Thursday, February 26, 2015

Author Forensic Question: Planting DNA Evidence


I’m considering writing a crime novel that involves the antagonist framing others for crimes he has committed. He is a genius level sociopath who studies his victims' habits by analyzing their trash.  His day job is with the local trash company (handy for him.)

Now the question. Can he use semen from a condom (if it's not too old) to plant on/in a victim? He rapes, kills, and then plants the evidence along with other clues that lead to his intended second victim?

Amryn says:

This is a great scenario for a novel and would certainly throw the police off for a while. For the antagonist to pull this off, he will need to take some precautions. First of all, if he rapes the victims himself, he’ll most certainly need to wear a condom. Secondly, how he kills his victims will be important in determining if he’s left any of his DNA behind. For instance, if he strangles them with his bare hands, it is possible his DNA could be found from a swab of the victim’s neck. The use of a knife would run the risk of cutting himself and leaving his own DNA behind that way.

As far as planting the evidence, that’s certainly possible. In fact, the reverse of this has been done in real life. A man was put in prison for rape, largely because of the DNA evidence against him. While he was in prison, he placed some of his semen in a ketchup packet and smuggled it out to a female friend. She then planted the semen on herself and said she’d been raped. When they collected the evidence and processed it, the DNA came back to the man who was in prison—a pretty good alibi for the time of the rape. He insisted that the DNA results must have been wrong in the first place or someone else had his DNA profile. Of course, his scheme didn’t work, and as far as I know, he’s still in prison. All that to say, yes, planting that sort of evidence is definitely possible.

If your antagonist takes the condom from someone else’s trash, he runs the risk of having another person’s DNA present as well. When things are thrown away, DNA from several sources (presumably everyone who lives in the house) will come in contact with other objects and transfer will happen. There might not be significant enough transfer to matter, but it could result in the bad guy inadvertently transferring the male’s DNA as well as his partner’s DNA to the victim. If that’s his intention, there’s no problem, but it could also provide a way for your hero to figure out that something just doesn’t seem right about this.

Amryn Cross is a full-time forensic scientist and author of romantic suspense and mystery novels. Her novel, Learning to Die, is available on Amazon. The first book in her latest series, loosely based on an updated Sherlock Holmes, is available for pre-order on Amazon. Look for Warzone in January 2015. You can connect with Amryn via her websiteTwitter and Facebook.

Tuesday, February 24, 2015

Choke Holds: A Police Perspective Part 3/3

Today I'm concluding a three part series written by Deputy Karl Mai that gives accurate inside information on police choke holds/stunning techniques, how and when they are applied. 

Follow the links for Part I and Part II.

Welcome back, Karl!

Some final words about all of these techniques.

First, they rely on the effects of a fluid shock wave to have the desired results. It’s not enough to simply strike/punch the target in the described area. Police are taught to strike and hold the pressure of the strike on the targeted area for a second, so to send a fluid shockwave through the body tissues. Also, and this would apply to a carotid restraint as well, police are taught to not let the target simply fall to the ground uncontrolled after using these techniques.

An uncontrolled fall can result in unexpected injuries, especially to a person’s head. After striking the target, if the target goes limp, or gets weak in the knees, police will try to grab hold of the target and guide them to the ground to prevent unwanted injuries. This may not be feasible depending on the dynamics of the fight, or if there are multiple attackers, but the goal of preventing unwanted injuries is always there.

In the case of your secret agent, former Special Forces guy, the writer should consider how the character will restrain the target after incapacitating them, knowing that the target will get up fairly quickly and be very capable of continuing the attack/pursuit.

Some suggestions:

1. If going up against the police or other agents, would be to use the officers own handcuffs or flexi-cuffs (basically large zip ties) to restrain the officer during the precious few seconds they are incapacitated.

2. Have the main character carry handcuffs, or flexi-cuffs of his own.

3. Simply have the character apply the technique, safely guide the target to the ground and use those seconds to run away. If there are additional pursuers, would the character want to waste time handcuffing the officer while other officers/agents are closing in on him?

