Case Report Forensic tools for the diagnosis of electrocution death: Case study and literature review Cristina Mondello 1 , Antonio Micali 1 , Luigi Cardia 2 , Antonina Argo 3 , Stefania Zerbo 3 and Elvira Ventura Spagnolo 3 Abstract Diagnosis of death by electrocution may be difficult when electric marking is not visible or unclear. Accordingly, the body of a man who appeared to have died from accidental electrocution was carefully forensically analysed. Macroscopic and microscopic analysis of the current mark was carried out using a variable-pressure scanning electron microscope equipped with energy dispersive X-ray microanalyser to highlight skin metallisation, indicating the presence of iron and zinc. The histological findings of electrocution myocardial damage were supported by the results of biochemical analysis which demonstrated the creatine kinase-MB and cardiac troponin I elevation. The effects of electric current flow were also highlighted by perforations of endothelial surface of a pulmonary artery using scanning electron microscope, and all the results were analysed by the main tools suggested in the literature. Keywords Electrocution death, metallisation, biochemical analysis, energy dispersive X-ray analysis, endothelial perforation, scanning electron microscope Introduction The diagnosis of electrocution depends on the morpho- logical findings of the current mark and the circum- stances of death. 1 Some electrocution deaths occur without detectable current marks on the skin, making forensic determination of the cause of death more dif- ficult, 2,3 especially in regard to including different or concurrent factors, 4 and all forensic tools currently available should be used. We report a case study of electrocution death, where the current mark on the skin was biochem- ically analysed, along with lung scanning electron microscope (SEM) analysis and metallisation assess- ment by variable-pressure scanning electron micro- scope (VP-SEM) with energy dispersive X-ray microanalyser (EDX). This case study highlights the usefulness of the forensic investigations, proving also a brief review of the literature on the main diagnostic tools for the diagnosis of electrocution which may also be helpful in cases where no electrical mark can be found. Case report The body of a 47-year-old man was found on a public road hanging with his legs attached to the electric wires of a light pole. Preliminary judicial investigation con- cluded that the man was trying to steal the galvanised steel ropes of the light pole. Relatives reported that the subject did not suffer from pathologies. After the crime scene investigation, an autopsy was ordered to assess the cause and manner of the death. 1 Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy 2 Department of Human Pathology of Adult and Childhood ‘‘Gaetano Barresi’’, University of Messina, Gazzi, Italy 3 Legal Medicine Section, Department for Health Promotion and Mother- Child Care, University of Palermo, Palermo, Italy Corresponding author: Elvira Ventura Spagnolo, Legal Medicine Section, Department for Health Promotion and Mother-Child Care, University of Palermo, Via del Vespro, 129, Palermo 90127, Italy. Email: elvira.ventura@unipa.it Medico-Legal Journal 0(0) 1–5 ! The Author(s) 2018 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav DOI: 10.1177/0025817217749503 journals.sagepub.com/home/mlj