A DECADE OF TRAIN-PEDESTRIAN FATALITIES - THE CHARLESTON EXPERIENCE

Although the cause of death is rarely in doubt in train-pedestrian fat alities, the manner of death is often unclear. The distinction between accident and suicide can only be made after careful evaluation of the history, scene investigation, autopsy findings, and toxicologic data. A retrospective analysis of 25 consecutive train-pedestrian fatalitie s investigated by our office between 1982 and 1992 is reported. The vi ctims were predominantly healthy, young males. All but one person died at the scene. The cause of death was massive blunt trauma in 88% of t he cases. In one case, the sole injury was decapitation. A tissue or b lood ethanol level greater than 99 mg/dL was detected in 80% of the ca ses. A total of 60% of the cases involved persons likely to have been sitting or lying across the railroad tracks: all but one of these vict ims were intoxicated. The manner of death was determined to be acciden tal in 92% of our cases. Decapitation by a moving train is an injury h ighly suggestive of suicide. Massive blunt trauma, especially in the s etting of ethanol intoxication, was highly associated with accidental death. Toxicologic analysis is essential in discriminating willful sui cide from alcohol-induced incapacitation resulting in accidental death . Homicide, disguised as an accident or suicide, must be ruled out in all cases. Accurate determination of the manner of death is an importa nt issue regarding civil litigation and dispersal of insurance benefit s.