ORCID Profile
0000-0002-9545-1917
Current Organisation
University of Adelaide
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Publisher: Elsevier BV
Date: 05-2019
DOI: 10.1016/J.JFLM.2019.04.002
Abstract: Tuberculosis (TB) is an infectious disease caused by Mycobacterium tuberculosis (MTB) that is most often transmitted by the inhalation of bacteria-containing aerosols. While there has been a decline in numbers of cases in certain countries, large population movements, the increasing emergence of drug-resistant strains and the association with human immunodeficiency virus (HIV) infection make it a disease that is increasingly seen in forensic practice. Mortuary staff are at risk of infection from penetrating sharp injuries, droplet inhalation, ingestion, direct inoculation, through skin breaks or through mucous membranes of the eyes, nose and mouth. While the health and safety measures outlined by agencies may vary slightly, the principles of handling infectious autopsy cases remain the same with awareness and education, immunisation and regular tuberculin testing of staff, pre-necropsy screening of decedents, use of personal protective equipment, and the implementation of safe sharps practices and measures to reduce aerosol formation.
Publisher: Springer Science and Business Media LLC
Date: 08-09-2023
Publisher: SAGE Publications
Date: 04-09-2023
Publisher: Elsevier BV
Date: 11-2021
Publisher: Springer Science and Business Media LLC
Date: 25-03-2022
DOI: 10.1007/S12024-022-00471-8
Abstract: Sodium nitrite (NaNO 2 ) is a compound with broad practical applications in food preservation, automotive maintenance, and animal control. Sodium nitrite is also potentially fatal when ingested, as it interferes with the ability of red blood cells to transport oxygen. While incidents of accidental consumption have been reported in the literature, case reports of sodium nitrite being used as a pharmacological suicide agent are becoming more frequent. Therefore, a study was undertaken to evaluate trends in sodium nitrite deaths in South Australia between 2000 and 2019. All cases of fatal sodium nitrite ingestion were identified in the Toxicology database and autopsy reports at Forensic Science SA (FSSA). Ten cases of fatal sodium nitrite ingestion were identified, with the rate of cases increasing significantly over the study period ( p .001). Of the ten deaths attributed to sodium nitrite toxicity, eight were male, and two were female. The age range of decedents was 22–74 years (mean 51.9, SD 21.1), 22–74 years for males (mean 58.4, SD 18.2) and 23–29 years for females (mean 26.0, SD 4.2). Males (80%) and those with a history of depression and/or suicidal ideation (70%) were over-represented within the study population. While autopsy findings were generally consistent with the literature, scene findings emphasized the accessibility of sodium nitrite to the general public. This study highlights both a significant increasing trend in the use of sodium nitrite in suicides and important analytical limitations in the evaluation of suspected cases.
Publisher: Elsevier BV
Date: 11-2020
Publisher: SAGE Publications
Date: 23-06-2023
DOI: 10.1177/00258024231183504
Abstract: Tapentadol is a relatively new synthetic opioid analgesic prescribed for the management of moderate to severe pain. While tapentadol has been shown to be more effective than traditional opioid analgesics, it still carries the risk of addiction, abuse, and misuse. In Australia, tapentadol has become one of the top five most commonly prescribed opioid drugs, with prescriptions increasing by approximately 150,000 each year since it first became available. The rapid increase in tapentadol prescriptions has occurred in parallel to an increasing number of post-mortem tapentadol detections in South Australia (SA). While the number of deaths in SA related to tapentadol use was low in the current study, findings suggest that an increasing trend of deaths involving tapentadol will continue in parallel to a rapidly increasing number of prescriptions, mirroring trends associated with traditional opioids in SA. As a comparatively new opioid analgesic, monitoring future trends will be important to determine if additional prescribing education, intervention, or restrictions are required.
Publisher: Springer Science and Business Media LLC
Date: 30-08-2019
DOI: 10.1007/S12024-019-00161-Y
Abstract: Tuberculosis (TB) is a bacterial infection caused by Mycobacterium tuberculosis. Although primarily a disease of the respiratory system it may be found in any organ or tissue. Global population movements and the emergence of resistant strains are contributing to increasing numbers of cases in certain populations. Subtlety of symptoms and signs, chronicity of disease and failure to seek medical assistance may result in the diagnosis only being made at the time of autopsy. For this reason forensic pathologists need to understand the protean manifestations of the disease and the variable mechanisms by which TB may cause death. This atlas overview provides descriptions of the pathological manifestations of TB in a variety of organs with accompanying illustrations. It serves as a summary of conditions that should be checked for at autopsy in suspected or confirmed cases.