Another thing to consider is, how would other officers/agents respond to witnessing the main character apply these techniques to one of their fellow officers?  The answer to that question is it raises the stake . . . a lot. 

If a cop sees someone attacking one of their own to the point of incapacitation, it allows for a lethal response. In other words, the character who is actually taking special measures not to have to kill the officer/agent, may suddenly find themselves getting shot at. Or the officer/agent who is being subjected to the technique will likely respond with lethal force if they can manage to do so.

In reality, the officer can’t know what their attacker’s intentions are or what they will do to the officer once incapacitated. Will the attacker simply walk away? Will the attacker continue to assault the officer causing further injury to the officer when the officer is incapacitated? Will the attacker take the officer’s gun and kill the officer, kill other officers, or kill other citizens?

Therefore, when facing incapacitation, loss of consciousness, or being put into a seriously inferior position (such as down on the ground with an attacker on top of the officer), an officer may respond with lethal force. Other officers witnessing this happen to a fellow officer may respond with lethal force as well.

Karl, my personal thanks to you for all of this great information. I know it will definitely make my novels more accurate!


Deputy Karl Mai is a 16 year veteran of the El Paso County Sheriff’s Office in Colorado Springs, CO.  He has mostly worked street patrol and as a Field Training Officer (FTO), but has also worked in the county jail and as a Detective.

Thursday, February 19, 2015

Choke Holds: A Police Perspective Part 2/3

Today we're continuing with a three part series on police choke holds from a law enforcement officer's perspective. 

This is Part II which covers the physiology and mechanism of these strikes. Great details for authors to use in their novels. You can find Part I here.

Welcome back, Karl!

Getting into the physiology of choke-hold techniques would be good background information for the writer/reader as well. First off, let’s clarify one thing. The police don’t “choke” people. Choking implies obstructing a person’s airway and limiting their ability to breath. Because a person can hold their breath for several minutes when calm, or even a mere twenty to thirty seconds while in the midst of a fight, this would be a bad technique for incapacitating someone.

The officer would not only have to apply enough strength to cut off the airway (which is a lot), but also overpower the target long enough for that person to lose consciousness. Using a technique that requires literally all of the officer’s own personal strength for twenty to thirty seconds is not feasible.

What the police actually do, and what you see in MMA, is generally one of several different carotid restraints. Blocking off the blood to a person’s brain at the point of the neck can cause a person to pass out in only a few seconds and requires far less strength to apply correctly. But again, the effects last only a few seconds.

In MMA and in police training, the technique usually involves applying external pressure to the carotid arteries, while not actually interfering with the person’s ability to breath. Some simple internet searching would provide names and a detailed explanation of the techniques for the author to use in their writing.

PLEASE NOTE: Many police departments actually frown upon use of carotid restraints in response to anything less than a serious attack, or even a lethal force situation, because it is very dangerous and can cause death. The police generally don’t have an MMA referee right there watching, telling the officer when to release the restraint and there’s no team of medics standing in the wings ready to immediately render aide, like there is in the world of MMA.

When talking about a strike to a nerve center with the goal of causing incapacitation, there are generally three proven techniques.

The first is called the brachial plexus stun. This is a strike aimed at a massive nerve complex in a person’s neck. The target is about half way between the shoulder and jaw bone and just forward of the major neck muscles on the side of a person’s neck. You can easily find the area by kneading the tips of your fingers deep into the skin of the described area. You’ll find that one spot that is dramatically more painful under the same amount of pressure than the areas around it.  That’s the brachial plexus nerve center.

The strike can be delivered with a normal closed fist punch, an open palm strike, or a forearm strike. If done correctly, the strike literally overloads the brain with pain and causes something akin to an electrical surge that will stun the attacker, make them get weak in the knees and possibly cause a very temporary loss of consciousness.

The police officer must take advantage of these few seconds to put handcuffs on the attacker or get them into some kind of restraint hold that will prevent the attacker from continuing to fight when they get their senses back.

