title: Death of a seven-month-old child in a washing machine: a case report.
abstract: The authors present a case which brings out a unique modality of child homicide by placing the baby in a washing machine and turning it on. The murder was perpetrated by the baby's mother, who suffered from a serious depressive disorder. A postmortem RX and then a forensic autopsy were performed, followed by histologic examinations and toxicology. On the basis of the results of the autopsy, as well as the histology and the negative toxicological data, the cause of death was identified as acute asphyxia. This diagnosis was rendered in light of the absence of other causes of death, as well as the presence of typical signs of asphyxia, such as epicardial and pleural petechiae and, above all, the microscopic examinations, which pointed out a massive acute pulmonary emphysema. Regarding the cause of the asphyxia, at least two mechanisms can be identified: drowning and smothering. In addition, the histology of the brain revealed some findings that can be regarded as a consequence of the barotrauma due to the centrifugal force applied by the rotating drum of the washing machine. Another remarkable aspect is that we are dealing with a mentally-ill assailant. In fact, the baby's mother, after a psychiatric examination, was confirmed to be suffering from a mental illness-a severe depressive disorder-and so she was adjudicated not-guilty-by-reason-of-insanity. This case warrants attention because of its uniqueness and complexity and, above all, its usefulness in the understanding of the pathophysiology of this particular manner of death.
authors.affiliation: Department of Public Health, Experimental and Forensic Medicine, Unit of Legal Medicine and Forensic Sciences "Antonio Fornari", University of Pavia, Pavia, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Osculati
authors.affiliation: Department of Public Health, Experimental and Forensic Medicine, Unit of Legal Medicine and Forensic Sciences "Antonio Fornari", University of Pavia, Pavia, Italy. visona.silvia@gmail.com.
authors.forename: Silvia Damiana
authors.initials: SD
authors.lastname: Visonà
authors.affiliation: Unit of Legal Medicine, University of Insubria, Varese, Italy.
authors.forename: Laura
authors.initials: L
authors.lastname: Re
authors.affiliation: Unit of Legal Medicine, University of Insubria, Varese, Italy.
authors.forename: Marta
authors.initials: M
authors.lastname: Sozzi
authors.affiliation: Service of Legal Medicine of Canton Ticino, Bellinzona, Switzerland.
authors.forename: Francesca
authors.initials: F
authors.lastname: Castelli
authors.affiliation: Service of Legal Medicine of Canton Ticino, Bellinzona, Switzerland.
authors.forename: Luisa
authors.initials: L
authors.lastname: Andrello
authors.affiliation: Department of Public Health, Experimental and Forensic Medicine, Unit of Legal Medicine and Forensic Sciences "Antonio Fornari", University of Pavia, Pavia, Italy.
authors.forename: Claudia
authors.initials: C
authors.lastname: Vignali
mesh_terms: D001237:Asphyxia / Q000209:etiology / Q000473:pathology*; D001469:Barotrauma / Q000209:etiology / Q000473:pathology; D002498:Centrifugation; D003865:Major Depressive Disorder / Q000523:psychology; D005260:Female; D006708:Homicide; D006794:Household Articles; D006801:Humans; D007223:Infant; D007298:Insanity Defense; D009035:Mothers / Q000523:psychology; D011656:Pulmonary Emphysema / Q000473:pathology; D011693:Purpura / Q000473:pathology
keywords: Child homicide; Filicide; Forensic pathology; Washing machine