An electrical lineman is found dead. Examination shows a single pale, parchmented, dry entry mark on the right palm with elevated edges (Joule burn). No exit wound is found. Which scenario BEST explains death without an exit wound?

• A Current passed through the body and was earthed via the entire skin surface (current grounding), dissipating without a focal exit ✓
• B The voltage was too low to produce an exit wound
• C The victim was wearing insulated boots preventing current flow to earth
• D Absence of exit wound means the death was not due to electrocution

Explanation

Exit wounds in electrocution occur where current leaves the body to reach earth. If the victim was standing on a broad conducting surface (wet ground, metal platform), current disperses over a large skin area to earth, dissipating energy diffusely without producing a localized focal exit burn. This is called 'diffuse grounding' and explains the absence of an exit wound despite a clear entry (Joule burn). Voltage alone does not determine the presence/absence of an exit wound; current path and earthing determine it.

Reference: The Essentials of Forensic Medicine and Toxicology (Narayan Reddy), 34th ed.

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Written and medically reviewed by the StethoPrep medical team.