Presentation number: AAFS 1

FENTANYL: HISTORY, ABUSE, DANGER

Peter Ausili

American Academy of Forensic Science, Colorado Springs, CO, USA

Illegal drug use and trafficking in the United States is at an all-time high. In addition to traditional drugs of abuse (Heroin, Cocaine, Methamphetamine and Marijuana) there has been a huge increase in the abuse of Novel Psychoactive Substances (NPS) such as Fentanyl during the last 15 years. Illicit abuse of Fentanyl and Fentanyl-related synthetic opioids began in the mid 1990’s of in the United States. This was the result regulations, policies and medical practice that focused on opioid medications (i.e. Oxycodone) as the primary treatment for pain. Hospital management and administration encouraged doctors to reduce patient pain to a self-described level of zero. Pharmaceutical manufacturers were eager to provide the products. As patients became addicted they had difficulty getting prescriptions legally renewed and then sought other sources for similar drugs. Gradually, other supply networks developed to provide Oxycodone and look-alike clandestinely manufactured synthetic opioids. Eventually, US drug control regulations improved, which led to entirely new substances of abuse. Fentanyl became a popular drug of choice. Precursor chemicals originate in China that are then shipped to Mexico for synthesizing into Fentanyl and Fentanyl analogues. These products are commonly mixed with Heroin, Cocaine, Methamphetamine, Marijuana and also compressed into look-alike tablets such as XANAX. It should be noted that the illicit drug user and the drug trafficker frequently don’t know the content or the concentration/potency of the drugs. There are many literature references that refer to the abuse of Fentanyl as like playing “Russian Roulette’. Fentanyl is 50 times more potent than Morphine and 100 times more potent than Heroin. Fentanyl analogues are even more potent. In 2021 there were 100,000 Fentanyl related drug overdose DEATHS in the United States. What about the future?? It might get worse before it gets better. Has anyone heard about Isotonitazine compounds?

Key words: Fentanyl, Synthetic Opioids, Drug Abuse


Presentation number: AAFS 2

COLLABORATION TO EFFECT IDENTIFICATION FOR UNKNOWN INDIVIDUALS RECOVERED IN A FORENSIC CONTEXT

Laura C. Fulginiti

American Academy of Forensic Sciences, Colorado Springs, CO, USA

In 2015 Arizona State University and the Maricopa County Office of the Medical Examiner agreed to collaborate to advance identification efforts for badly degraded and burned decedents. The concept was to apply techniques derived for extracting and amplifying ancient DNA samples to these individuals to assess the efficacy for obtaining useful profiles. In Arizona, as in many arid, hot environments, individuals who die in the desert and are not found for a protracted time are subjected to extremes of temperature, solar exposure and animal predation. These combine to remove the organic matrix of the bone and the most likely sources of usable DNA. Current analytical kits have failed to produce enough DNA for scientific identification. Similarly, in badly burned bodies there is a threshold beyond which standard techniques cannot extract enough DNA to create a strong profile. One mandate of a medical examiner or coroner is to make an identification of decedents within their jurisdiction. When standard techniques are unsuccessful, the decedent remains unidentified. Practitioners are constantly reviewing these cases in the context of scientific advances and thinking outside of the box to effect opportunities for identification. The proposal to use aDNA methodologies for these cases provides a new avenue for success. NIJ funding has allowed testing several methods in order to determine which is the best for yielding enough DNA for identification. The protocols have had differing levels of success ranging from very good to no results. Predictably the cremated and most degraded samples are the ones with minimal yields. DNA profiling is a boon to forensic science in many contexts. Identification of unknown decedents is a small portion, but it plays a critical role. Without identification families are left in limbo, legal processes stop, and law enforcement investigations are derailed. In the United States there are tens of thousands of unidentified decedents languishing in medical examiner and coroner offices, or in pauper cemeteries. Advancing methods for assessing these individuals creates hope that more will move from the unidentified column into the identified column. This research hopes to play a large role in that transition.


