Different Presentations of Victims of Lightning During Thunderstorm

Different Presentations of Victims of Lightning During Thunderstorm

J Indian Acad Forensic Med. July-September 2013, Vol. 35, No. 3 ISSN 0971-0973 Original Research Paper Different Presentations of Victims of Lightni...

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J Indian Acad Forensic Med. July-September 2013, Vol. 35, No. 3

ISSN 0971-0973

Original Research Paper Different Presentations of Victims of Lightning During Thunderstorm *Chandra Prakash, **Ishwer Tayal

Abstract Thunderstorms are classic weather events. Huge electrical forces are involved, producing millions of amperes and phenomenal voltages within microseconds of time. Hundreds of deaths occur each year from atmospheric lightening stroke, especially in tropical countries. Understanding lightning related casualties is more than just reporting numbers of deaths. As death takes place immediately, no signs of vital reaction are to be expected in connection with bizarre presentations of victims and torn clothing further arouse suspicions of foul play and sometime person at a considerable distance from the spot of lightning, is killed with no mark of injury due to ‘return shock’ i.e. discharge of charged cloud induced electricity from his own body. More people are struck by lightning in hilly states blessed with heavy rains than in all other states on average both indoor and open fields. This article reveals a series of such cases brought to the Government Medical College, Haldwani.

Key Words: Lightning, Cause of Death, Filigree Burns, Injury Patterns The north and south poles and the areas over the oceans have the fewest lightning strikes. The place where lightning occurs most often is near the small village of Kifuka in the mountains of eastern Democratic Republic of the Congo [6], where the elevation is around 975 meters (3,200 ft). On average this region receives 158 lightning strikes per square kilometer a year. [7] During thunderstorm the lightening flash/stroke discharge many current peaks varying from 10,000-200,000 Amp occurring in fraction of a second affecting an area of about 30m distance. [8] Because lightning can travel through air, plumbing systems, and land phone lines it can struck people working in open fields or in their houses until 30 minutes after the final thunderclap is heard. Victims may present with minor injuries with no loss of consciousness to severe cardiopulmonary arrest or fatal injuries, however, the long-term effects on their lives and the lives of their family members can be devastating. Lightning causes human injury by 4 distinct mechanisms: [8] 1. The direct effect of electric current; 2. Burning by superheated air; 3. Effects of expanded and repelled air around flash and 4. The “sledge hammer blow” death by compressed air pushed before the current.

Introduction: In many cultures, lightning has been viewed as part of a deity or a deity itself including the Hindu God Indra. In French and Italian culture it express "Love at first sight". For some political parties such as the People's Action Party in Singapore and the British Union of Fascists lightning flashes are symbol of power. It is also a common insignia for military communications units throughout the world. Lightning is a massive electrostatic discharge caused by the circulation of warm moisture-filled air through unbalanced electric field in the atmosphere, accompanied by the loud sound of thunder. A typical cloud to ground lightning strike can be over 5 km long. [2] A typical thunderstorm may have three or more strikes per minute at its peak. [3] Lightning strikes 40–50 times a second worldwide, for a total of nearly 1.4 billion flashes per year. [4] Cloud-to-ground (CG) lightning accounts for 25% of lightning globally. Lightning is not distributed evenly around the planet. [5] About 70% of lightning occurs on land in the tropics, where most thunderstorms occur.

Corresponding Author: **Assistant Professor Department of Forensic Medicine, Government Medical College, Haldwani E-mail: [email protected] *Prof. & HOD DOR: 30.10.12 DOA: 21.7.12

Case 1: Direct Lightning Strike: It was a case of 25 year old male laborer brought by the police for post mortem

