A young male of 28 yrs was involved with road traffic accident while crosslng road. The victim expired on the spot. Police sub inspector from shabag thana made the inquest report & brought the dead body to the Dhaka Medical College morgue. Post mortem examination was done.

2. Case Report
A Gase of Road Traffic Accident in the Perspective of
Forensic Medicine
Rehana Yusufl, Matia Ahmed2
Abstract:
A young male of 28 yrs was involved with road traffic accident while crosslng road. The
victim expired on the spot. Police sub inspector from shabag thana made the inquest
report & brought the dead body to the Dhaka Medical College morgue. Post mortem
examination was done.
Keyword: Road Traffic Accident, expired, inquest repoft, post mortem examination.
(J Uftara Adhunik Med Coll. 2013; 3(2) : 203-207).
lntroduction:
Road Traffic deaths are a major global health &
development problem. Each year, nearly '1.3 million
people die as a result of a road traffic accident, more
than 3500 death each day in the world. Road traffic
injuries are among the three leading causes of death
for young people aged 5 to 44 yrs1.
Road trafficaccidents in Bangladesh have been rapidly
increasing with huge mortality. Road traffic injuries
will become the third leading contributor to the global
burden of disease & injury, by 2020 which is reported
by WHO2. Injuries & death due to road traffic accident
are a major public health problem in ourcountry. More
than 85% of all death & 90% of disability from road
traffic accident occur in developing countries. Due to
rapid modernization and urbanization vehicles are the
1st requirement for transport whtch are expanding
rapidly & resulting in injuries & death in our country3.
Accident is an unexpected event, an unforeseen
occurrence of an unfortunate nature. lt is an event
which is neither expected nor desired.
Accident occurring suddenly, unexpectedly,
uneventfully under unforeseen circumstances.
Numerically road traffic accident, account for the great
majority worldwide, through injuries & fatalities occur
in all form of transportation. ln developing countries
RTA is the most common cause of death below the
1. Department of Forensic Medicine, Uttara Adhunik Medical
College, Uttara, Dhaka
2. Department of Physiology, Uttara Adhunik Medical College,
Uttara, Dhaka
Address for correspondence: Dr. Rehana Yusuf, Department
of Forensic Medicine, Uttara Adhunik Medical College, Uttara, Dhaka
age of 50 & in young aged group, this trend is more
marked. Road traffic accident injuries account for high
medical care costs & loss of productivity in our
countrya. There has been an alarming rise in road
accidents, significantly high way accidents, in
Bangladesh over the past few years. According to a
study conducted by the Accident Research Center
(ARC) of BUET, road accidents claim on average
12,000 lives annually & lead to about 35,000 injuries.
According to World Bank Statistics, annual fatality
rate from road accidents is found to be 85.6 fatalities
per 10,000 vehicles. Hence, the road in Bangladesh
have become deadly. A high groMh in urbanization &
motorization can be identified as one of the factors
leading to the higher number of road accidentss'
Unfortunately the likelihood of being in a road traffic
accident at some point in peoples life is quite high.
Most people travel in cars or motorbikes everyday to
go to work or take children to school. Being in a road
traffic accident is a frightening experience & one that
the people would not like to repeat. A moderate road
traffic accident can result in damage to the parties,
vehicles & some minor bodily injuries6.
Cause of road traffic accident:
There are many causes of road traffic accidents. The
accidents may occur due to the following causes fault
of the victim, fault of the driver, fault of the vehicle,
fault of the another vehicle, not involving in the accident,
Bad road condition, wrong signaling, bad weather etc'
ln Bangladesh everyyeara large portion of totaldeath,
is due to road traffic accident. Most faults are
negligence of controlling authority. They do not survey
thefitness of the vehicle & skillness of the diver propedy.
Most of the vehicles are unfit & most of the drivers

3. r
J Uttara Adhunik Med. College
have no properdriving training & driving licenceT. Most
of the drivers are unskilled more over Bangladesh is a
highly populated developing country. Roads & bridges
are not developed. Overloading of the vehicle by
passenger or by goods causes the driver to lose the
control of the vehicle during turning or slowing the
speed. Besides this, the pedestrians do not follow
the traffic rule. Because most of them are illiterate
they have no idea about traffic rule. Above all these
reasons road trafficaccidents are more in Bangladesh.
The pattern of injuries is fatal & other wise varies
considerably depending upon whetherthe victim is a
vehicle occupant, a motor cyclist, a pedal cyclist or a
pedestrian. Pedestrians suffer most often, the
proportion of these walking victims varies greatly
according to the traffic patterns of different countries.