Publisher: Elsevier BV
Date: 08-2019
DOI: 10.1016/J.JFLM.2019.06.003
Abstract: Although the diagnosis of drowning may appear straightforward the reality is that it is sometimes one of the most difficult in forensic pathology. To begin with, there is no universal agreement on what constitutes drowning with some definitions using the term in the absence of a lethal outcome. Next are the significant problems that arise in finding immersed bodies and in assessing the death scene. Prolonged post mortem intervals are associated with artefactual modifications of the body from putrefaction and post mortem animal predation. Both of these may create and disguise injuries. The absence of pathognomonic pathological features at autopsy and the presence of potentially life threatening underlying organic illnesses complicate determination of both the cause and manner of death. There may even be no autopsy findings to indicate that immersion had occurred. Finally, the unreliability of laboratory tests with significant overlap with control cases where death had no association with immersion presents further problems. Thus lethal drowning remains a complex event that requires the use of a wide variety of information sources, not just data gleaned from the dissection table.
Publisher: Elsevier BV
Date: 02-2020
DOI: 10.1016/J.JFLM.2020.101914
Abstract: While planned complex suicides utilize more than one method, on occasion a planned suicide merely involves augmentation of the lethality of the chosen single method. A study was undertaken of augmented suicidal drownings from Forensic Science SA, Adelaide, Australia over a 25-year period (1993-2017). 493 cases (M:F 2.6:1) were found in which death was attributed to drowning. The age range for males was 7mths-93yrs (mean 43.7yrs) and for females 11mths-87yrs (mean 48.2yrs). A subset of 116 suicidal drownings (M:F 1.2:1) had a male age range of 17-86yrs (mean 52.3yrs) and for females 19-68yrs (mean 57.4yrs). 16 in iduals in this group (3% of drownings overall) had utilised weights to assist in their submersion (M:F 1.7:1), with an age range for males of 30-84yrs (mean 63.3yrs) and for females 38-81yrs (mean 54.6yrs). The most common weights were bricks, rocks or concrete blocks (N = 7) with weights that were tied to the body most often attached to the neck (N = 7). Augmented drowning by using weights to enhance submersion was not common in this population and was predominantly a technique utilised by older males. Augmentation of a suicide method may be extremely useful support at a death scene to exclude an accident.
Publisher: Informa UK Limited
Date: 05-05-2020
Publisher: Springer Science and Business Media LLC
Date: 09-08-2022
DOI: 10.1007/S12024-022-00511-3
Abstract: This study was undertaken to review fatal cases of insulin overdose in South Australia (SA) over a 20-year period to assess rates and characteristics of insulin-related deaths among insulin-dependent diabetics and non-diabetics for all manners of death. Records from the National Coronial Information System (NCIS) and Forensic Science SA (FSSA) were searched for all cases of fatal insulin overdose in South Australia (SA) between 2000 and 2019. Collected variables included age, sex, cause of death, scene findings, manner of death, decedent medical and personal histories, biochemistry, toxicology, histopathology, and autopsy findings. Statistical analyses were performed using R (version 4.1.2). Forty cases of insulin overdose were identified in SA between 2000 and 2019. Twenty-nine cases (72.5%) were suicides, with the remaining cases classified as accidental or undetermined intent. Thirteen of the 22 insulin-dependent diabetics (59%) had a history of depression, 10 of whom had previously demonstrated suicidal ideation. The current study has shown that suicides using insulin among insulin-dependent diabetics are equally as prevalent, if not more so than fatal accidental insulin overdoses. This can largely be attributed to insulin-dependent diabetic access to a potentially lethal substance. Suicide prevention strategies should focus on insulin-dependent diabetics with a history of depression, particularly for those with access to rapid-acting insulin.
Publisher: Elsevier BV
Date: 05-2019
DOI: 10.1016/J.JFLM.2019.04.003
Abstract: Tattoos have been previously linked to high-risk behaviours involving drug use, sexual promiscuity, mental health disorders such as depression and subsequent suicidality, aberrant personality traits including lack of sociability and reduced inhibition, psychopathy and schizophrenia. All of these have been associated with violent and early deaths. Given the recent increase in numbers of in iduals being tattooed in Western communities, a retrospective study was undertaken of 100 consecutive autopsy cases with tattoos over a 5-year period from 2013 to 2017, with age and sex-matched controls. Although those with ≥5 tattoo regions were slightly younger than those with <5, 47.4 compared to 49.7 years, this did not reach statistical significance (p = 0.35). Similarly, there were no significant differences in the cause and manner of death among the groups (p = 0.09). This study has, therefore, shown no significant association between the number of tattoos and premature mortality, or between the cause and manner of death and the presence or absence of tattoos. Previous stereotypes regarding tattooed in iduals may no longer apply.
No related grants have been discovered for Lilli Stephenson.