title: Integrating engineering principles into the medico-legal investigation of a rare fatal rollover car accident involving complex dynamics.
abstract: Rollover car accidents can be the result of forceful steering or hitting an obstacle that acts like a ramp. Mortality from this type of car accident is particularly high, especially when occupants are thrown out of the vehicle. We report a case of a 67-year-old man who died after a rollover accident that occurred when he was driving a car equipped with a glass moonroof. He was found inside his car with his safety belt correctly fastened and the roof shattered. At autopsy, a wide avulsion injury of the head was observed, which was associated with an atlanto-axial dislocation and full-thickness fracture of the cervical body and posterior facet joints of the seventh cervical vertebra. The data collected at the scene of the accident were integrated with the autopsy results to yield a forensic engineering reconstruction. This reconstruction elucidated the dynamics of the event and correctly ascribed the lesions observed at autopsy to the phases of the rollover. Afterward, an analysis of the scientific literature concerning rollover crash tests was conducted to understand why the driver sustained fatal injuries even though his seatbelt was properly fastened.
authors.affiliation: Institute of Public Health, Legal Medicine Section, Catholic University of the Sacred Heart, Largo Francesco Vito 1, 00168, Rome, Italy. vincenzograssi@live.com.
authors.forename: Vincenzo M
authors.identifier: http://orcid.org/0000-0001-7632-128X
authors.initials: VM
authors.lastname: Grassi
authors.affiliation: Institute of Public Health, Legal Medicine Section, Catholic University of the Sacred Heart, Largo Francesco Vito 1, 00168, Rome, Italy.
authors.forename: Flaminia
authors.initials: F
authors.lastname: Castagnola
authors.affiliation: Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Rome, Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: Miscusi
authors.affiliation: Institute of Public Health, Legal Medicine Section, Catholic University of the Sacred Heart, Largo Francesco Vito 1, 00168, Rome, Italy.
authors.forename: Fabio
authors.initials: F
authors.lastname: De-Giorgio
mesh_terms: D000063:Accidents, Traffic; D000368:Aged; D001268:Atlanto-Axial Joint / Q000293:injuries / Q000473:pathology; D002574:Cervical Vertebrae / Q000293:injuries / Q000473:pathology; D000069836:Degloving Injuries / Q000209:etiology / Q000473:pathology; D044707:Forensic Sciences / Q000379:methods; D006801:Humans; D004204:Joint Dislocations / Q000209:etiology / Q000473:pathology; D008297:Male; D055585:Physical Phenomena; D012535:Scalp / Q000293:injuries; D016103:Spinal Fractures / Q000209:etiology / Q000473:pathology
keywords: Atlanto-axial dislocation; Forensic autopsy; Forensic engineering reconstruction; Road car accident; Rollover