Presentation number: AAFS 3

THE PAST, CURRENT, AND FUTURE OF FORENSICS IN THE US. CRIME SCENE TRAINING

Henry Lee1,2,3

1 Henry C. Lee Institute of Forensic Science, West Haven, CT, USA, 2College of Criminal Justice and Forensic Sciences, University of New Haven, USA, 3Singapore Home Team Science & Technology Agency (HTX) (TSAP), Singapore

Contemporary law enforcement has expanded its ability to solve crimes by the adoption of standardized forensic testing procedures. Today, crimes can only be solved by the combinations detailed examination of the crime scene and analysis of forensic evidence, the utilization of the open and close sources of big data bases and the theory of Cloud data mining and crime scene reconstruction. Knowledge of forensic evidence is not only crucial in criminal investigations and prosecutions, but also vital in civil litigations, major man-made and natural disasters, and the investigation of global crimes. However, there was not much consensus on what and how to be training or educate future forensic scientists in crime scene investigation. In the past, this type training is done by localized apprenticeship. The current training program is focused on the standardized procedure for crime scene technician. This type of inadequate training was unfortunately overlooked and created many issues and problems for forensic field. The future crime scene training program should be conducted with a global effort in the ability of observation, and recognition, the systematic and logical analysis, the correct interpretation of test results, and reconstruction of the scene. This includes not only the first responding officer, detective, the crime scene technicians, investigators, forensic scientists but also the judges and attorneys. The training of advanced investigative skills (such as GPS positioning, Cell phone tracking, Social network, E-evidence, Video image analysis, Big Date Analytics, Artificial intelligence, Theory formation, Forensic DNA Genealogy, Trace Evidence Analysis, Pattern Evidence Recognition and Crime Reconstruction) will be discussed, and the ability to observe and  analysis of crime scene and Forensic Evidence will also be covered, Famous cases will be utilized to illustrate the importance of new concepts in forensic crime scene training.


Presentation number: AAFS 4

FORENSIC SCIENCE STANDARDIZATION EFFORTS BY THE AMERICAN ACADEMY OF FORENSIC SCIENCES (AAFS) ACADEMY STANDARDS BOARD (ASB)

Carl R. McClary

Department of Justice, Bureau of Alcohol, Tobacco, Firearms, and Explosives, Atlanta, Georgia, USA

The goal of this presentation is to educate an international audience on the history and progress and also the motivation behind the American Academy of Forensic Sciences, AAFS, Academy Standards Board, ASB. The presenter is the past president of the Academy with extensive experience with standards development organizations. The AAFS’ contribution to forensic science standards has been significant since first forming its standards development organization beginning in 2015. In that same year it received American National Standards Institute, ANSI, accreditation for the American Standards Board, the ASB. Material and Methods – Academy Standards Board, ASB, statistics on standards, guidelines, and technical reports were utilized to present a historical account of ASB progress. When the ASB was created, consensus bodies were formed representing numerous forensic science disciplines. Within the consensus bodies, the interest categories, developed and approved by ANSI, represent various stakeholders who provide various perspectives resulting in standards that meet necessary objectives by the end user. A public balloting process, an ANSI requirement, ensures a free and open process. Results – The presentation will include types of interest categories, stakeholders, ASB procedural requirements, and up to date progress and goals of the ASB consensus bodies. Since the date of inception, the ASB has gone from an idea to a fully functioning development program with volunteers from thirteen (13) forensic disciplines creating over 76 standards, guidelines, or technical records. Conclusion – The ASB ‘s progress in publishing standards, guidelines, and technical reports is impressive given the relatively short period of time since they were formally established and accredited by ANSI. That progress, along with the history of the program, will be provided in detail in this presentation.

