title: The pathology of lethal exposure to the Riot Control Agents: towards a forensics-based methodology for determining misuse.
abstract: The aim of this is to review deaths associated with the use of Riot Control Agents (RCAs) and to assess how the presenting pathologies is such cases may better inform cause of death conclusions upon autopsy. We also sought to present which additional steps should be added to the Minnesota protocol and the European harmonization of medico-legal autopsy rules in suspected cases of deaths associated with the use of RCAs. We included 10 lethal cases in our study. In three cases, RCAs were found to be the sole cause of death, in three cases RCAs were ruled a secondary cause of death due asphyxia or asthma subsequent to exposure to RCAs and in four cases RCAs were contributory factors to death. In three cases the responsible agents were identified as Chloroacetophenone (CN), Chlorobenzylidene malononitrile (CS) and Oleoresin capsicum (OC) and in the remaining 7 cases, the agent was OC alone. As there are no specific findings in suspected cases of death associated with RCA use, establishing cause of death and whether RCAs are the sole cause or only a contributory factor will be based on the elimination of other possible causes of death. For this reason, a specifically structured autopsy is essential. This specifically structured autopsy should contain basic principles of the Minnesota Protocol and the European harmonization of medico-legal autopsy rules with the following additional steps taken: examination of clothing, eyes, and skin; examination of pharyngeal, tracheobronchial, and eusophegeal mucosas; and a thorough recording of the steps taken by the party conducting the arrest, including other possible causes of in-custody death, as well as a detailed medical history of the deceased.
authors.affiliation: Department of Forensic Medicine, Bulent Ecevit University, Zonguldak, Turkey. Electronic address: sadik_toprak@yahoo.com.
authors.forename: Sadik
authors.initials: S
authors.lastname: Toprak
authors.affiliation: Istanbul University, Institute of Forensic Medicine, Istanbul, Turkey. Electronic address: gokhanersoy@yahoo.com.
authors.forename: Gokhan
authors.initials: G
authors.lastname: Ersoy
authors.affiliation: Stockholm International Peace Research Institute, Signalistgatan 9, 169 70 Solna, Sweden. Electronic address: hart@sipri.org.
authors.forename: John
authors.initials: J
authors.lastname: Hart
authors.affiliation: Stockholm International Peace Research Institute, Signalistgatan 9, 169 70 Solna, Sweden. Electronic address: clevestig@sipri.org.
authors.forename: Peter
authors.initials: P
authors.lastname: Clevestig
mesh_terms: D000328:Adult; D001237:Asphyxia / Q000139:chemically induced; D001249:Asthma / Q000139:chemically induced; D049429:Forensic Pathology / Q000379:methods*; D053593:Forensic Toxicology; D006801:Humans; D008297:Male; D008487:Medical History Taking; D008875:Middle Aged; D009206:Myocardium / Q000473:pathology; D010936:Plant Extracts / Q000009:adverse effects / Q000506:poisoning; D020545:Respiratory Mucosa / Q000473:pathology; D012137:Respiratory System / Q000473:pathology; D012304:Riot Control Agents, Chemical / Q000009:adverse effects* / Q000506:poisoning*; D009763:o-Chlorobenzylidenemalonitrile / Q000009:adverse effects / Q000506:poisoning; D002721:omega-Chloroacetophenone / Q000009:adverse effects / Q000506:poisoning
chemical_list: D010936:Plant Extracts; D012304:Riot Control Agents, Chemical; C018620:oleoresins; D009763:o-Chlorobenzylidenemalonitrile; D002721:omega-Chloroacetophenone
keywords: Crowd control agent; Forensic pathology; Forensic science; Oleoresin capsicum; Pepper spray; Riot Control Agent