Plevinskis P., Varsan E.

FORENSIC MEDICINE

Scentific article

The article discusses the problematic issues of the forensic service in the conditions of the fire emergence with a large number of victims, on the example that occurred in one of the remote areas of the Odessa region. The problematic issues of diagnosis of thermal injuries and poisoning by toxic products of combustion, as well as the specifics of the work of forensic doctors at the scene of the incident and in the sectional hall, are considered. Attention is also paid to the shortcomings in the organization of such activities − the lack of a developed regulatory framework for the occurrence of an emergency situation, including fire related, the lack of proper specialized training of experts in these cases, shortcomings in establishing interaction between experts and judicialinvestigative authorities. The overwhelming majority of recommendations currently available concern standard situations − detection at place of incident one, rarely − two or more dead bodies, the presence of one or several victims among the survivors. At the same time, in present, more and more often began to meet completely non-standard situations of traumatizing people − situations where the defeat is massive (the death toll is estimated at least by the dozens, injured survivors, by the dozens and hundreds). The fires also are included here; and the forensic doctors are engaged in. These situations fall under the concept of emergency. In wide sense, an emergency can be defined as a combination of negative factors that have developed to this point, creating a certain situation in which a significant deviation from the normal process takes place. Us, as forensic doctors, will interest emergency situations attended with appearance of large number of victims. The specificity of these incidents makes ordinary standard recommendations unsuitable for the work of forensic doctors at the scene of accident, and requires a completely different tactic of forensic medical activity, a tactic which will be based on the highest efficiency and good organization of the forensic medical service. The basis of this study was the case that took place on July 31, 2015 in one of the remote areas of the Odessa region, inside the hotel (hereinafter the time and place of the incident, the plot of the case was changed for ethical reasons; these changes cannot influence on exposition of narrow medico-legal data and on the interpretation of the results of the study). In the hotel there was a fire that caused a massive loss of life. We analyzed data such as the structure of causes of death, the age and sex of the victims, as well as features of the organization and production of forensic medical activities in this emergency. Deficiencies in the work of the experts were identified and analyzed. The specifics of such incidents should include: 1) a large number of victims; 2) extremely high intensity of mechanical traumatic effects on the bodies of the victims, the impact of toxic compounds and the presence of combined injuries; 3) a high degree of destruction of bodies, up to individual fragments, which greatly complicates the identification of the dead; 4) the large size of the scene, which complicates the primary inspection and requires the involvement of a significant number of participants, including specialists; 5) a tight time frame for the inspection of the scene of incident, establishing the preliminary causes of death, identification the victims. So, the analysis of expert practice shows that in emergency situations attended with mass death of people and appearance of large number of victims, at the scene of incident are mainly involved the forces and possibilities only of the territorial Regional Bureau of Forensic Medicine in whose territory the incident took place. It seems that further research on this issue should be directed to the development of a normative base for the forensic medical service in cases of emergencies with a mass number of victims, to specific algorithms for the experts activities, the order of their interaction with each other and with the judicial and investigative authorities in such cases.

emergency situations, fire, toxic combustion products, forensic (medico-legal) examination, mass death of people, inspection of the scene of the incident

