MOTOR VEHICULAR

COLLISION
Comprehensive evaluation of traffic accidents
requires investigation of the collision scene,
assessment of damage to the vehicle and
examination of the victim.
Correlation of all these components often
allows an accurate opinion regarding the
mechanism of injury.
Pathologist speaks with accident investigator
or reviews the collision report prior to
beginning the autopsy.
Major categories of traffic fatalities:

Vehicular occupant: driver or

passenger
Pedestrian
Motorcyclist: driver or passenger
Pedal cyclist or bicyclist
Vehicular Occupant
Questions that must be answered:
Driver of vehicle
Deployment of restraint system
Contributions to collision
Alcohol or drug
Natural disease
Reckless driving
Falling asleep at the wheel
Distraction
Weather conditions
Mechanical failure
Correlate autopsy findings with collision
dynamics
Consider more than 1 impact
especially if vehicle rotated or rolled
or decedent had been ejected
Identity of driver often disputed when
there is more than 1 occupant.
 Vehicular Occupants

Before the autopsy, know the ff:

Number of vehicles involved
Type of vehicle
Collision partner, i.e, other vehicle or fixed
object
Point and direction of impact
Velocity of collision
Extent of intrusion
Rollover
Seating position
Restraint system deployment
Point of body contact within vehicle
Ejection
 Patterned Injuries

Fractured laminated windshield glass –

vertically oriented, striated abrasions and
incisions on forehead
Metal frame around windshield – scalp or
face lacerations and avulsions
Shattered tempered glass from side and rear
windows - dicing injuries (clusters of
punctate, linear to angulated cuts) on the face
and upper body
 Restraint System Injuries

Seat belts – linear band of abrasion or

contusion obliquely oriented across the chest
(shoulder component) or horizantal band
across the lower abdomen (lap component)
Especially when belts are incorrently worn.
Osteoporosis
Airbags
Many features of modern vehicle design
influence the type of injuries observed.
Padded interiors
Recessed instrument panels
Energy-absorbing steering wheels
https://www.necksolutions.com/whiplash-neck-injury/
http://www.whiplashcompensationclaims.org/whiplash-prevention
Toxicology is an important component
in the investigation of traffic deaths.
Carboxyhemoglobin
Alcohol
Drugs
 Special Cases

Post-collision vehicle fires – did the

occupant die as a result of the collision
or the fire?
Suicide by vehicle
 Secondary Impacts

With the ground or pavement

PEDESTRIAN INJURIES
 Dynamics depend on

Victim’s height
Speed of the vehicle
Pont of impact on the vehicle
At low speeds and front impact

1. pedestrian held by inertia on hood

2. When car decelerates, pedestrian is
released and continues forward onto
pavement
At higher speeds and front impact

Pedestrian thrown into the glass or

metal frame of the windshield or even
up and over the car and then onto the
ground.
With children or higher vehicles

Where the initial impact is above the

pedestrian’s center of gravity, the victim
is forced downward and run over.
Brown University
Important to examine clothes.
 Bumper Injuries

Its presence is evidence that the front of

the vehicle struck the pedestrian.
Consists of a horizontal band of
abrasion and contusion below the knee,
frequently overlying a fracture of the
tibia and fibula.
Measure height above heel of lower
extremity injuries to compare with the
bumper height of the vehicle.
Injury lower than bumper height →
vehicle braking at moment of impact
 Bump from behind

Hyperextension type of injuries

Stretching or splitting lacerations in
the inguinal regions or perineum
Atlanto-occipital dissociation
Cervical or thoracolumbar spine
fractures
 Secondary Impacts

With the ground or pavement

 In grazing type collisions with
fender or side of vehicle

Pedestrian is thrown laterally.

 Correlate the collision
investigation with the autopsy
findings to answer the questions:
Identity of the pedestrian
Identity of the vehicle
Pedestrian action prior to being struck
Run-over
Contributing factors
Intoxication
Driver error
Pedestrian error
Visibility of pedestrian
Modifiable environmental hazards
 MVA

Accident – almost always

Suicide – rare
Homicide - rare
 Motorcyclists and Bicyclists

Comparable to injuries of pedestrians

and ejected occupants.
Usually become airborne during the
collision, landing some distance form
the point of impact.
Injuries of motorcyclists more likely to
be fatal.
 Standard for
Motor Vehicular Accident
Specimens
(1) Histology
Retain brain/lung/kidney tissue for possible fat stains
(fat embolism).
Sections of brain to determine diffuse axonal injury
(corpus callosum, parasagittal white matter, pons).
(2) Toxicology
Appropriate toxicological examination.
(3) Radiology
Consideration of radiographs depending upon the
case in question.