Death Due to Fatal Accidental Electrocution: A case report CASE REPORT Death Due to Fatal Accidental Electrocution: A case report A. G. Pathak1*, N. A. Devraj2, K. M. Chaudhari3, R. K. Gadhari4 1 Associate Professor & Head, Hospital Dhule, Maharashtra. 2,3,4 Assistant Professor, Dept. of Forensic Medicine, SBH Medical College & General (civil) ABSTRACT BACKGROUND: Electrocution is an uncommon cause of death and occurs commonly due to accident. Deaths caused by the passage of electric current, irrespective of the source of such current are described as electrocution. The severity caused due to electrocution could extend from simple to severe shock leading to death of a person. Most of the victims of high- tension electrocution die at the scene or declared dead before treatment. In first case report, deceased having fatal electric shock brought to casualty & declared dead.In second case report, deceased fell down from height due to electric shock &resulting in head injury. Keywords: electrocution, high voltage electrocution, charring, wound of entry and exit. *Corresponding author Dr. Nilesh A. Devraj Plot No 1, Gutt No 5/1, Samarth Nagar, Pimprala Shivar, Jalgaon, Maharashtra. 425002. Email: [email protected] No: +919833125415 mortality rate. In this case report we are presenting two cases of death due to fatal electrocution which highlights some of the typical features of electrocution due to high voltage such as massive destruction of soft tissue along with exposure of underlying bone. Case Report no 1: A 14yrs old boy was brought to casualty with history of electric shock while playing cricket. He was declared dead at casualty before treatment and dead body was sent for post-mortem examination. After receiving accidental death report from investigating agency and history obtained from relatives and eye witnesses, it was prima facie concluded by us that it was a case of death due to electrocution. The deceased was playing cricket in the vicinity of two high tension electric wires. While playing, the ball got entangled on the top portion of a truck. The deceased climbed up the truck to remove the ball. At that time, there occurred physical contact with high voltage wires and he got electrocuted. On external post-mortem examination, we noticed the clothes were burnt, at the site of electrical injuries. Singing of scalp hairs, eyebrows, eyelashes were present. Multiple wounds of electrocution were present over the dead body as follows. 1) Wound of electrocution over face at the level of lower jaw and extending backwords covering the right lateral neck region and reaching up to lower border of right scapula. It was bone deep. Gross 121 e ISSN:2320-2742 INTRODUCTION Deaths caused by the passage of electric current, irrespective of the source of such current are described as electrocution1. Electrocution is an uncommon cause of death and occurs commonly due to accident2 Electricity has astonishingly very good importance in human’s life. One cannot believe to live without electricity. But we as human being should not overlook the pro’s&con’s of electricity in our life. The endangerment of electricity varies from simple harmless shock to severe muscle contraction, unconsciousness and death. Sometimes the victims may be thrown to ground causing more fatal injuries. The first electrical fatality was recorded in France in 1879 when a stage carpenter was killed by an alternating current (AC) of 250 volts3. In India voltage supply for domestic use electricity is around 220 to 240volts. Electrocution results when a person exposed to fatal amount of electricity and it involves both high voltage (> 600 to 750 V) and low voltage (<600V) currents4. Injuries from high voltage electrocution pose a serious threat to life, increasing the Int J Res Med. 2015; 4(1);121-124 p ISSN: 2320-2734 Death Due to Fatal Accidental Electrocution: A case report charring, blackening, smell of burning and Underlying occipital bone was fractured destruction of soft tissues at the site of jaw (injury due to fall from height). 3) with exposure of periostium of underlying Lacerated wound present over right elbow mandibular bone & teeth with loosening of postero-laterally with fracture of radiustooth from socket was seen. Signs of vital ulna & lower end of humerus (injury due reaction were present. 2) Wound of to fall from height). electrocution was present over left forearm On internal post-mortem examination, on dorso-lateral side extending from lower under scalp hematoma was present over rd 1/3 up to index finger of left hand, it was left fronto- parieto- temporal region with bone deep and underlying bones were subdural hematoma over left cerebral intact. Signs of vital reaction were present. hemisphere at parieto-temporal region. 3) Wound of electrocution was present Subarachnoid hemorrhage was noted all over left thigh at medial border extending over the brain surface. 3rd, 4th, 5thribs were up to scrotum and penis, pubic hairs were fractured on right side with multiple singed and both testis exposed to exterior. lacerations to right lung. Multiple Signs of vital reactions were present. contusions were present left lung. Thoracic On internal post-mortem examination cavity contained 500ml of blood & blood organs, hyoid bone, thyroid cartilage, clots. Petechial hemorrhagic spots were trachea were intact. Petechial hemorrhagic seen on anterior aspect of heart. Other spots were seen on anterior aspect of heart, internal organs were intact & stomach was over both pleurae & meninges. Brain & empty. So based upon history of the case lungs were edematous and congested. & post-mortem findings, we gave our Stomach was empty. So based upon opinion as to the cause of death as “death history of the case & post-mortem due to intracranial hemorrhage due to