Key words: AAFS, ASB, forensic standards


Presentation number: AAFS 5

CORRECTING MISCARRIAGES OF JUSTICE – INNOCENCE PROJECT OF CROATIA

Damir Primorac1,2, Lucija Sokanovic3, Andrej Bozhinovski4

1Faculty of Law, University of Mostar, Mostar, Bosnia and Herzegovina, 2University Department of Forensic Sciences at University of Split, Split, Croatia, 3Faculty of Law, University of Split, Split, Croatia, 4Department of Criminal Law, Faculty of Law, University of Zagreb, Zagreb, Croatia

The presentation focuses on the issue of wrongful convictions and subsequent DNA testing as a method for proving innocence at persons deprived of liberty, through the perspective of the newly established and experimental “Innocence Project in Croatia”. The presenters will talk about the project’s main aim, specific objectives, as well as obtained initial results from the field research. Furthermore, the presenters will present the positive influence of the American innocence projects of the Croatian criminal justice system, through the perspective of the Croatian legal practice and the position of the criminal justice system as a whole concerning the ramification, obtaining and storage of DNA evidence from severe form of criminal acts, including the re-opening of the criminal procedure due to new DNA evidence as a cause wrongful conviction. The presentation will conclude with the encouragement of establishing a national database providing detailed information on previous cases of wrongful convictions and the positive experiences from the U.S. National Registry of Exonerations and the establishment of conviction integrity units as positive examples from which Croatia and other legal jurisdictions in the region should learn.


Presentation number: AAFS 6

ARREST-RELATED DEATH BY PRONE RESTRAINT CARDIAC ARREST

Victor W. Weedn1,2, Alon Steinberg3; Pete Speth4

1District of Columbia Office of the Chief Medical Examiner, SW, Washington, DC, USA, 2Department of Forensic Sciences, George Washington University, NW, Washington, DC, USA, 3Cardiology Associates Medical Group, Ventura, CA, USA 4Retired forensic pathologist/medical examiner; Consultant, Wenonah, NJ, USA

Several causes of death have been postulated for agitated subjects who have succumbed after a police encounter, particularly when they have been restrained in a prone position.  Much of the literature has focused on excited delirium or restraint asphyxia as the cause of these deaths; often stress with underlying cardiac issues has been imputed.  A recent review of the literature declares that restraint is the common factor.1 More recently, Steinberg ascribed acute severe metabolic acidosis with an inability to compensate with respiratory alkalosis as the cause of these deaths in the setting of prone restraint and proffered the term, “Prone Restraint Cardiac Arrest” (PRCA).2 Pulseless electrical activity (PEA) and asystole are consistent with this concept.  We present two cases that demonstrate the danger of prone restraint and, we believe, serve as examples of PRCA. The first case involved an obese 51-year-old male subject, high on PCP and cocaine and hallucinating.  His hands were cuffed behind his back and his legs shackled by police while supine on the ground.   Emergency medical personnel placed him prone and strapped on a manual stretcher, which was then placed on a wheeled stretcher and further straps placed.  He struggled against the restraints, but then became unconscious as he was loaded on the ambulance.  He was repositioned supine in the ambulance.  He had been prone for 10 minutes.  His initial EKG rhythm was bradycardia, but subsequently no carotid pulse was felt and then the electrical activity was lost (asystole).  He arrived in the emergency room in a state of pulseless electrical activity (PEA), but he was successfully resuscitated.  His end title CO2 was found to be markedly elevated.  Upon his hospital admission, an arterial blood gas revealed severe acidosis (pH of 7.015) and a significantly elevated pCO2 (70.5 mmHg).  An echocardiogram in the hospital showed a normal heart function.  He died of brain death 3 ½ days after his arrest.  Autopsy revealed an enlarged and dilated heart with no gross atherosclerosis and evidence of reperfusion injury. The second case involved an obese 41-year-old male, high on amphetamine and methamphetamine, seen by police stepping in and out of a busy roadway, shouting and talking to an imaginary, threatening person.   He sat, sweating and breathing heavily, as requested by the police and his hands were cuffed behind his back.  He suddenly got up and began to run when three officers took him to the ground where he thrashed about and kicked his legs. Police rolled him prone and leg shackles were applied.  At one point, he uttered, “I can’t breathe!”  Emergency medical personnel arrived and placed a rigid board on his back and an officer was asked to sit on top.  After a couple of minutes, he was turned supine and found to be unresponsive.  He had been prone for 15 minutes.  ACLS was initiated.  The EKG revealed PEA which deteriorated to asystole.  Venous blood gases revealed a profound acidosis (pH 6.64) and a markedly elevated pCO2 (157 mmHg).  He was pronounced dead shortly after arrival in the emergency room.  An autopsy disclosed bruising on his back, a moderately enlarged heart with focal severe coronary artery stenosis.

