Case 3 Period of Neglect

A 16-month-old female was discovered on the edge of Lake Wilson on the island of Oahu, Hawaii. The child was in a clear area surrounded by heavy vegetation (Goff et al. 1991). When found, she was suffering from dehydration, bruising and had numerous insect bites. Initially, the period of exposure was estimated as being 2 days. Given the state of dehydration, a pediatrician suggested that the period was longer and that the child would most probably have died within the next 24 h. The child was clothed in a sweatshirt, t-shirt, a pair of pants and disposable diapers. On the front of the pants, from the waistband to a point below the knees, there were eggs masses of a Calliphoridae (Fig. 14.1). When the clothing was removed, numerous 1st instar larvae (measuring 3-4 mm total length) and fewer 2nd instar larvae ,(measuring 5 mm total length) of Chrysomya megacephala were discovered in the diapers and pants (Fig. 14.2). Additional 1st and 2nd instar larvae of this same species were recovered from the vagina and rectum of the child and appeared to be feeding on tissues at those sites. Rearing data for this species from controlled studies conducted by Goff (unpublished data) at 26°C and 28°C indicated the most mature larvae would have required 39 and 36 h, respectively, to reach the stage of development represented. Using ADH calculations without a base temperature to adjust for normal body temperature, it was estimated that it would have required 23.5 h to reach the most mature stage of development for the specimens collected from inside the diapers.

In this instance, the time interval estimated by the insect activity did not account for the entire period of abandonment for the child. This was later found to have been approximately 36 h. The fly species, C. megacaphala, is a common early invader of decomposing remains in the Hawaiian Islands, typically arriving within minutes following death. Although this species has been implicated in myiasis in other parts of the world (Zumpt 1965; James 1947), it has not been previously implicated in cases of human myiasis in Hawaii. This species is strongly attracted to fecal material and this was probably the initial attraction for the flies in this case as well as Case 1 above. It should further be noted that, in Hawaii, this species has not been observed ovipositing on a moving animal. This would indicate that the child was relatively motionless at the time of oviposition and this would fit well with the more extended period of abandonment in this case. As C. megacephala also tends to seek out darker areas for oviposition, it might be assumed that, at the

Fig. 14.1 Pants of child showing egg masses fc tVbä

Fig. 14.2 Second instar larva of C. megaca-phala

time of oviposition, the child was lying face down. This would be indicated by the location of the egg masses on the front of the child's pants.

In this case, the entomological evidence in combination with the report from the pediatrician was used to establish the period of abandonment. The child's mother was charged with attempted murder and subsequently convicted at a trial held in Honolulu in 1990. Also introduced during the trial was evidence of previous abuse, including old bruising of the back and shoulders of the child.

A similar situation was reported by Benecke and Lessig (2001) for a case in Germany. In this instance, however, the child died and a post mortem interval of 6-8 days was established. Three species of flies were represented on the body: Calliphora vomitoria, Fania canicularis, and Muscina stabulans. While C. vomitoria was collected from the face of the child, F. canicularis and M. stabulans were present only in the genital area. Based on developmental stages present, the authors concluded that the child had not been cleaned for a period of approximately 14 days prior to discovery of the body.

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