head findings, we gave our opinion as to the injury following electrocution” cause of death as “death due to DISCUSSION electrocution” Diagram: 1 Distribution of electricity Case Report no 2: (reference no4) 42yr old male was brought in dead condition to the casualty with a history of fall from the electric pole to the ground. The deceased was a wireman by occupation and was working on a high voltage electric pole for maintenance work. Suddenly his head got into contact Photograph of Case report 1: 1showing with electric wires; he got electrocuted and typical burn injury due to fatal fell on the ground. Dead body was sent electrocution for post-mortem examination. On external post-mortem examination, we noticed the clothes were intact having blood stains over shirt. Singings of scalp hairs were present. Two injuries were present over the dead body as follows: 1) wound of electrocution (burn area of size 5cm x 3cm, with crater formation at the site of Photograph of Case report 1: Showing contact) present over right side of scalp at burn injury extending up to scapula the level of parietal region, situated 2cm lateral to midline; it was extending from right parietal region to frontal region with irregular margins and it was bone deep. Underlying bone was fractured. Signs of vital reaction were present. 2) Lacerated wound was present over occipital region of scalp obliquely placed, and was bone deep. 122 Int J Res Med. 2015; 4(1);121-124 e ISSN:2320-2742 p ISSN: 2320-2734 Death Due to Fatal Accidental Electrocution: A case report 11 as seen in this case. The electrostatic Photograph of Case report 1: Showing forces are responsible for the gross burn injury involving genitals & medial mechanical effects on the body and its aspect left thigh clothing which occur in high voltage injuries10. In case report no 1, entry & exit wound of electrocution is difficult to appreciate due to multiple fatal burn wounds, charring at the site of tissue & gross damage as extremely high voltage current causes Photograph of Case report 2: Shows gross destruction & charring of soft tissues black charring of skin over scalp as along with exposure of underlying bone. entry point of electrocution Our finding is consistent with author11who mentioned that in case of high voltage electrocution there may be extensive burning or even charring of the body. In case report no 2. We could appreciate wound of entry of electrocution but wound of exit was not present & associated The laws of physics demand that circuit be external & internal injuries due to fall from completed for a flow of electrons to occur. height following electrocution were noted. It is this flow of electrons that constitutes Electrocution continues to be responsible electric current. The quantum of electrons for a significant number of deaths in adult constitutes the amperage, whereas the population. Deaths are often are force or potential difference between the accidental, associated with work place two ends of circuit constitutes the voltage. injury7. Almost all Indian workers were The effects upon a body depend on both forced to work in the most dangerous jobs the amperage as well as the voltage of 1 without effective safety measures. Many electric current .The amount of current workers are unaware of the potential that will flow through or over the body electrical hazards present in their work may be determined by the formula A= V ÷ environment, which makes them more R, where A is current in amperes, V is vulnerable to the dangers of electrocution. potential difference in volts and R is the Thus, it seems that the high rate of work resistance of the body in ohms. The flow related electrocution mortality in our of current through the body is great, if the country can be due to low safety training voltage is high (more than 1000volts) or if for workers and their employers 12. Incase the resistance is low5. of death due to electrocution unfortunately Most fatalities occur with the domestic in most of the cases there are no pathovoltage between 110 & 380 volts, which is gnomic features, so determination of the the voltage range of houses & industrial cause of death relies heavily on the electricity. The transmission (over circumstances of death and the findings of 13800volt) & distribution (fewer than typical electric burn at autopsy 11. The 13800volt) lines typically carry the high most appropriate steps to take in voltages6. Most of deaths in fatal minimizing the chances of childhood electrocutions isasystole, ventricular electrical injuries and fatalities are to keep fibrillation or respiratory arrest secondary electric appliances in child proof cabinets, to tetanic contraction of respiratory particularly in the bathroom where there is muscles or damage to central respiratory 7& 8 access to water. Most of the electrocution control . Most of the victims of highdeaths are preventable in nature and they tension electrocution die at the scene or can be prevented by implementing proper declared dead before treatment and not all education programs to the society the cases show typical entrance & exit 9 including the electricity board workers wounds , which is similar with this case. 9& with regards to the usage of safety Charring of the skin is frequently present appliances and insulators. 123 Int J Res Med. 2015; 4(1);121-124 e ISSN:2320-2742 p ISSN: 2320-2734 Death Due to Fatal Accidental Electrocution: A case report Conflict of interest: Nil. with emphasis on human factors. J. Source of funding: Nil. Forensic Sci. 1992; 37: 1016- 22. 8. Martinez JA, Nguyen T. Electrical REFERENCES 1. Prof. T. D. Dogra, Lt. Col. injuries. South. Med. J. 2000; 93: AbhijitRudra, Lyon’s Medical 1165-8. Jurisprudence & Toxicology, 11th 9. 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