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1 ISSN 0971-0973
Case Report
Abstract
Deaths due to fall from height are more commonly seen in urban area especially where high rise
buildings are constructed. Invariably such falls from great height results in tragic death of the innocent
victims mainly construction workers who are working without any safety measures. A fatal fall from height
can result from accident, suicide or homicide. This paper reports an unusual incident where four
construction worker suffered accidental fall due to snapping of the cable of a temporary elevator erected
at the construction site. Out of the four victims, one died on the spot while the remaining three victims
were hospitalized who subsequently died within few hours of admission due to the fatal injuries sustained
during the fall. The medico-legal autopsy on each of the victims showed characteristic pattern of skeletal
and internal injuries sustained on account of blunt trauma due to fall from height . The following case is
reported due to its rarity and unusual form of accidental death due to fall from height.
Key Words: Fall from height, Elevator, Accident, Blunt trauma, Skeletal & Internal Injuries
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J Indian Acad Forensic Med. Jan-March 2013, Vol. 35, No. 1 ISSN 0971-0973
subsequently succumbed to their injuries within e. Tearing of the pleura at sites subjacent to
3 hours of admission. the displaced fractures of ribs.
A complete and thorough medico-legal f. Avulsion of posterior attachments of the
autopsy was conducted on the body of each domes of the diaphragm on both sides.
victim on the next day. All the victims were male g. Contusion of both lungs at their hilae.
between the age group of 30 years to 40 years. h. Two irregular tears over the posterior aspect
On external examination it was found that all the of the right lobe of the liver.
victims were of moderate to average built. Rigor i. Contusion of the right psoas muscle along
mortis was well developed. The post mortem its entire length.
lividity was faintly developed over back and j. Compression fracture of the lower half of the
th
dependant parts except over the areas of body of 5 lumbar vertebra.
contact flattening. k. Fracture of the body and alae of the sacrum
The post-mortem lividity was fixed. with dislocations of the lumbosacral and
There was oozing of blood from the nostril of both sacroiliac joints.
one of the deceased victim. The victims had l. Fracture dislocation of pubic symphysis.
suffered external injuries in the form of multiple m. Fracture dislocation of atlanto occipital joint.
irregular impact abrasions with subjacent n. 2600 ml of fluid blood was drained and 440
contusions, irregular grazed abrasions and gm of clots was evacuated from the sub
irregular stretch lacerations. Out of the three diaphragmatic space of both sides.
admitted victim, one deceased victim showed Case 2: Male, 37 years
presence of sutured surgically incised wounds of On External Examination:
exploratory laparotomy and thoracotomy with a. Swelling, visible deformity and compound
intercostal drainage. The details of injuries of fractures and dislocation of lower ends of
each victim is described as below both Tibia and Fibula of both legs, Talus and
Case 1: Male, age 34 years Calcaneum of both the foot.
On External Examination: On Internal Examination:
a. Swelling, visible deformity and compound a. Fracture of the sternum at the junction of the
fracture and dislocation of lower ends of Manubrium with the body.
both bones of the right leg, fracture of Talus b. Contusion of anterior pericardium.
nd th
and Cuboid bones of the right foot. c. Displaced fracture of ribs from 2 to 7 rib
rd th
b. Swelling and visible deformity of the left of right side and 3 and 4 ribs of left side of
ankle joint and foot, with palpable fractures the chest anteriorly in midclavicular line with
of lower ends of both bones of the left leg contusion of subjacent intercostal muscle.
st nd rd
and fracture of Talus and Calcaneum bones d. Displaced fractures of 1 , 2 and 3 ribs of
of the left foot. right side at its posterior end with subjacent
On Internal Examination: contusion.
a. Subarachnoid haemorrhage about 20 ml at e. Bilateral haemothorax of about 1500 ml of
the base of the brain. fluid blood. Tearing of pleura at sites
b. Contusions of the intercostal muscles of the subjacent to the displaced fractures of ribs.
right side of the chest over the front from the f. Roughly triangular penetrating laceration
th
clavicle down to the level of the 6 rib and 1cm X 1cm X 1cm deep on posterior aspect
th th
over the outer aspect, along the 7 , 8 and of upper lobe of right lung.
th
9 intercostal spaces of size maximum 18 g. Multiple contusions of size ranging from 3
cm X 16 cm and minimum 11.5 cm X 13.5 cm X 2 cm to 1 cm X 1cm on both upper and
cm. lower lobes of both lungs.
c. Contusions of the intercostal muscle of the h. Haemo peritoneum of about 800 ml of blood.
left side of the chest over the front extending i. Contusion of anterior surface of right lobe of
st th
downwards from 1 rib to the 6 rib size liver.
19.5 cm X 16.5 cm and over the front and j. Multiple contusions of size ranging from 3.2
th th
outer aspect of the 9 and 10 intercostal cm X 2 cm to 1.8 cm X 1 cm on the coils of
spaces, size 6 cm X 10 cm associated with intestine and mesentery.
th th
undisplaced fracture of the 9 and 10 rib in k. Bilateral perirenal haematoma.
anterior axillary line. l. Fracture dislocation of the lumbar spine at
th rd th
d. Displaced fracture of the 7 rib on right side the level of 3 and 4 lumbar vertebra.
nd rd th
and 2 , 3 and 4 ribs on the left side at m. Fracture dislocation of the cervical spine of
nd rd
their costovertebral junction. 2 and 3 cervical vertebra with contusion
of underlying cervical spinal cord.
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J Indian Acad Forensic Med. Jan-March 2013, Vol. 35, No. 1 ISSN 0971-0973
Dr. G R Bhaskar
(06-Oct-1926 to 17-Nov-2012)
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