1. Matyishev АА, redaktor. Osmotr trupa na meste ego obnaruzheniya. Sankt-Peterburg: Lan; 1997. 288 s. [in Russian].
2. Plevinskis PV. Spetsifika doprosa, sledstvennogo eksperimenta i proverki pokazaniy na meste pri rassledovanii prestupleniy protiv zhizni i zdorovya. Chernovtsyi: Finart; 2012. 147 s. [in Russian].
3. Matyishev АА, Molin YuA, redaktoryi. Osmotr mesta proisshestviya i trupa. Sankt-Peterburg: Professional; 2011. 532 s. [in Russian].
4. Tuchik ES. Nauchno-organizatsionnyie printsipyi sovershenstvovaniya effektivnosti vzaimodeystviya organov zdravoohraneniya i pravoporyadka pri osmotre trupa na meste ego obnaruzheniya [avtoreferat]. Moskva: Moskovskiy meditsinskiy stomatologicheskiy institut im. N.A. Semashko; 1997. 30 s. [in Russian].
5. Interpol. Disaster Victim Identification Guide [Internet]. File: DVI Guide (version 2018). Part ‘A’. Available from: http://www.interpol.int/ Media/Files/INTERPOL-Expertise/DVI/DVI-Guide-new-version-2018. Accessed: January 21, 2019.
6. Winskog C, Tsokos M, Byard WR. The progression from disaster victim identification (DVI) to disaster victim management (DVM): a necessary evolution. Forensic Sci Med Pathol. 2012;8(2):81-3. Available from: https://link.springer.com/content/pdf/10.1007%2Fs12024-011-9295-9. pdf Accessed: January 22, 2019. DOI: 10.1007/s12024-011-9295-9
7. Kolkutin VV, Korotun VN, Borodulin DV, Onyanov AM, Shmarov LA, Fetisov VA. Opyit organizatsii ekspertnoy deyatelnosti spetsialistov Permskogo kraevogo byuro sudebno-meditsinskoy ekspertizyi pri pozhare v klube «Hromaya loshad». Sudebno-meditsinskaya ekspertiza. Moskva: MEDIA SPHERA. 2010;53(4):38-9. [in Russian].
8. Borodulin DV, Mosiyash VB, Kozlova MV, Onyanov AM, Hohlova EV, Vershin LO. Sluchai gibeli lyudey v pozharah po dannyim Permskogo oblastnogo byuro sudebno-meditsinskoy ekspertizyi. Problemyi ekspertizyi v meditsine. Izhevsk: Ekspertiza. 2003;3(2):32-4. [in Russian].
9. Pigolkin YuI, redaktor. Sudebnaya meditsina i sudebno-meditsinskaya ekspertiza. Moskva: GEOTAR-Media; 2014. 728 s. [in Russian].
10. Bulankina IA. Sovershenstvovanie metodov diagnostiki morfofunktsionalnogo sostoyaniya kozhi pri ozhogovoy bolezni (morfologiya, biomehanika): Perspektivyi razvitiya i sovershenstvovaniya sudebno-meditsinskoy sluzhbyi Rossiyskoy Federatsii. В: Bulankina IA, redaktor. Materialyi V Vserossiyskogo s’ezda sudebnyih medikov; 2000; Moskva-Astrahan. Moskva-Astrahan; 2000. s. 116. [in Russian].
11. Hohlov VV. Sudebnaya meditsina. Izd-e 3-e pererab. i dop. Smolensk: Smolenskaya oblastnaya tipografiya im. V.I. Smirnova; 2010. 992 s. [in Russian].
12. Mishalov VD, redaktor. Sudebnaya meditsina. Chernovtsyi: Misto; 2018. 574 s. [in Russian].
13. Vsemirnaya organizatsiya zdravoohraneniya. Sozdanie vozmozhnostey VOZ dlya obespecheniya gotovnosti i prinyatiya mer po reagirovaniyu na buduschie masshtabnyie i ustoychivyie vspyishki zabolevaniy i chrezvyichaynyie situatsii: Doklad Sekretariata ot 09 yanvarya 2015 goda [Internet]. Zheneva: Vsemirnaya organizatsiya zdravoohraneniya; 2015. Dostupno: http://apps.who.int/gb/ebwha/pdf files/EBSS3/EBSS3 3-ru. pdf [in Russian].
14. Tuchik ES. Organizatsionnyie printsipyi deyatelnosti sudebno-meditsinskoy sluzhbyi v usloviyah katastrofyi [avtoreferat]. Moskva: Moskovskaya meditsinskaya akademiya im. I.M. Sechenova; 1993. 27 s. [in Russian].
15. Krivda GF, Krivda RG, Slyusarenko OO, Umanskiy DO. Organization of Priority Actions for Mass Victims Identification and Chronology of the Disasters, Which Have Taken Place in the Odessa Region. Sudebno-meditsinskaya ekspertiza. Dnepr: Driant. 2018;(1):4-6.
16. Popov VL. Sudebno-meditsinskaya ekspertiza pogibshih pri krupnomasshtabnyih pozharah. Sudebno-meditsinskaya ekspertiza. Moskva: Meditsina. 1992;35(2):16-8. [in Russian].

«Bulletin of problems biology and medicine» Issue 1 Part 1 (148), 2019 year, 366-370 pages, index UDK 616.718-001.5-091:611.718

10.29254/2077-4214-2019-1-1-148-366-370