2003-04-02 EAFE: Forensic Entomology and Neglect of Elderly
From ForensicWiki
Source: Meeting of the EAFE (European Association for Forensic Entomology, Frankfurt, Germany, 2.-4. April 2003):29-30
NEGLECT OF THE ELDERLY: CASES AND CONSIDERATIONS
Mark Benecke
[Artikel über Pflegevernachlässigung Rheinische Post 2006]
Click here for the .pdf of the final article (BENECKE M, JOSEPHI E, ZWEIHOFF R (2004) Neglect of the Elderly: Forensic Entomology Cases and Considerations. Forensic Science International 146 Suppl 1:S195-S199), or for an article about Neglect of Children
Wounds of living persons are a potential target for the same flies that live,
or feed early on corpses [e.g., 1]. This can lead both to complications in
estimation of PMI, or to additional information that might be valuable in
a trial, or during the investigations [2]. With forensic entomology, and
forensic entomologists being more and more present, even lower profile cases
like the neglect of elderly people (without violence being used against them;
i.e., natural death) comes to our attention. Furthermore, much more
people grow older than in the past years which leads to increased awareness
of malpractice of caregivers in the professional, and personal environment
(in German: “Pflege-Vernachlässigung”) [3].
We briefly sketch three cases in which forensic entomology helped to better
understand the circumstances of death, and especially before death.
Case 1
Elderly women found dead in October 2002 in her 3rd floor apartment in urban
Cologne, Germany. Apartment was very clean except of the bath room in which
a bath tub had been filled with water, and clothing. Exclusively dead adult
flies of the species Muscina stabulans FALLÉN were found spread on
the floor; no blow flies in the zoological sense of the meaning were present
in any live stage. Calculation of PMI led to an interval of around three
weeks. This would have been a misconduct of the paid professional care giver
who was supposed to check fort he women every week.
The caregiver claimed that she had called the women ca. two weeks ago to
check on her; the now dead women allegedly rejected a visit. This possibility
could not be ruled out since the old woman was known to be healthy, yet mentally
unstable and behaving “difficult” against everybody.
In clear contrast to the entomological findings, it was assumed that the
care giver tried her best; no prosecution followed.
Case 2
In September 2002, an old woman was found dead in her apartment in an urbanized
town in western Germany. Her foot was wrapped in a plastic bag; inside, numerous
larvae of Lucilia sericata were found. The care giver openly stated that
„it was well possible that the foot of the person was wrapped in a plastic
bag, and that maggots may have been present inside during the lifetime of
the woman“.
The age of the maggots was estimated as four days (4x 24 hrs). However, judging
from the deep tissue loss at the foot, it was discussed that most likely,
the maggots had been feeding on the living women for at least a week whilst
she was still alive but then left the bag to pupate elsewhere. The apartment
could not be checked for pupae, however.
Case 3
In March 2002, the corpse of an old woman found in her apartment in an urban
apartment in a western German town. The apartment was not cleaned up, and
on the actual corpse, the following insects were found: Larval Fannia canicularis
flies, larval Muscina stabulans flies, and adult Dermestes lardarius beetles.
These insects are known to build up populations inside of human housings
[e.g. 4,5] but Fannia frequently hints towards the presence of feces, and
urine in cases of neglect [2]. In this case, further evidence for this possibility
was found in the fact that the skin of the corpse was not fed on by the larvae.
Pupae (of an unknown species) were reported but not collected.
The son of the woman who is slightly mentally disturbed (retarded) is currently
accused of misconduct of taking care of his mother. At the time of the EAFE
congress, the decision of the court will be known, and presented.
Conclusion
From the actual case work, we get the impression that misconduct of elderly
people currently becomes a severe problem in aging societies like Germany.
From a juridical standpoint, it is -- and will be -- very difficult to judge
if the care giver is guilty of misconduct, or not. Forensic entomology can
give important insights into the dynamics, the amount, and the final state
of bodily care that was given to the neglected person.