The second technique is known as the, “Gerber Slap.”  This is an open palm strike targeted at the base of the skull, right where those big muscles on the back of the neck attach. The person delivering the strike is trained to slightly cup the hand, so the pressure of the strike actually comes through the fingertips and from the meaty part at the base of one’s palm. Similar to the brachial plexus stun, this causes a massive sensory overload in the brain and a stunning effect, or even a temporary loss of consciousness.

The last one is called the, “Super Scapula Stun.”  This is a strike that you might commonly associate with Hollywood, when the secret agent walks up behind the target and delivers a sharp, Karate type chop, with the blade of their hand, to the target’s shoulder and the target falls to the floor, unconscious.

In reality, it is much harder to pull off and requires significantly more force and pressure than Hollywood ever depicts. The target for the super scapula is the meaty portion of the trapezius muscles, within a couple inches of the neck. The strike is delivered in a downward and inward motion, usually with a closed fist, hammer like motion (as if to stab downward at the target with a knife).

For the best results, both fists should be used, striking at both sides (left and right) simultaneously. Police are often trained that if the target is standing, jumping up to deliver the strike from a higher position is preferred. The police are also trained to kick the target in the back of the legs hoping to drop them to their knees before delivering the strike, again allowing for a strike to come from above. The reason is simple combat physiology. You can hit something harder using that hammer fist strike that is well below shoulder level, than something which is at or above shoulder level.

We'll conclude with Part III next Tuesday.

Deputy Karl Mai is a 16 year veteran of the El Paso County Sheriff’s Office in Colorado Springs, CO.  He has mostly worked street patrol and as a Field Training Officer (FTO), but has also worked in the county jail and as a Detective.

Tuesday, February 17, 2015

Choke Holds: A Police Perspective Part 1/3

This question was sent to me via e-mail by a reader. In light of the recent choke hold death of Eric Garner that involved police, I thought it would be interesting to cover it here from a police training perspective so I've invited just such a person to handle this question. This information will be split over three posts.

Today is Part I.

James asks:

I came across your website when searching out forensics for my novel and wondered if you might be able to assist me.

I am writing a contemporary spy thriller set in the UK. In my spy thriller my protagonist is escaping the police and wants to knock one of them out. But he is a good guy and the police aren’t the baddies in the piece, they’ve just got in the way. So he has no desire to do permanent damage to the cop.

In Hollywood, a blow to the head is enough but I know that in reality there is no guarantee that this will render someone unconscious and is just as likely to cause brain injury. Other techniques in films are choke holds and striking certain nerves in the neck.

My question: Are either of these options really feasible? If my character was ex-special forces would he be able to choke someone just long enough to make them lose consciousness while avoiding starving the brain of oxygen and thus causing brain damage?

Similarly, are there any nerves or blood vessels that he could strike or cut off that would render the victim unconscious while avoiding serious harm? If the victim were struggling would this make a difference?
Karl Says:

The answer to much of this is ‘yes’ there are several ways to temporarily incapacitate a person via choke hold, or a strike to one of several nerve centers.

What Hollywood generally gets wrong is how long this effect lasts. Hollywood will show a person getting “knocked out,” and there is time for the hero to drag the limp body off to a dark corner, or simply leave them behind where they fall and continue their mission, escape, etc.

The truth is, many of these techniques will merely stun a person, and rarely knock them out. Either way, the effects only last for a few seconds, even if the person is knocked unconscious. In law enforcement, when we train with these techniques, the general rule of thumb is that the technique must be followed with handcuffing, or another approved restraint technique.

If a police officer has legal justification to apply a “choking” restraint against a person, or if we strike one of the nerve centers with a goal of stunning them, the same officer will generally have enough cause to arrest that person as well. But the main reason for the restraints is because the cop doesn’t want the attacker to simply get up a few seconds later and continue the attack.

One of the best examples I can give you is the very real world of Mixed Martial Arts (MMA). Watching this sport on television demonstrates my point perfectly. The fighter who gets incapacitated, knocked out with a punch, or choke hold generally gets up within just a few seconds. Generally, he wants to continue the fight even though they have actually just lost the fight and may not even realize it. 

