enhances the diagnostic skill of the initial treating physician when he or she is confronted with a crash victim in the emergency department. Ideally, when the victim arrives at the hospital, the emergency room physician should be supplied with the details of the crash including the type of vehicle, position within the vehicle, use or nonuse of restraint systems, and the direction of the impact. When a fatality results from a car crash, ideally the autopsy pathologist should inspect the vehicle or at least view pictures of the exterior and interior of the vehicle to help establish the pathogenesis of injury in a specific collision. Unfortunately, because of time constraints, this ideal is not always achieved. Because of the considerable volume of civil and criminal litigation resulting from highway crashes, there is a need for competent medical expertise to help both the plaintiff and the defendent. The pathologist involved in forensic work and the treating physician play a particularly important role in the judicial arena.