At the same time, forensic entomology helps to excuse care givers who did
actually do their duty whilst maggot infestation of a person´s wounds
occurred during a normal interval of non-visits.
Acknowledgements
The criminal police forces, and the D.A.´s offices of the cities of
Dortmund, Cologne, and Bonn, as well as the members of the Institute for
Legal Medicine of the city of Dortmund contributed significantly to the cases.
Especially, I wish to thank Dr. Josephi, Dr. Ralf Zweihoff, KHK´in
Doro Christmann (Case 2), and the departments KK 11 (homicide detective´s
bureaus) of the PP´s (Police HQ´s) of Köln, Dortmund, and
Bonn.
References
[1] Fleischmann W, Grassberger M, Erfolgreiche Wundheilung
durch Maden-Therapie, Thieme & Karl F. Haug Fachbuchverlag, 2002.
[2] Benecke M, Lessig R, Child neglect and forensic entomology,
Forensic Science International 120 (2001)155-159.
[3] DPA (German Press Agency), Studie an 17000 Leichen:
Jeder Siebte vor Tod falsch gepflegt, dpa # 051402 Jan 03 (Jan 5, 2003).
[4] Smith KGV, A manual of forensic entomology, The Trustees
of the British Museum (Natural History), London, 1986.
[5] Schroeder H, Klotzbach H, Oesterhelweg L, Puschel K,
Larder beetles (Coleoptera, Dermestidae) as an accelerating factor for decomposition
of a human corpse, Forensic Science International 127 (2002) 231-236.
[6] Benecke M, Insects and Corpses, in: Baccino E (ed.)
16th Meeting of the International Association of Forensic Sciences, Monpellier,
France, Sept. 2-7, 2002, Monduzzi Editore, Bologna, 2002, p. 135-140.
Click here for the .pdf of the final article (BENECKE M, JOSEPHI E, ZWEIHOFF R (2004) Neglect of the Elderly: Forensic Entomology Cases and Considerations. Forensic Science International 146 Suppl 1:S195-S199)
Mark Benecke, Ph.D., Certified & Sworn In Forensic Biologist, International Forensic Research & Consulting, Postfach 250411, 50520 Cologne, Germany; E-Mail: forensic@benecke.com, www.benecke.com, Emergency Phone +49-173-287-3136, FAX +49-221-660-2644.
[Artikel über Pflegevernachlässigung Rheinische Post 2006]
Wounds of living persons are a potential target for the same flies that live,
or feed early on corpses [e.g., 1]. This can lead both to complications in
estimation of PMI, or to additional information that might be valuable in
a trial, or during the investigations [2]. With forensic entomology, and
forensic entomologists being more and more present, even lower profile cases
like the neglect of elderly people (without violence being used against them;
i.e., natural death) comes to our attention. Furthermore, much more
people grow older than in the past years which leads to increased awareness
of malpractice of caregivers in the professional, and personal environment
(in German: “Pflege-Vernachlässigung”) [3].
We briefly sketch three cases in which forensic entomology helped to better
understand the circumstances of death, and especially before death.
Case 1
Elderly women found dead in October 2002 in her 3rd floor apartment in urban
Cologne, Germany. Apartment was very clean except of the bath room in which
a bath tub had been filled with water, and clothing. Exclusively dead adult
flies of the species Muscina stabulans FALLÉN were found spread on
the floor; no blow flies in the zoological sense of the meaning were present
in any live stage. Calculation of PMI led to an interval of around three
weeks. This would have been a misconduct of the paid professional care giver
who was supposed to check fort he women every week.
The caregiver claimed that she had called the women ca. two weeks ago to
check on her; the now dead women allegedly rejected a visit. This possibility
could not be ruled out since the old woman was known to be healthy, yet mentally
unstable and behaving “difficult” against everybody.
In clear contrast to the entomological findings, it was assumed that the
care giver tried her best; no prosecution followed.