It's as if the fighter’s brain has been paused as a result of being temporarily stunned from the knockout punch and as soon as the PLAY button is pressed, the fighter’s brain and body want to start where they left off, which was in the middle of a fight. This is why you will often see the referee having to restrain the fighter who was just knocked out and explain to them, “Dude, you just lost. You got knocked out.”  This sometimes takes a few moments to sink in with the recently knocked out fighter.

They are still overcoming the effects of the being knocked out. Their brain is still trying to catch up. They don’t remember falling to the canvas like a sack of bricks. Sometimes the fighter falls and his hands are still up in a fighting position, but his eyes are staring off into space. But they still get up after only a few seconds and they are very capable of continuing the fight, but the rules of MMA prevent this. There are no rules on the street and a police officer must take into account that the person will continue the fight unless something is done to prevent it.

We'll continue with Part II on Thursday. 

Deputy Karl Mai is a 16 year veteran of the El Paso County Sheriff’s Office in Colorado Springs, CO.  He has mostly worked street patrol and as a Field Training Officer (FTO), but has also worked in the county jail and as a Detective.

Thursday, February 12, 2015

An 1887 Rule Book for Nurses-- Has Anything Changed?

Recently, I was tagged on FB for a blog post entitled A List of Rules for Nurses . . . From 1887

To me, it's interesting that some things haven't changed in over 100 years.

The first several rules are about keeping the ward clean, warm and bright! I'm glad I'm not mostly responsible for sweeping and mopping floors, bringing in coal, and filling kerosene lamps. However, in the ER, it just might surprise you how much of the room the nursing staff overturns just to keep the patients flowing through the unit. 

In some ways, nurses in 1887 might have had it marginally better. They still worked 12 hours shifts but got time off on Sunday for the Sabbath from 12pm-2pm. I doubt my nurse manager would approve anything of the sort if I was working a Sunday shift. Should I ask? 

One of the rules reads: "Any nurse who smokes, uses liquor in any form, gets her hair done at the beauty shop or frequents dance halls will give the director of nurses good reason to suspect her worth, intentions and integrity."

Honestly, I don't know if this standard has changed-- simply morphed. 

Let's take the action of a hospital to not hire smokers. Or the case of this nurse getting fired for posting a photo of an empty but recently used trauma room (even though it was a repost from a doctor's Instagram account and he was not fired.) Even today, nurses have to be very careful about what they post to social media-- it can be detrimental to your job.

What do you think? Are nurses better off today than one hundred years ago?   

Tuesday, February 10, 2015

Author Question: Oleander Poisoning

Robin Asks: What might be the effects of yellow oleander if it is brewed into a tea with the intention to poison someone?

Jordyn Says:

Interesting question, Robin.

From my research, it seems like all parts of the oleander plant are toxic and poisoning occurs if someone ingests the nectar from the flowers or ingests the leaves of the plant-- which could likely be dried and brewed in a tea. Evidently, you can be poisoned as well from honey made by bees gathering nectar from the plants. Evidently, oleander poisoning is a big problem in South Asia.

From what I gather, oleander has digitalis-like effects on the heart. Digoxin (or Lanoxin) is a drug that slows the heart beat down and also makes the heart pump more efficiently. It's most commonly used with rapid heartbeats that are generated from the top side of the heart like atrial fibrillation. It can also be used in combination with other drugs for patients who suffer from congestive heart failure.

A great way to research what the victim in your novel might be experiencing is to look at digitalis toxicity or poisoning. These symptoms can include irregular pulse, palpitation, nausea, vomiting, abdominal pain, headache and vision changes (blurred or yellow vision.) Patients who have poorly functioning kidneys will develop these effects faster. This may be a good thing to add to your story line.

Death likely occurs from interruption of the normal cardiac rhythm and/or a rise in serum potassium levels which is very toxic to the heart. Potassium is used to stop the heart in lethal injection executions. This article highlights five cases of accidental or intentional ingestion of digoxin and the effects it had on the patient.