References:

  1. Strömmer EMF, Leith W, Zeegers MP, Freeman MD. The role of restraint in fatal excited delirium: a research synthesis and pooled analysis. Forensic Sci Med Pathol. 2020; 16(4):680–692. DOI: 10.1007/s12024-020-00291-8.
  2. Steinberg A. Prone Restraint Cardiac Arrest: A Comprehensive Review of the Scientific Literature and an Explanation of the Physiology. Med Sci Law. 2021; 61(3):215-226. DOI: 10.1177/0025802420988

Presentation number: AAFS 7

OPEN WATER AQUATIC SCENE PROCESSING FOR DEATH INVESTIGATIONS

Andrea Zaferes

Forensic Aquatic Consulting & Training, LLC., Shokan, New York, USA

Learning Overview: After attending this presentation, attendees will understand the critical need of crime scene investigators (CSI) and other investigators to identify, document, and preserve potential evidence on open water scenes. Impact on the Forensic Science Community: This presentation will impact the forensic science community by demonstrating the unique challenges presented by bodies reportedly found in open water scenes, the detection and documentation of evidence in open water scenes, and the recognition and investigation of crimes that involve open water scenes. This presentation will present novel solutions, tools, and protocols to utilize CSIs, marine patrol officers, public safety dive team personnel, and other first responders, to identify and collect often-missed evidence. Bodies reportedly found in open water (BRFIOW) may represent natural, accident, suicide, and homicide manners of death. In the latter case the death may have occurred on land with a postmortem body disposal, may have initiated on land with resulting incapacitation followed by submersion with one of the causes of death being drowning, or with the homicide solely involving submersion and drowning.  Asphyxiation, whether criminal, accidental, or suicidal, is a process that can be fatal or non-fatal. Asphyxiation directly impedes respiration or blood flow to the brain through various methods, such as strangulation (1), drowning (2), and inert gas (3). Criminal asphyxiation occurs in domestic violence (4), child/elder abuse (5), sex crimes (6), state and non-state tortur (5), and human trafficking (7).  The diagnosis of fatal asphyxia, criminal or benign, requires an informed and accurate scene investigation, and a careful exclusion of underlying injury or disease processes (8). Despite the adoption of widespread legislation(x) specifically targeting asphyxiation violence, evidence collection is sparse and convictions are rare (9). This is partly because criminal asphyxiation often presents with nonspecific findings (10) and minimal or no obvious external injury, can be a diagnosis of exclusion, and lends itself to crime scene staging (11).  Therefore, these cases require the preservation and collection of often circumstantial evidence present at the initial scene. Capturing this evidence is especially critical when victims and witnesses may be unable to participate beyond the initial scene for fear of retaliation and safety. As such, crime scene investigators (CSIs) are in a unique position to provide a variety of solutions. It is the job of CSIs to document and process a scene (location, victim, suspect) in its totality as it appears upon arrival.  In criminal asphyxiation cases, CSIs are the most apt to capture often missed evidence, including fingernail scrapings and injuries present on suspects. CSIs may also be the only practitioners who can forensically document initial and follow-up injury presentation. For example, in non-sexual asphyxiation cases, victims are unlikely to receive forensic nurse examinations. CSIs’ interactions with victims and suspects can also provide unique opportunities to identify and document signs and symptoms of asphyxia and indicators of abuse. For equivocal fatal cases, CSIs can provide the information necessary for investigators to detect staged scenes and for medical examiners to accurately determine cause and manner of death. This novel use of CSIs can be achieved by developing protocols, using investigative forms, and implementing training. Protocols are needed to dispatch CSIs to possible criminal asphyxiation scenes and to provide guidance for evidence recognition, documentation, and processing. CSIs must also be properly equipped with knowledge and evidence-based forms in order to effectively work these often-challenging cases. A current obstacle, as will be demonstrated in this presentation, is insufficient CSI training on criminal asphyxiation in the US as shown by a lack of its mention in CSI textbooks and training syllabi. Overcoming this requires a forensic community response.  As a first step in this response, this presentation will introduce tools for CSIs, including investigative forms and protocols for possible asphyxiation scenes. This presentation illustrates the challenges presented by criminal asphyxiation, provides solutions that CSIs can provide, and CSI tools for investigating strangulation cases. With standardized agency protocols, tools, and specialized criminal asphyxiation training, CSIs can help identify, document, and preserve critical evidence in these cases.