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J Indian Acad Forensic Med. July-September 2013, Vol. 35, No. 3 examination with alleged on the spot death as a result of Thunderstorm when the deceased was returning from his work with three friends near Gola gate forest area of Lalkuan, Nainital. External Examination: Shirt was torn and burnt mostly around shoulder and collar. In pocket there were 2-3 coins which were distorted and melted. Superficial to deep Burn injuries were present on the right lateral aspect of upper half of the body (involving the right side of head, neck, shoulder, chest, abdomen and right upper limb). Base of the burnt area was reddish and parchmentized. Laceration of scalp was accompanied with burning and singing of scalp hair on the right side of head. Typical leaf like erythematous filigree burn marks was present on chest and abdomen mostly on the right side up to right shoulder region. Clotted blood was present in the left ear canal along with hemorrhagic congestion of the left eye. Internal Examination: Diffuse Sub-galeal Hematoma was present under the scalp with extensive sub dural hemorrhage over the fronto-lateral aspect of the both cerebral hemispheres and all the internal organs were congested. The cause of death in this case was failure of functions of brain as a result of electrical discharge due to lightning which is sufficient to cause death. [9]

ISSN 0971-0973

Case 3: The Strike Survivors: Mother of the child (reported in case no 2) was handling Woodstock inside the house due to water leaking from terrace and was thrown away by the struck of lightning during thunderstorm. She suffered severe shock and was admitted in hospital in unconscious condition for twenty four hours, after which she recovered with complaint of weakness/ parasthesia in left upper and lower limb. She had retrograde amnesia and described a sensation of being struck on the back of the neck. No residual symptoms were left. Other members of family were sleeping on the first floor of the house and sustained minor injuries with no need of hospitalization.

Discussion: The effects of lightning are extremely bizarre and unpredictable. While two persons standing side by side during a stroke, one may be struck and killed whereas the other remains unharmed. Converse may also be true as was seen in case of 23 climbers caught in a thunderstorm while climbing up a steep mountain in Japan. Only one of them was struck but all were dead. [10] Most fatalities occur in open, while persons in the building may be affected if they are carrying or wearing something which may attract lightning or are present in living room with a chimney or television aerial. Objects at a distance of 100 feet or more may be struck as was in case of an African reported by Skan in which a large hole in the neck, fractures in skull and tearing away of left shoulder inside hut due to lightning was reported. [10] A person may be killed by lightening and yet the clothing may not be damaged. On the contrary, the clothing may be burnt without causing any injury to the person. As was seen in case of a girl riding a horse and killed by lightning which struck her through a metal stud on the top of her hat, melting her nylon panties and tore her jodhpurs as described by Mant. [10] Arborescent markings/ Filigree burns are pathognomonic for injury by lightning. It is not associated with burning but indicates the path taken by the electrical discharge. It appears within 1 hour and disappears in 24 hours if the person survives. The primary burn is usually on the head and may be diffuse as in case 1 it extends to back. There are obvious flash burns in 70% of cases but they may be absent. Injury may in the form of bruise or lacerated wound usually located at head and may be attributed to ‘sledge-hammer blow’ by the compressed air.

Case 2: Indirect Lightning Strike: This is a case of 13 years old male child alleged to have died due to lightning during th thunderstorm on 16 September 2012, while eating maize (Bhutta) inside kitchen at ground floor of his house. History of thunderstorm in the locality and evidence of damage to houses, trees, cattle etc in the vicinity and smell of singeing was present as per inquest papers. External Examination: Clothing was intact, eyes were suffused with blood, face was livid, lips and nails were cyanosed, fecal matter was present at anal orifice, no mark of injury was present. Fern like pattern of eryhtema was present on the front of chest and shoulders. Putrefactive changes were present in the form of greenish discoloration of distended abdominal wall etc. Internal Examination: Stomach was found to be full of undigested maize grains and was weighting 712 grams, lungs were congested and weighting 174 and 197 grams, no other significant finding was present other than visceral congestion. The cause of death was Asphyxia as a result of lightening during thunderstorm.

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J Indian Acad Forensic Med. July-September 2013, Vol. 35, No. 3 11.

