Case report
Fatal injury by high-pressure water jet unit – A case report

https://doi.org/10.1016/j.jflm.2021.102270Get rights and content

Highlights

  • This is a rare case of a fatal case of high-pressure water-inflicted injury in the femoral region.

  • High pressure water becomes a blunt force weapon.

  • The number of high-pressure water jet devices is developed in our daily life.

  • We should pay much attention for using high-pressure water jet devices.

Abstract

Herein, we report a fatal case of high-pressure water-inflicted femoral injury. A male worker in his twenties was found at the construction site with significant bleeding from the left femoral region. At three hours after discovery, his death was confirmed in an emergency hospital. The deceased was noted to be 182 cm in height, 62.5 kg in weight, and postmortem rigidity strongly appeared in his whole joints. Externally, there was a large, 28-cm laceration in the left medial femoral region, wherein the subcutaneous muscle layer was drastically contused and transected, and both the femoral artery and vein were completely disrupted. This injury also penetrated into the left popliteal region similar to an impalement injury, producing a small, circular, 1.5-cm wound exit site. Moreover, two lacerations in the right anterior femoral region were presented in an inverse “U”-like shape, with injury lengths of 14 cm and 26 cm. Internally, every organ was apparently anemic, given that the water jet lance produced pressures ranging from 10,000–40,000 psi. Thus, the cause of his death was diagnosed as hemorrhagic shock secondary to femoral artery and vein disruption caused by a high-pressure water jet unit.

Introduction

Recently, various high-pressure water jets have been used in our lifestyle, such as in water fountains, water skiing, water sliders, and car wash jets, or in industries, such as in breaking concrete, cleaning chemical pipes, and firing hose jets, among others. Although high-pressure water jet devices have improved our life, several lines of accumulating studies have reported some accidental fatal cases due to injuries caused by these devices (Table 1). In this manuscript, we report a fatal case of high-pressure water-inflicted femoral injury and discuss trends and issues regarding these cases.

Section snippets

Case profile

At 3:30 p.m., a male in his twenties was found at a construction site with significant bleeding from the left femoral region. He was a construction worker who was cutting concrete using a high-pressure water jet unit since 2:00 p.m. According to his colleagues, he normally operated a high-pressure water jet unit at 3:00 p.m. Unfortunately, 3 h after discovery, his death was confirmed in an emergency hospital. A medico-legal autopsy was then carried out on the next day in order to determine his

Postmortem computed tomography (PMCT)

PMCT showed subcutaneous and intramuscular gas at the left and right thigh regions (Fig. 1). However, both femurs did not appear to be fractured.

Autopsy findings

The deceased was 182 cm in height and weighed 62.5 kg. Postmortem rigidity strongly appeared in his whole joints, and postmortem lividity, being dark purplish red in color, was moderately found on the back and posterior legs, marginally disappearing when they were pressed. Rectal temperature was also noted to be 34 °C. Palpebral conjunctiva were pale. In the left medial femoral region, there was a deep, fatal, large laceration, which was 28 cm in length (Fig. 2A), extending from the middle

Discussion

In this case, the left femoral injury was estimated to be stabbed with something baculiform at high speed, and the right femoral injuries were seemingly inflicted by skin traction through tangential impact of the same weapon. Thus, we could conclude that a high-pressure water jet unit was the weapon in this case. Transection of both the femoral artery and vein, along with findings of anemic organs, also suggested severe blood loss. Considering the autopsy findings and police scene

Acknowledgements

We sincerely thank Fukumi Furukawa, Emi Shimada and Akihiko Kimura for their technical support and instructive suggestion.

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