Case 2
In September 2002, an old woman was found dead in her apartment in an urbanized
town in western Germany. Her foot was wrapped in a plastic bag; inside, numerous
larvae of Lucilia sericata were found. The care giver openly stated that
„it was well possible that the foot of the person was wrapped in a plastic
bag, and that maggots may have been present inside during the lifetime of
the woman“.
The age of the maggots was estimated as four days (4x 24 hrs). However, judging
from the deep tissue loss at the foot, it was discussed that most likely,
the maggots had been feeding on the living women for at least a week whilst
she was still alive but then left the bag to pupate elsewhere. The apartment
could not be checked for pupae, however.
Case 3
In March 2002, the corpse of an old woman found in her apartment in an urban
apartment in a western German town. The apartment was not cleaned up, and
on the actual corpse, the following insects were found: Larval Fannia canicularis
flies, larval Muscina stabulans flies, and adult Dermestes lardarius beetles.
These insects are known to build up populations inside of human housings
[e.g. 4,5] but Fannia frequently hints towards the presence of feces, and
urine in cases of neglect [2]. In this case, further evidence for this possibility
was found in the fact that the skin of the corpse was not fed on by the larvae.
Pupae (of an unknown species) were reported but not collected.
The son of the woman who is slightly mentally disturbed (retarded) is currently
accused of misconduct of taking care of his mother. At the time of the EAFE
congress, the decision of the court will be known, and presented.
Conclusion
From the actual case work, we get the impression that misconduct of elderly
people currently becomes a severe problem in aging societies like Germany.
From a juridical standpoint, it is -- and will be -- very difficult to judge
if the care giver is guilty of misconduct, or not. Forensic entomology can
give important insights into the dynamics, the amount, and the final state
of bodily care that was given to the neglected person.
At the same time, forensic entomology helps to excuse care givers who did
actually do their duty whilst maggot infestation of a person´s wounds
occurred during a normal interval of non-visits.
Acknowledgements
The criminal police forces, and the D.A.´s offices of the cities of
Dortmund, Cologne, and Bonn, as well as the members of the Institute for
Legal Medicine of the city of Dortmund contributed significantly to the cases.
Especially, I wish to thank Dr. Josephi, Dr. Ralf Zweihoff, KHK´in
Doro Christmann (Case 2), and the departments KK 11 (homicide detective´s
bureaus) of the PP´s (Police HQ´s) of Köln, Dortmund, and
Bonn.
References
[1] Fleischmann W, Grassberger M, Erfolgreiche Wundheilung
durch Maden-Therapie, Thieme & Karl F. Haug Fachbuchverlag, 2002.
[2] Benecke M, Lessig R, Child neglect and forensic entomology,
Forensic Science International 120 (2001)155-159.
[3] DPA (German Press Agency), Studie an 17000 Leichen:
Jeder Siebte vor Tod falsch gepflegt, dpa # 051402 Jan 03 (Jan 5, 2003).
[4] Smith KGV, A manual of forensic entomology, The Trustees
of the British Museum (Natural History), London, 1986.
[5] Schroeder H, Klotzbach H, Oesterhelweg L, Puschel K,
Larder beetles (Coleoptera, Dermestidae) as an accelerating factor for decomposition
of a human corpse, Forensic Science International 127 (2002) 231-236.
[6] Benecke M, Insects and Corpses, in: Baccino E (ed.)
16th Meeting of the International Association of Forensic Sciences, Monpellier,
France, Sept. 2-7, 2002, Monduzzi Editore, Bologna, 2002, p. 135-140.
Click here for the .pdf of the final article (BENECKE M, JOSEPHI E, ZWEIHOFF R (2004) Neglect of the Elderly: Forensic Entomology Cases and Considerations. Forensic Science International 146 Suppl 1:S195-S199)
Mark Benecke, Ph.D., Certified & Sworn In Forensic Biologist, International Forensic Research & Consulting, Postfach 250411, 50520 Cologne, Germany; E-Mail: forensic@benecke.com, www.benecke.com, Emergency Phone +49-173-287-3136, FAX +49-221-660-2644.