Treatment of the patient with oleander poisoning is largely supportive and can include some or all of the following.

1. Decrease the amount of drug/poison in the person's blood. This is generally done if we know the patient has taken a lethal dose within one hour of hitting the ER. Generally, activated charcoal is given by mouth. Hopefully, the patient will voluntarily swallow it. If not, we'll place a tube into their stomach and give it that way.

2. Decrease cardiac arrhythmias. This can be done with two drugs. One is atropine which helps to increase slow heart rhythms and the other is lidocaine which helps control an irritable heart which can lead to lethal ventricular arrhythmias. Of course, cardiac defibrillation is indicated for patients suffering from shockable rhythms. Here is a post I did about the appropriate use of electricity in patients.

3. Treat increased serum potassium levels. The goal of this is to drive potassium back inside the cells which will decrease the levels in the blood. The drugs given to lower serum potassium are sodium bicarbonate and glucose and insulin (given together) IV. Kayexalate is a binding agent that needs to find it's way to the gut somehow. Easiest way is to insert it rectally.

4. Dialysis to lower drug levels.

5. Digoxin binding agents.

The research on what works best is not entirely settled which is good for an author because it gives you a lot of leeway when writing.

It was hard to find cases of "natural" poisoning using plants. This Wikipedia article points to three but you have to consider the source. You'd likely have to ingest a lot. Cardiac glycosides (as the drug Digoxin is) have a long half-life (meaning they stay in your system for several hours) so you could theorize that a potent tea given three times a day could have a cumulative effect.

Hope this helps and best of luck with your novel!

Thursday, February 5, 2015

New Medical Device: Zoll R Series Defribillator

It's difficult for new medical devices to impress me. This one did.

One of the challenges in medicine is doing effective CPR. Research studies have consistently shown that what generally saves a patient's life is early and effective CPR. That's when all the other bells and whistles that we have in our medical stockpile will work.

However, you might be surprised at how ineffectively we do CPR. For one thing, it's physically hard to compress the chest enough to generate a pulse. Second, it's tough to measure the effectiveness of compressions. The way this is traditionally accomplished now is through palpating a pulse during CPR (which is difficult to do accurately) or to measure what's called end tidal CO2 which is best accomplished when a patient has a breathing tube down their trachea.

Another difficulty in doing CPR is the amount of artifact it creates. Artifact is something you see on the monitor that isn't a true representation of the patient's condition. For instance, if a patient is connected to a monitor and you pick up their ECG leads and shake them-- you can make it look like they're in a lethal cardiac rhythm.

If you're doing effective compressions, you can't see the patients underlying rhythm but stopping CPR to check a patient's rhythm takes away from its effectiveness as well. It takes a while to establish pulsatile flow with CPR so every time you stop, the patient can suffer.

The Zoll R Series Defibrillator attempts to change some of these issues and if it is able to do what it says-- it could mean a big improvement for patient care.

It has a pad that is placed at the center of the patient's chest. This measures the effectiveness of compressions and makes sure they are at the right rate and depth. It also allows you to see the patients underlying rhythm while compressions are ongoing which can lead to better treatment at the bedside when a rhythm changes.

It will be interesting to see if a device like this will decrease the morbidity and mortality around code events.

I was not paid by the company to review this product.

Tuesday, February 3, 2015

Dr. Richard Mabry: Blast Injury Hearing Loss

It's always a pleasure to host Dr. Richard Mabry. His expertise was of great value in a manuscript I critiqued on hearing loss related to being in a confined space during an explosion. His next novel, Fatal Trauma, releases May 2015. 

Welcome back, Richard!

One of the possible medical scenarios for fiction is a hearing loss after a blast injury. I’ve read my share of detective stories and mysteries where gunshots occur, but only rarely have I seen addressed the ringing in the ears (tinnitus) and occasional brief hearing loss that may follow. But gunshots aren’t the only source of hearing change from loud sounds.

