title: ["Natural" death of a person under the care of a custodian].
abstract: An ambulance service doctor was called to the death of a 76-year-old woman and attested cardiac arrest and psycho-organic brain syndrome as the cause of death on the death certificate. At the second external examination mandatory before cremation, extensive hematomas were detected on the right thorax and multiple haematomas in the face and on the forehead. The autopsy initially ordered by the public health officer revealed serial rib fractures and a fractured skull. After notifying the prosecutor, a forensic autopsy was ordered and death was found to have been caused by fat embolism following massive blunt force to the thorax with serial rib fractures and haematopneumothorax. After that, the adopted son, who had been appointed care custodian for the woman, and his wife were suspected, because they had given contradictory explanations for the injuries. At first, they were only suspected of failure to render assistance, but in the end they were both charged with murder. Only because of the second external examination prescribed by the law still in force could the errors of the improper first external examination be corrected.
authors.affiliation: Institut für Rechtsmedizin der Universität Essen.
authors.forename: Kurt
authors.initials: K
authors.lastname: Trübner
authors.forename: Manfred
authors.initials: M
authors.lastname: Kleiber
authors.forename: Steffen
authors.initials: S
authors.lastname: Heide
mesh_terms: D000368:Aged; D001344:Autopsy; D003482:Custodial Care / Q000331:legislation & jurisprudence*; D003704:Dementia / Q000473:pathology*; D003937:Diagnosis, Differential; D004552:Elder Abuse / Q000331:legislation & jurisprudence*; D005104:Expert Testimony / Q000331:legislation & jurisprudence; D005260:Female; D005858:Germany; D006323:Heart Arrest / Q000473:pathology*; D006708:Homicide / Q000331:legislation & jurisprudence*; D006801:Humans; D009104:Multiple Trauma / Q000473:pathology*