No abstract

We present the first ever case of homicidal poisoning due to injection of methidathion, an organophosphate insecticide. Case: A 4-month-old baby presented to the emergency department with chief complaints of unconsciousness and irregular respiration. A bitter odour and an injection site with a greenish blue colouration and two bullaous lesions were noticed by the emergency department physicians. Postmortem examinations revealed a wide shiny blue colouration of the antecubital region with oedematous muscular fascia and focal liquefaction necrosis. Blood and tissue levels were positive for methidathion. Our case report emphasizes the necessity of a detailed crime scene investigation and postmortem examination for the possibility of homicide in such cases. Although injection sites may be the expected results of medical treatment, dermal lesions also may be associated with injections of toxic substances.

Guidance and education are important tools for prevention from corrosive injuries, but we believe that the best weapon is to restrict easy access to corrosive agents by prohibiting the free commercialization of these most potent agents.

ABSTRACT

Child abuse-maltreatment syndrome can be described as child death due to repeated episodes of physical abuse and neglect. Here we present a case of child physical abuse and neglect causing death due to duodenal perforation. A five year old boy was reported to have stomachache occurring one day before death. He was admitted to a private health clinic where he was discharged after an analgesic injection. Because of increasing complaints he was applied to the same clinic, afterwards sent to an Emergency Department where he died during resuscitation. At autopsy, external examination revealed several traumatic injuries and two bite marks of different age, while internal examination revealed 500 ml of dirty yellowishgreenish free liquid in abdominal cavity and a perforation 0.5 cm in diameter of the duodenum wall. Insufficient parental supervision in spite of continuous traumas strongly indicates negligence or intentional abuse by parents. Additionally, insufficient medical follow up, besides; not disclosing the injuries on child's body adds medical malpractice aspect to this case.