Internal signs are not very characteristic. Death can be instantaneous due to ventricular fibrillation as a result of electrical discharge or asphyxia and delayed as a result of burns or occasionally from thrombosis of cerebral or coronary arteries. Those who survive may have the long term side effect. The strike survivors may have: 1. Memory loss 2. Personality changes 3. Difficulty carrying on more than one task at a time 4. Fatigue 5. Irreparable nerve damage 6. Chronic pain and/or headaches 7. Difficulty sleeping 8. Dizziness

12. 13. 14. 15. 16. 17. 18. 19. 20.

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Spitz,W.U. and Fisher R.S. Medico-legal investigation of death pp.316.chales c thomas1973. Chandra Parkash. 2010. Medico-legal Update Journal. Jan-June, vol.10, issue.1.pp. 09-11. Dominick J., Di Maio. Forensic Pathology, P.374-6; 1993 Vij Krishna. Textbook of Forensic Medicine and Toxicology, 3rd Edition, page no.279-81. Biswas Gautam. Review of Forensic Medicine, P. 198; 2010 Shepherd Richard. Simpson’s Forensic Medicine, 12th Edition. Subrahmanyam B. V. Modi’s Medical jurisprudence & Toxicology, 22nd Ed.2001.pp.320-3. Reddy Narayan K.S. The essentials of Forensic Medicine & Toxicology, 24th ed. p.282-3; 2005. V.V.Pilllay. Text book of Forensic Medicine and Toxicology, 13 th ed. P.168; Paras Publications; 2003. P.V.Guharaj. Forensic Medicine. 2nd ed. 2003.p. 201-2.

Case 1: Victim with Torn Clothing due to Direct Lightning Stroke

Cause of Death: Death is always due to accident. Sometimes appearances left on human body closely resemble those produced by criminal violence. Thus a person may be found dead in an open field or on highway with torn clothes, contusions, lacerations and fractures raise doubt of foul play. In such cases, the diagnosis should be based on: 1. History of thunderstorm in the locality. 2. Evidence of damage to houses, trees, cattle etc in the vicinity. 3. Absence of wounds indicating homicidal death. 4. When the lightning current path passes through rock, soil, or metal these materials become permanently magnetized. Even metals with very high melting points such as Gold may volatize and the melted metal may be implanted into the skin, producing distinctive coloring.

Case 1: Typical Leaf like Filigree Burns in Direct Lightning Stroke

Case 2: Victim of indirect Lightning Stroke

References: 1. 2. 3. 4. 5. 6. 7. 8. 9. 10.

Lyon. Textbook of Medical Jurisprudence and Toxicology; 11th ed, P.1009-10; Delhi Law House Publisher. Uman, Martin A.' "All About Lightning"; p. 55,81; Dover Publications N.Y.; 1986; ISBN- 2-486-25237-x Jason Payne-James, Busuttil, William S. Smock. Forensic Medicine Clinical and Pathological Aspects, Cambridge University Press, First Ed; 2003, pp.8. John E. Oliver. Encyclopedia of World Climatology. National Oceanic and Atmospheric Administration, 2005; ISBN 978-1-40203264-6. Retrieved February 8, 2009. Uman, Martin A. (1986). All about Lightning. Dover Publications, Inc. pp. 103–110. ISBN 978-0-486-25237-7 P.R. Field, W.H. Hand, G. Cappelluti et al."Hail Threat Standardisation". European Aviation Safety Agency. November 2010; RP EASA.2008/5. "Kifuka – place where lightning strikes most often". Wondermondo. Retrieved November 21, 2010. "Annual Lightning Flash Rate". National Oceanic and Atmospheric Administration. Retrieved February 8, 2009. "Where Lightning Strikes". NASA Science. News. December 5, 2001. Retrieved July 5, 2010. Chao. T.C., Pakiam J.E., Chia J.A. Study of lightning death in Singapore. Singapore Medical Journal vol 22(3) June 1981

Case 2: Fern like pattern of eryhtema present on the front of chest and shoulders

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