For instance, Bangladesh has a high rate pedestrians
accidentss. Victims of RTA are pedestrian victims,
while walking or crossing the road. Occupant victims
of the offender vehicle, driver, front seat occupant, rear
seat occupant, occupant victim of the offended vehicle
60-80% vehicular accidents are frontal collision; other
forms are side swiping, rolling over & rear impacts. ln
countries, where the use of seat belts has been made
compulsory, a drop in fatality rate of up to 25% has
been record€d, with similar large reductions in serious
injuries, specially maxillo fascial trauma. The most
common seat belts used are diagonal pus lap strap.
It is also called "Three points' attachment belts".
Simple lap strap is dangerous to aortas. ln developing
countries driver impairment is an important component
of road traffic accidents. Driving at excess speeds,
while under the influence of alcohol or drug, while
spleepy or tired, when visibility is compromised, or
without protective gear for all vehicle occupants are
major factors in crashes deaths & serious injuriesl0.
Alcohol is a contributorfactor in the causation of road
traffic accident. Both the drunken drivers &
pedestrians are responsible for road traffic accident.
The alcoholics driver experiences & increase in
boldness & impulsiveness. This results tendency to
drive faster & more erratically. Road traffic accidents
cause death of the victims on the road or soon after
wards, where there are organ damage, severe
haemorrhage, blockage of air passage from blood or
traumatic asphyxia from fixation of the chest cage by
crushing by some part of vehicle. Delayed death can
be caused by continuing bleeding, intracranial
haemorrhage, renal failure, fat embolism, local
infeclion, chest & other systemic infection, myocardial
Vol. 03, No, 02, July 2013
or cerebral infarction etc. defect in sight or hearing
may have contributed to the RTA11.
The cause of death in car occupants following an
accident are most commonly related to head, neck
or chest injury. ln a series of 1000 consecutive death
of car driver, 42o/ohave skullfracture, 30% have bony
neck injuries, 69% have bony chest injuries, 53% have
brain damage,3To/o rupture aorta & 16% traumatic
rupture of the heart & 50% has some form of other
organ injuries4. The problem grew overtime & has been
regarded as a massive outbreak of a fatal disease.
Road fatalities are said to be correlated with a number
of factors, number of population & increasing numbers
of vehicles, length of roads, weather condition,
mechanical condition of vehicles, drivers, consideration
of traffic laws, commuter safety skills & mores.
The case presented here is a male of 28 yrs involved
with road traffic accident. He died on the spot. The
dead body was sent to the mortuary of Dhaka Medical
College by Shahabag Thana police for medico legal
autopsy.
History
A man aged about 28 yrs was involved with road traffic
accident on27.04.08 at'10:30 a.m. while crossing
road. Hewas run over by a bus. Thevictim expired on
the spot. Police sub inspector from Shahbag Thana
made the inquest report & brought the dead body to
Dhaka Medical College morgue on27.04.08 at 1:00
p.m. the escorting police constable ldentified the dead
body. Post mortem examination was done on 27.04.08
at 1:20 p.m.
On External Examination
Body build -Average, Complexion-Fair, Rigor mortis
- Present all over the body, Mouth - Partially Opened.
Eyes - Closed. Hand were clenched.
Multiple abrasions of different size & shape on different
parts of the body.
lnternal Examination
On dissection - Examination of clotted blood were
found in chest & abdominal cavities. All organ in chest
& abdominal cavities were pale.
Head - Scalp - Haematoma in Rt half.
Skull - Fracture of Rt temporal bone mening as -
were torned.
Brain - Haemorrhage all over the brain that is
intracranial haemorrhage.
204

4. A Case of Road Traffic Accident in the Perspective of Forensic Medic.ine
Neck structure were healthy
ln chest
Bruise in Lt Chestwhich was 5'X4'
Heart - was ruptured
Rib fracture - Lt Side 2nd 1s 7th
Lungs - Lt Lung rupture & Rt Lung pale
ln abdomen
Stomach - pale & contained liqutd food
Urinary bladder @ healthy & full with urine
All organs were pale.
Rt Femurwas fractured.
Opinion - ln my opinion death was due to haemor,rhaEe
followed by shock resulting from above mentronec
injuries in RTA which was antemortem & accidena
in nature.
Discussion:
ldentification of the deceased:
ln any case of road traffic accident the important role
of the Forensic specialist is to the victims. lf the face
is not grossly distorted, the dead body can be easily
identifled by the relatives. lf not possible due to gross
disfiguration, then wearing, birth mark, tattoo mark,
scar mark, occupational mark, keys etc, may help in
identification of the dead body. Following observation
of the type & the nature of the injuries inflicted the
body of the victim. lt is essential to identify whether
the victim was a pedestrian, driver, front-seat or rear
seat occupants
The cause & mechanism of death:
The post mortem exar ^a';o''l ihere was no evidence
of natural disease. 3-i -ac scre'atal injuries to head,
chest & abdomer So :-e :'3ss . ly of death due to
natural cause cos c l€ -- 3: 3-: As the coronary
arteries & its brarc'es ,'.e'e -e€ :-.' &'.rere was no
narrowing of the ate' z --e' :-e - 'ocardrum of
heart valves were l'ea:-., s: :e.::- :-e :c cardiac
pathology could be exr-:3:
Purpose of post mortem erarnination in road
traffic accident:
The investigation of roac ]!=rl l$rlr-: :- - .':t ':
the following PurPose: -
. To identifY the cause 3' z:t'=+-'
Rehana Yusuf & Matia Ahmed
. To allow adequate compensation to the victim, if
he is aliveorthe next-of-kin, if thevictim is dead.
