Visual assessment of the timing of bruising by forensic experts

Pilling, M.L.; Vanezis, P.; Perrett, D.; Johnston, A.

doi:10.1016/j.jflm.2009.10.002

« Previous Next »Journal of Forensic and Legal Medicine
Volume 17, Issue 3 , Pages 143-149, April 2010

Visual assessment of the timing of bruising by forensic experts

M.L. Pilling, BMedSci (Hons) (Medical Student)
- Barts and The London School of Medicine and Dentistry, University of London, UK
P. Vanezis, OBE PhD FRCPath (Professor)
- Cameron Forensic Medical Sciences, Barts and The London School of Medicine and Dentistry, University of London, UK
- Corresponding author. Address: Cameron Forensic Medical Sciences, Clinical Pharmacology, Barts and The London, London EC1M 6BQ, UK. Tel.: +44(0)20 7882 3401, mobile: +44(0)7802 563 223; fax: +44(0)20 7882 3408.
D. Perrett, PhD CChem FRSC (Professor)
- Bioanalytical Science, Barts and the London School of Medicine and Dentistry, University of London, UK
A. Johnston, PhD FRCPath (Professor)
- Clinical Pharmacology, Barts and The London School of Medicine and Dentistry, University of London, UK

Received 22 December 2008; received in revised form 22 July 2009; accepted 25 October 2009.

Abstract

Introduction

Forensic experts are frequently asked to comment on the age of injuries and interpretation may have significant medico-legal consequences. The purpose of this study is to determine the accuracy with which forensic experts can visually age a bruise from photographs produced under standard conditions.

Methods

Bruises were produced on the upper arms of 11 subjects by a suction pump. Sequential photographs were taken daily until they were no longer visible to the naked eye. Fifteen forensic experts who did not know the age of the bruises were asked to estimate their ages and also to place them in chronological order.

Results

Hundred and thirty-two images of 25 bruises were produced, ranging from 0 to 209h in age. There was considerable inter- and intra-observer variability in accuracy (median difference between the estimated age and the real age=26.0h (95% C.I. 24.0–31.0h). There was greatest accuracy for bruises photographed between 0 and 12h. No significant differences were seen between male and female observers (p=0.553) and performance was also unaffected by the age of the observer (p=0.160). Of the bruise images placed in chronological order >80% of the observers made between 0 and 2 errors.

Conclusion

Bruise age estimates by forensic experts, from photographs, are unreliable. However, it appears that the vast majority of observers are better able to place bruises from the same subjects in their chronological order.

Keywords: Bruising, Skin, Ageing, Forensic experts