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Germany. On a rainy September day, a 32-year-old man was working on a 50-m (164 ft) high Ferris wheel, which had to be dismantled after the end of a local carnival. He was working on the axis of the Ferris wheel at a height of 28 m (92 ft). He wore a safety harness and special work shoes. Witnesses stated that his safety rope was fixed to his safety harness, but not to the Ferris wheel. In this way, the man was not protected against falling. He suddenly lost his grip and probably slipped on the wet metal. He then fell to the ground. Witnesses saw the man in a head-first fall onto the base of the Ferris wheel and hit his head on the edge of the metal platform.

Fig.1 End position after the fatal fall with destroyed skull. Black arrow: point of first impact with smashed brain tissue. White arrow: fragment of the cranial roof.

During the fall, the witnesses perceived no vocal expressions. Whether there were active body movements is unknown. Finally, the man was found lying in a supine position. Smashed parts of his brain and fragments of the comminuted cranial roof were found in the impact area, with a splash pattern of blood and brain tissues for several meters around. Nevertheless, the witnesses immediately started cardiopulmonary resuscitation, which was continued by the arriving emergency doctor despite the obviously fatal head trauma. The man died immediately from severe open head trauma with decerebration.

Fig.2 Corpse covered with a grey blanket. In front of the corpse is the point of the first impact of the head (black arrow). From here, a splash pattern of blood and smashed brain tissue extend towards upper edge and right upper corner of the image.

At autopsy, the man had a weight of about 71 kg (156 lbs) and body length of 170 cm (5’7). Only sparsely developed livores at the back of the body were found. A few conjunctival petechiae were present in the eyelids. Massive craniocerebral trauma with central rupture of the scalp was present. The skull was extensively fractured with comminuted fractures of the cranial roof and base. The head appeared to be split into two parts. Cleavage of the anterior cranial fossa and a rupture of the dura mater were observed. The temporal muscles were destroyed. The man had a deep facial skin rupture, especially of the nose and left upper lip region. Multiple fractures of the facial bones, especially of the forehead, were observed. The man was decerebrated with the destruction of the brain in several small parts with a total weight of 600 g. The cerebellum and pons cerebri showed contusions.

Fig.3 Base of the Ferris wheel. The corpse is covered with a grey blanket. White arrow: brain tissue.

The laryngeal cartilage was vertically fractured. Blood was found in the trachea and deep bronchi. Multiple fat and muscle hematomas of the thoracic and abdominal wall were found. A massive thoracic trauma with fractures of the sternum and multiple bilateral rib fractures with a left hematothorax, an extensive hematoma of the left pleura parietalis, and a rupture of the inferior lobe of the left lung was present. The autopsy revealed multiple lacerations of the liver tissue in the abdominal cavity. A bloodless spleen and anemic kidneys with a hilus rupture of the right kidney were found in the bloodless abdominal cavity. Aortic injuries were not present.

Fig.4 Destroyed head with a disrupted scalp, fragmental fracture of the cranial roof, ruptured dura mater and missing brain.

The man had fractures of all four extremities, including an open wrist fracture of the right arm, an open left forearm fracture, and left proximal and right distal femoral fractures. The extremities showed diffuse abrasions of the skin. No fractures of the spine were found. Chemico-toxicological analysis and the determination of blood alcohol concentration were inconclusive. The cause of death was polytrauma, including severe traumatic decerebration.

Fig.5 Open fracture of the left upper arm.

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