. To punish the offender, if any offence involved
. To search guidelines toward prevention of future
accidents
. ldentification of pedestrian, driver, front seat
occupants & rare seat occuPants
For these purpose, road traffic accidents should be
rnvestigated by a team of expert which, in addition to
ar: experienced investigating police officer, should also
-cr;Ce automobile expert & medico legal expert.
Motor traffic act
i:cc'c nc to BPC 279; whoever drives any vehicles
r' 'ces o' any publrc way tn a manner so, rash or
^e! ge': as io endanger human Iife, or to be likely to
csuSe --1 o' ^.Jry to any other person, shall be
our s-ec ,'. :' -l-sonment of either description for a
terrr ..,^ c' -a) ex:e^C 3 yrs or vrith fine which may
sublect:o :ne n rrr'rluT of one thousand taka. extend
to five thousanc taka. or vrith both.
Studies on Road Traffic Accident:
A WHO advisory group in '1956 defined accident as
an "unpremeditated event resulting in recognizable
damage". The term RTAis defined as any person who
was killed out might or who died within 30 day as a
result of accidents. Accidents constitute a variable
epidemic. They mark now fourth in order among the
leading causes of death, and are responsible for
approximately 8% of all death in the world, 7.9% in
the developing countries & 7.5% in developed
countries. Accidental death are caused by a wide
varietyof road, rail, air, shipping, industrial& domestic
tragedies. An estimated 4 million people die in every
year from injuries globally. About one million people
die of intentional injuries or violence & about 3 million
die of unintentional injuries including those result in
from accident on road,, domestic accident, industrial
accidents, fire arm, drowning, poisoning, fallfrom hight
& naturaldisasters.
About l.2million lives are lost in every year by road
traffic accident around the world of which 8,00000 lakh
mortality is in developing country. Motor vehicle
accidents account for around 22o/o o'f reported
-o-tality.
3a-g'aCesh have a fatality rate in road accident that
s 2l : -es higher than that in the developed countries
a-;

5. J tJEaAdrunik Med. College
& il has one of the highest accident rate in the world.
Studies done by WHO, shows that road traffic
accidents account for 2.5% of the total deaths. These
deaths are largely preventable through the concerted
efforts of institutions & civil society & by implementing
effective road safely measures that tackle leading risk
factors & enable a comprehensive & safe road traffic
system all over the world12. Considering the
importance of the road traffic accident (RTA) issu"e,
world health organization had taken the "Road safety
ls NoAccident"As a themeforworld health Day-2004.
First united Nation road safety week was observed
from 23rd to 29th April 2007 & the United Nations
general assembly resolution in March 2010,
proclaimed period from2011lo2020 as a "Decade of
action for road safety" with the goat to stabilize &
reduce the fatalities due to road traffic accidentsl3.
Preventive measure for Road Traffic Accident
(RrA):
I n Bangladesh, the primary contributin g factors lead ing
to road traffic accidents has been both identified of
course neglected for the longest time adverse road
ways, road side environment, poorly designed
junctions & road sections, reckless driving, drunk
driving, vehicles driven by helpers without proper driving
training & driving license, excessive speeding,
dangerous overtaking, failure to obey mandatory traffic
regulation by pedestrians, mechanized & non
mechanized vehicles playing on the same streets for
example a slow moving rickshaw as opposed to a
very fast moving truck & defective vehicles of course
unsafe driving practice, not using helmets & seatbelt
while driving & using mobile phone by drivers during
driving. Other includes very low level of awareness &
traffic sense among the citizens, mainly illiterate
because of inadequate education, severe loopholes
in traffic law enforcement rules etc14. Here the traffic
police department has a crucial role to play in
identifying & holding accountable reckless driving,
speeding, overtaking & unstable or overloaded vichles.
The maintenance, repair & expansion of road coupled
with setting up drivers on national high ways,
cautioning signals for hazardous locations,
disseminating information on driving & road safety to
massages through media &exemplary punishmentfor
violating traffic laws allthese are needful measure to
decrease road traffic accidents.
