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Preventable fatal injury during rally race: a multidisciplinary approach Stefania Zerbo 1 & Clio Bilotta 1 & Giulio Perrone 1 & Ginevra Malta 1 & Giuseppe Lo Re 2 & Maria Chiara Terranova 2 & Antonina Argo 1 & Sergio Salerno 2 Received: 1 July 2020 / Accepted: 16 November 2020 # The Author(s) 2020

Abstract Introduction The motor vehicle crash (MVC) constitutes an important challenge for forensic pathology in order to identify the manner and cause of death. Our study focuses on a fatal accident during a rally race corresponding to MVC sub-category. Materials and method Postmortem computed tomography (PMCT) was performed before the conventional autopsy. Autoptic and PMCT data were compared. Data collection allowed analyzing biomechanical dynamics of the incident and post-traumatic injuries through qualitative-statistics and solicitation quantitative indices. Results Photo and circumstantial evidence analysis showed a wrong installation of double shoulder belt system of head and neck support (HANS) collar. PMTC clearly highlighted multiple and bilateral fractures involving roof and base of skull; a displaced fracture of the right acetabulum was also encountered. Autopsy confirmed PMCT data and revealed a brainstem laceration. AIS (Abbreviated Injury Scale) achieved a maximum score in consideration of fatal injuries. Discussion The injuries analysis resulting from photographic surveys examination, conventional autopsy, and PMCT has led us to confirm a fatal front collision with a tree trunk. Head trauma represents a major injury in the present case. In this case, head injuries, related to whiplash trauma, are a consequence of a double shoulder belt system (HANS collar component) wrong installation. Conclusion MVC and especially high-speed motor racing represent an important death cause. There was, for this reason, a marked development of cars and occupants’ safety systems, such as HANS collar. PMCT improves the diagnostic performance of conventional autopsy and increases forensic medical knowledge related to traumatic injuries. Keywords Rally race . Injury . HANS collar . Forensic pathology, Postmortem CT

Introduction

Highlights • MVC and especially high-speed motor racing represent an important death cause. • HANS collar is important safety system; it restricts head and neck movements. • The combination of autopsy and PMCT is an advantage especially in case of multiple traumas. * Clio Bilotta [email protected] 1

Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, Section of Legal Medicine, University of Palermo, Via del Vespro 129, 90127 Palermo, Italy

2

Radiology Section, DIBIMED, University of Palermo, Via del Vespro 129, 90127 Palermo, Italy

The motor vehicle crash (MVC) constitutes an important challenge for forensic pathology, especially in recent years. Our study focuses on a fatal accident during a rally race; therefore, it corresponds to MVC sub-category. Rally is a motorsport discipline taking place on public, asphalt or dirt, road. Moder