References:

  1. Messing JT, Patch M, Wilson JS, Kelen GD, Campbell J. Differentiating among Attempted, Completed, and Multiple Nonfatal Strangulation in Women Experiencing Intimate Partner Violence. Womens Health Issues. 2018 Jan-Feb;28(1):104-111. doi: 10.1016/j.whi.2017.10.002.
  2. Leth PM. Homicide by drowning. Forensic Sci Med Pathol. 2019 Jun;15(2):233-238. doi: 10.1007/s12024-018-0065-9.
  3. Cuypers E, Rosier E, Loix S, Develter W, Van Den Bogaert W, Wuestenbergs J, Van de Voorde W, Tytgat J. Medical Findings and Toxicological Analysis in Infant Death by Balloon Gas Asphyxia: A Case Report. J Anal Toxicol. 2017 May 1;41(4):347-349. doi: 10.1093/jat/bkx006,
  4. Pilla M, van den Heuvel C, Musgrave I, Byard RW. Increasing incidence of nonlethal inflicted injuries in paediatric homicides: A 45-year study. J Forensic Leg Med. 2018 Oct;59:4-7. doi: 10.1016/j.jflm.2018.07.007.
  5. Zilkens RR, Phillips MA, Kelly MC, Mukhtar SA, Semmens JB, Smith DA. Non-fatal strangulation in sexual assault: A study of clinical and assault characteristics highlighting the role of intimate partner violence. J Forensic Leg Med. 2016 Oct;43:1-7. doi: 10.1016/j.jflm.2016.06.005. Epub 2016 Jun 24.
  6. Sarson J, MacDonald L. Developing a normative standard: Acknowledging non-state torturers’ acts inflict femicidal risks. Femicide Volume XIII Collecting Data on Femicide. 2020, 94-101.
  7. Chan HCO, Beauregard E. Prostitute homicides: A 37-year exploratory study of the offender, victim, and offense characteristics. Forensic Sci Int. 2019 Jan;294:196-203. doi: 10.1016/j.forsciint.2018.11.022.
  8. Byard RW. Asphyxia Pathological Features. In Payne-James J, Byard RW, editors. Encyclopedia of Forensic and Legal Medicine (Second Edition).  Elsevier B.V. 2016;252-260.  
  9. Reckdenwald A, King DJ, Pritchard A. Prosecutorial Response to Nonfatal Strangulation in Domestic Violence Cases. Violence Vict. 2020 Apr 1;35(2):160-175. doi: 10.1891/VV-D-18-00105
  10. Cordner S, Ehsani J, Bugeja L, Ibrahim J. Pediatric Forensic Pathology: Limits and Controversies. The inquiry into Pediatric Forensic Pathology. Ontario, Canada. Victorian Institute of Forensic Medicine. November 2007, Amended February 2008.
  11. Bitton, Yifat, and Hava Dayan. “‘The Perfect Murder’: An Exploratory Study of Staged Murder Scenes and Concealed Femicide. The British Journal of Criminology 59.5 (2019): 1054-1075.

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Published: June 21st, 2022;

Copyright: © 2022 ISABS & IAR Publishing. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.