As citizens, we too have a role to play in ensuring
road safety, while travelling in public transport,
Vol. 03, No. 02, July 2013
passagers should protest & stop speeding & reckless
driving by bus & taxidrivers. Owners of motorvehicles
should ensure that employed drivers have genuine
licenses, are properly trained & skill in driving & drive
responsibly. Road safety education to pedestrians,
especially children & old people with in communities
by community leaders is also a good way to promote
road safety & to reduce road traffic accidentsE.
Legislation, law enforcing & traffic management
agencies are one side of the solution to the problem
of safe road - no accidents. The other side in the
users of roads, drivers, pedestrians & city dwellers,
all of them should abide by the traffic rules & properly
use of the road then there is possibility to reduce
road traffic accident. The most alarming phenomenon
is when pedestrians cross roads where & when they
are not supposed to do this. lt is very difficult for drivers
in these situations to control their vehicle & save the
life of the pedestrian. So, if the pedestrian cross the
road carefully & use over bridge or underpass during
crossing the road, road traffic accident are decreased.
To reduce occunence of RTA, people should be awared
by using television & radio as effective toolss. The
BRTA has an important role to reduce RTA. The
authorities don't survey the vehicles regularly. lf the
authorities survey the vehicles regularly & give the
fitness certificate of the vehicles properly, it also
reduces RTA. lmproving vehicular visibility is also
important. Two wheeled vehicles such as motor cycle,
which are not easily visible to larger vehicle operators.
lmproving the visibility of cirivers in night or during fog
can reduce RTA. Mandatory using of seat belt, helmet
reduce traffic injuries. Restriction of use of mobile
phone by driver during driving reduces RTA. Restriction
of slow moving vehicle such as rickshaw, cart wheel
in the road where high speed vehicles move, reduce
the RTA.
Recommendations:
School based road safety awareness programmes
should be periodically conducted. Traffic rules & speed
limit should be strictly followed by all the drivers.
Vigilant watch & punishment system should be
established by BRTA & traffic police department for
violation of the rules.
United Nation has proclaimed year 2011 to 2020 as
"Decade of action for road safety; 2011-2020" &
activities all over the world has been launched since
'11h May, 2011 . As a part of the global initiatives, action
206

6. A Case of Road Traffic Accident in the Perspective of Forensic Medicine
should be taken to make young people aware about
their "Major kille/' all over the world & to take preventive
steps against it1a.
Conclusion:
RTA occurs as a result of the interaction of a number
of factors, the drivers, the vehicle & the environment
all play critical roles in the occunence & outcome of
road traffic injuries. Defining the problem & its
contribution factors is a vital step in establishing
preventive measures to ameliorate road ffic safty
problem. A lot of our traffic & road accilent & safety
problems can be solved if drivers & pedestriars ae
both more responsible. There is hol,Iet€r rrys catEge
on the horizon. Bangladesh has impressive records
of family planning, primary school enrollment
especially girls & immunization. A lot d Utese have
been possi ble through usi rB tdevbim, raf,o & pifi€
media to create awareness, tiru.Eh state hEnrcntirn
. The state needs to come fumad uilh iruralive ktec
on how to make the other skle of the cclin - drivers,
pedestrians & city dwdlers dance on the safe road -
no accidents.
Referencqs:
1. World Health Report 2002 M-lO Geneva.
Rehana Yusuf & Matia Ahmed
Peden M. Scurfield R. Steel D et al, World report on road
traffic injury prevention, Geneva, World Health
Organisation, 2004.
Michael M & Claude J. Romer, Accident in Children,
Adolescent & Young adults. A major public health problem,
World Health Statistics Quarterly. Vol 39, No 3, 1986.
Davis F.A. Taber's Cyclopedic Medical Dictionary. 4b edition
P.O. Asian Economic Edition, 1994.
My Bangladesh, Road Accidents in Bangladesh - The
Neglected Social Epidemic Page 9 to 13.
Road TraftAc.cident compensation claims, 2012. Page 1
ol 2.
Principles of Forensic Medicine. Apurba Nandy P 286.
Road Accidents in Bangladesh - The neglected social
Ef*rernic page 2 of '13.
frEht Bernad: Sirnpson's Forensac iredidrc: 'l1th edition.
1Sl7: P{)
Bd* R6 S*:ok. Grirefr€s hr Edinatrg the Coast of
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Ory;gl br -E rEilitEa Deve,emenf 2m3).
The EsscnB d Fqen* ttdcirc and Toxi:obgy. 24th
Edtixr,an5, PqeZ3J..
lErota V-M- Pnarcrrtrrt d red accident ,ole d Healfl
Serv*:es- Smsfi Hild MardFAp.il 19fl): P 92-93.
Decade of Actitrr for Road Safiety 2011-2020.
Road AcciJent - Stand up ageinst the Aarmir€ Threat
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