Medicolegal Autopsies and Causes of Death in Mass Casualties in a Developing Country and Challenges Encountered

Abstract

Background: Mass casualties are frequent occurrences in low income societies where multiple factors result in premature deaths. The pathologist has a crucial role in the effective management of the corpses of victims of mass casualties. This role must be attended to with the engagement of the minimum standards of forensic medicine that would allow revisits to the cases without losing vital records.
Aims and Objectives: The study reviewed the autopsies conducted on mass casualties at OAUTHC, Ile-Ife; for the most vulnerable gender, methods of preservation, pattern of injuries, circumstances of death, mechanisms of death, cause of death, challenges encountered in the management of the corpses, and results of toxicology studies.
Materials and Methods: There was a review of the reports of autopsies conducted on mass casualties by anatomical pathologists at the Obafemi Awolowo University Teaching Hospitals Complex (OAUTHC), Ile-Ife and their jurisdiction of practice over a period of January 2010 - December 2017.
Results: A total of 52 cases were analyzed, all homicidal deaths consisting of 46 cases of deaths due to communal crisis and 6 cases of poison related deaths. The homicidal deaths resulted from blunt force to the head in 32 cases, sharp force in 9 cases, severe burns in 3 cases and strangulation in 2 cases. Most of the deaths was due to raised intracranial pressure complicating severe head injury. The cases of suspected poisoning at autopsy showed severe anatomic and pathological changes which were the basis of pathophysiological basis of death but toxicology was unhelpful in the detecting the poison, perhaps due to preservation technique.
Conclusions: The role of the forensic pathology is pivotal in the management of deaths in mass casualties. Forensic pathology practitioners in resource limited must at least keep to minimum standards to ensure basic documentation are not compromised.