Let’s take an example of a blast in a confined space—a bomb, for instance. The first type of hearing loss to be considered would be due to the physical trauma to ears. Compression waves of a blast often rupture an eardrum, typically producing a triangular tear in the tympanic membrane. These sometimes heal spontaneously while other cases require a specialist to apply something like a paper patch to speed healing. In some situations a surgical procedure (tympanoplasty) is necessary.

Blast injuries can also disrupt the continuity of the three bones that form the chain conducting sound waves through the middle ear. This type of injury always requires surgical correction. However, assuming there is no damage to the inner ear (actual organ of hearing), all the injuries listed thus far are “conductive” losses—a hearing loss due to interruption of the conduction of sound.

When hearing is tested, levels are checked using earphones (air audiometry) and then a conductor of sound placed against the mastoid bone (bone audiometry). If there is a conductive loss, the air levels are decreased, but the bone levels remain fairly normal (because the sound short circuits the middle ear and goes direct to the organ of hearing). If both air and bone levels are down, the loss is caused by problems in the inner ear and is called “nerve” loss.

Noise, however produced, can also damage the inner ear (the curious can look up “Organ of Corti”), producing either a temporary or permanent nerve-type hearing loss. A rock concert may make a person’s ears ring and produce a temporary hearing loss (temporary threshold shift, or TTS) for up to a day or two.

Gunfire can do the same thing, and the bigger the gun, the bigger the bang, and the bigger the chance for noise-induced hearing loss (NIHL). This is sometimes temporary, but with repeated exposure or one huge sound exposure, the loss may be permanent. Although experimental treatments exist, at present there is no recognized treatment for NIHL and the tinnitus that accompanies it. How can you tell if the loss is permanent? You retest, because, as the saying goes, “only time will tell.”

Let me make a final point. What happens in your story isn’t as important as what happens in your life. Use ear protectors when you mow the lawn or at the shooting range. Encourage your kids to keep their exposure to noise down. And, if a sound makes your ears ring, avoid it in the future.


Richard Mabry is a retired physician, past Vice President of the American Christian Fiction Writers, and auth or of “medical suspense with heart.” His novels have been a semifinalist for International Thriller Writers’ debut novel, finalists for the Carol Award and Romantic Times’ Reader’s Choice Award, and winner of the Selah Award. His latest, Critical Condition, is his seventh published novel. You can follow Richard on his blog, on Twitter, and his Facebook fan page.

Sunday, February 1, 2015

Up and Coming

Hello Redwood's Fans!

How is everyone doing? Today, I am saving lives in the pediatric ER while the rest of you are enjoying the Super Bowl. So-- who are you rooting for? I live in Colorado so I would have a difficult time rooting for either team. I think both teams exhibit poor sportsmanship and if New England really did deflate those balls then the Colts should have gone to the big game.


If, amongst all the Super Bowl hype, you've missed that there is a large measles outbreak happening-- tune your ears in. I am fully in favor of vaccinating your children. If you are vaccinated, your chances of getting measles is 1% and you'll likely be less sick if you do contract the disease. If you're not vaccinated, your chances of acquiring the disease is 90%-- pretty much you're going to get measles. Also, herd immunity, which I've blogged about here, needs to be 95% to protect you if you're not vaccinated. So-- if you live in a community where vaccination rates are low and you're not vaccinated either-- pretty much plan on getting the measles if just ONE kids pops up with them.

To those of you who feel getting the real measles is better or wanted to spare your children a shot-- here's a link for you discussing how potentially dangerous measles infection is. Even if your child doesn't realize the most serious complications they're going to be sick for 1-2 weeks and will need to be isolated.

Here's my point. If you, as a parent, would get the vaccine during a major outbreak you should get it preventively.

For you this week.

Tuesday: Friend and author Dr. Richard Mabry stops by to discuss blast injury related hearing loss. Did you know he's got a new novel releasing soon!

Thursday: A new medical device for you to use in your fiction novels.

Have a great week!