FORENSIC CASE REPORTS

By
Dimas Adi Soewignyo
(H1A013019)

Mentor
dr. Arfi Syamsun, Sp. KF, M.Si.Med
Preface

traffic accident one of the most highlighted problem because

almost every day there was an accident

Traffic accident claims more than 1.2 million lives each year and
have a huge impact on health and development. They are the
leading cause of death among young people aged between 15
and 29 years, and cost governments approximately 3% of GDP.

Forensics determining wound qualification determining

criminal penalty for culprit
Identity

Name: Tn. W
Sex: Male
Age: 22 years
Religion: Islam
Occupation: Souvenirs trader
No. Medical record: 596655
Anamnesis

Patient came to emergency departement of province hospital

on September 14th at 09.00. Patient came with a lot of
wounds in his body. Patient claimed to be injured from falling
after crashing into the sidewalk while riding a motorcycle.
Patient claimed he looked toward the back right before
crashing into the sidewalk.
Vital Sign

GCS E4V5M6
Blood pressure was 130/70 mmHg
Temperature was 20x/minute
Heart rate was 92x/minute
Respiratory rate was 20x/minute
Wound Description
An irregularly shaped wound
was in the left abdominal region
with a distance of five
centimeters from the longitude
that passes through the navel
and was ten centimeters away
from the latitudes that pass
through two nipples. The length
of wound was four sentimeters
and the width of wound was
two sentimeters. The wound
margin was clearly visible, the
edge of wound was flat, the
base wounds color was pink.
The tissue that makes up the
base of the wound was dermis.
The area around the wound
border shows blackish skin.
There were two irregularly shaped
lesions in the left back foot area. The
center point of the first wound was
ten centimeters from the left heel.
The upper end and the lower end of
the second wound was eight
centimeters and two feet five inches
from the ankle. The length and the
width of the first wound was three
sentimeters and one sentimeter. The
length, the longest width and the
shortest width of the second wound
was five point five sentimeters, three
point five centimeters, and two
point one centimeters.
The first wounds margin was clearly
visible, the edge of wound was flat,
the base wounds color was pink. The
tissue that makes up the base of the
wound was dermis and there was an
epidermis that had not been
completely peeled off too. There was
a red liquid inside. The area around
the wound border shows blackish
skin. The second wounds margin
was clearly visible, the edge of
wound was flat, the base wounds
color was pink. The tissue that makes
up the base of the wound was
dermis and there was an epidermis
that had not been completely peeled
off too. There is a red liquid inside .
The area around the wound border
shows blackish skin.
An irregular shape wound on the
fifth left toe. The length was zero
point nine sentimeter and the
width was zero point seven
centimeters. The wound is clearly
visible, the edge of the wound is
flat. There was a reddish fluid on
the base wound.
There were three wound on the left
thigh and left leg. The first wound
was irregularly shaped, located
beside the left knee with the bottom
end fifteen centimeters from the
heel, the top edge spaced two
centimeters from the top of the left
knee, the outermost edge had the
distance of thirty centimeters from
the heel, the deepest edge had the
distance of six centimeters from the
top of the left knee. The second
wound was oval, located on the
upper left knee. The deepest end
was two centimeters from the top of
the left knee from inside. The outer
edge was one centimeter from the
top of the left knee when measured
from the outside.
The third wound was irregularly
shaped, located on the outer left
thigh. The lower end is ten inches
from the top of the left knee. The
top end is eighteen feet a
centimeter from the groin. The
outer end was fifty seven
centimeters from the left heel. The
innermost end was twelve point two
centimeters from the top of the left
knee. The size of the first wound
was thirty centimeters long, with
the longest width was nine point
two centimeter wide, the shortest
width was three and a half
centimeters. The second wounds
length was four point five
centimeters with the width was two
centimeters . The third wound size
was eighteen centimeters length
and the width wasnine point five
centimeters
The first wounds margin was clearly
visible, the edge of wound was flat,
the base wounds color was pink. The
tissue that makes up the base of the
wound was dermis. There was a red
liquid inside . The area around the
innermost boundarys wound shows
reddish skin. The second wounds
margin was clearly visible, the edge
of wound was flat, the base wounds
color was pink. The tissue that makes
up the base of the wound was
dermis. There was a red liquid inside.
The area around the wound border
shows blackish skin. The third
wounds margin was clearly visible,
the edge of wound was flat, the base
wounds color was white. The tissue
that makes up the base of the wound
was dermis.
There were two injuries in the
right knee region. The first wound
was round, the first end was
thirty two centimeters away from
the ankle. A second round wound
with the first end was at thirty
one point eight centimeters from
the groin, the second end had a
distance four point four
centimeters above the top of the
right knee. The first wound had
size two centimeters, the second
wound had six sentimeters length
and eight point nine sentimeters
width.
The first wounds margin was
clearly visible, the edge of wound
was not flat. There was a cliff
wound consisting of skin tissue.
The tissue that makes up the base
of the wound was dermis. There
was a red liquid inside. The
second wounds margin was
clearly visible, the edge of wound
was flat, the base wounds color
was pink. The tissue that makes
up the base of the wound was
dermis. There was a red liquid
inside.
There was an irregular shaped
wound behind the right elbow.
The top end was two point two
centimeters from the right elbow,
the bottom end was seventeen
centimeters from the right wrist.
The wound length was seven
point nine centimeters and the
width was two point seven
centimeters. The wounds margin
was clearly visible, the edge of
wound was flat, the base wounds
color was pink. The tissue that
makes up the base of the wound
was dermis. There was a red
liquid inside. The angles wound
was taper.
Therapeutic action in emergency
departement

