- Analyze the physics of the incident
- Determine the actual injuries
- Analyze the "predicted" and actual injuries
- Evaluate the "as-described" incident
- Analyze the mechanism of injury
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- Gather relevant physical data, e.g., the scene, others involved, reported and possible impact surfaces, electrical conductors, machinery characteristics, reported and possible height of falls, etc.
- Analyze the testimony of emergency services and law enforcement first responders and witnesses.
- Inspect vehicles, restraint systems, helmets, and so forth for deformation, witness marks, presumed blood stains, etc.
- Document the "as-described" (e.g., from testimony) dynamics of the incident ... these dynamics may or may not be supported by analysis.
- The actual injuries (or lack thereof) may be concealed in medical record nuances missed by non-medical biomechanical experts.
- Note that chronic pain can be considered an injury in and of itself.
- Analyze the role of preexisting conditions in the response of the individual to trauma, e.g., see Case Study: Lumbar spine injury with predisposing condition).
- Establish the actual injuries and the medical reality which must be satisfied by any proposed theory of the mechanism of injury.
- Estimate the injuries which are "predicted" by the "as-described" biomechanical model based solely on the "as-described" incident.
- These "predicted" injuries may or may not match the actual injuries, which are consistent with the more realistic biomechanical model.
- The more realistic biomechanical model is based on both the physics of the incident and all the available medical data, e.g., see Case Study: Snowmobile helmet failure and fatal brain injury.
- Compare the forces and dynamics predicted by the "as-described" biomechanical model to the forces and dynamics given by the more realistic biomechanical model.
- If the forces and dynamics produced by the two models do not agree, the "as-described" incident description is probably wrong.
- If so, update the forces and dynamics to those produced by the more realistic biomechanical model, e.g., see Case Study: Bus vs. pedestrian fatal accident.
- Use the combination of realistic and "as-described" biomechanical models to decide whether the "as-described" incident really happened.
- If the actual injuries are inconsistent with the realistic biomechanical model, it is unlikely the incident caused them.
- A realistic model by nature describes body movement and the effects of restraints, e.g., seatbelts in a "what if" alternative scenario.
- Calculate the causal connection (if any) between the incident as described and the mechanism and occurrence of the actual injuries "as simply as possible, but not simpler." (Albert Einstein)
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Engineering + Medicine = Mechanism of Injury
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