NaCl 0,9%
Povidon iodin
Asam mefenamat 500 mg x 3 during 5 days
Traffic Accident Definition

UU No. 22 2009 articles 1 verse 24:

Traffic Accidents are unexpected and accidental incidents on

roads involving vehicles with or without other road users
resulting in human casualties and / or property losses.

UU No. 22 2009 articles 229 verse 1:

a. Light traffic accident: Property losses

b. Moderate traffic accident: Property losses and mild injuries

c. Severe traffic accident: Severe injuries/death

Mild injuries: No need hospitalization
Severe injuries, injury that make victims:
get sick and there is no hope to heal at all or cause death;
incapable of continuing to perform job or job duties;
lose one of the senses;
suffer from severe or paralyzed disabilities;
disturbed thinking power for 4 (four) weeks more;
death of a fetus; or
injuries requiring hospitalization for more than 30 (thirty) days
Number of Traffic Accidents Events
Mortality of traffic accidents in Indonesia according to road
users category
Factors that Influences Traffic Accidents

Human: Vehicle:

Careless The brakes do not work

Sleepy, Flat tire

Drunk Skid

Tired The vehicles light is not on

Unskilled Environment:

Undisciplined Bad road conditions such as

damaged, slippery, and holey
High speed roads

Cornering road

Street lights

Rain
Trauma on Traffic Accident

Trauma due to the first contact with the vehicle

Parts of vehicles that often cause this trauma are usually
bumper, rearview mirror, spakbor.
Type of wound: Abbration of press wound
Trauma from falling
Type of wound: Abbration of shear wound and/or tear wound
Trauma from being crushed by tires (rollover)
The Law of Traffic Accident

UU No. 22 2009:
Articles 234, 235, 236, 237 Duties and Responsibilities of
Drivers, Owners of Motor Vehicles, and / or Corporate
Transport
Articles 238, 239 Duties and Responsibilities of
Goverment
Articles 240, 241 Victims right
Case Discussion

UU No. 22 2009 articles 1 verse 24:

Traffic Accidents are unexpected and accidental incidents on roads involving

vehicles with or without other road users resulting in human casualties and /
or property losses.

In this event, a traffic accident occurs without the involvement of other road
users or travelers so that the patient can not be charged to criminal law.

Wound qualification: Mild wound, because patient didnt need hospitalization

Conclution

From the facts found from the examination of the patient, I conclude that a 21
years old man has been examined with a height of one hundred and sixty
centimeters and a weight of fifty kilograms. In the person was found wound on
the left abdomen, left leg back, fifth left toes, left side of the patient's left leg,
left side outer leg, right knee, and right elbow. The wound can be caused by
contact with a blunt object. During the process of wound healing, the victim
does not require hospitalization and the wound does not interfere his daily
activities as a merchant gift.
Suggestion

A doctor is expected to know and understand all aspects related to

the problem of traffic accidents and from the medicolegal aspect
due to the increasing number of traffic accidents from year to year.
A doctor must be careful in examining the injuries in the patient's
body because of a wound will help investigators uncover the case
both the type of injury suffered by the victim and the form of the
cause of the substance used by the offender