Michael Shkrum - Academia.edu (original) (raw)

Papers by Michael Shkrum

Humana Press eBooks, 2007

Evaluations of crash protection safety features require measures for quantifying impact severity.... more Evaluations of crash protection safety features require measures for quantifying impact severity. Velocity change (delta-V) is the major descriptor of collision severity used in most real-world crash databases. One of the limitations of delta-V is that it does not account for the time over which the crash pulse occurs (delta-t). Late model GM vehicles equipped with event data recorders capture the cumulative delta-V in 10 ms intervals over the crash pulse. Deceleration can be readily calculated from these data and provides a complementary measure of severity that has not previously been available for real world crashes. The relationship between maximum delta-V and deceleration was examined for different vehicle platforms involved in real world frontal impacts and frontal crash tests. Maximum deceleration was observed to be closely correlated to the maximum delta-V.

PubMed, 1989

A 64-year-old woman, who was taking long-term enteric-coated aspirin therapy for rheumatoid arthr... more A 64-year-old woman, who was taking long-term enteric-coated aspirin therapy for rheumatoid arthritis, was prescribed approximately twice her normal dosage (7.1 g daily) during a ten-day convalescence following surgery. Although she presented with features mimicking sepsis, biochemical analysis, ie, a spuriously high carbon dioxide content, suggested salicylate intoxication (admission salicylate concentration, 5.13 mmol/L). She died on the third day after admission. Autopsy showed no major source of infection except for bronchopneumonia. Long-term users of a high-dose aspirin are at risk for potential salicylate intoxication. The metabolism of salicylate, particularly its excretion kinetics, can make small upward dosage adjustments hazardous. Salicylate has widespread metabolic effects that can mimic other medical conditions, leading to delayed diagnosis of salicylate intoxication. Increased mortality and morbidity may result.

PubMed, 1989

Extra-adrenal myelolipomas are rarely reported lesions, with only 18 cases found in the world lit... more Extra-adrenal myelolipomas are rarely reported lesions, with only 18 cases found in the world literature. We report a series of three cases, all occurring in women in an age range of 68 to 83 years (mean, 77 years). One patient presented with a pelvic mass while the other two cases were incidental findings at autopsy. All lesions were presacral in location, encapsulated, and not attached to adjacent structures. Sizes ranged from 6 to 12 cm in greatest dimension and from 72 to 330 g. Color was a variegated yellow to red-brown. Microscopically, all were composed of mature fat and focal collections of normal hematopoietic elements. The nature of these lesions is not known but most authors favor a choristomatous origin. They must be distinguished from extramedullary hematopoietic tumors seen in patients with severe anemias, myeloproliferative disorders, and skeletal disease.

American Journal of Forensic Medicine and Pathology, Dec 1, 1996

This study investigated the role of the front airbags in two moderate severity single vehicle fro... more This study investigated the role of the front airbags in two moderate severity single vehicle frontal impacts where there were unusual fatal outcomes. In both cases, either trauma from the collision or airbag involvement was hypothesized to be involved. In one case, the front airbags did not deploy and the belted male driver was found dead at the scene. Post-mortem evidence indicated that the occupant had a bicuspid aortic valve and sudden aortic dissection likely precipitated by the collision. In the other case, a belted elderly female front passenger sustained severe head and neck injuries due to interaction with the first stage of the advanced passenger's airbag, and subsequently died in hospital. The elderly female had an underlying arthritic degenerative cervical spinal disc and facet disease which contributed to the injuries. In-depth investigation and reconstruction, including linking crash and injury data was critical for understanding occupant injury mechanisms, and determining the role of the front airbags in these two cases.

More than thirty years ago, the Road Safety and Motor Vehicle Regulation Directorate of Transport... more More than thirty years ago, the Road Safety and Motor Vehicle Regulation Directorate of Transport Canada began establishing multidisciplinary accident research teams across Canada. Historically, these teams have been located in universities under the direction of one or more professors who have an interest in, and a commitment to, road traffic safety. The motivation for this data collection project is to provide the ministry with the necessary field research data that will identify important safety issues and monitor responses to government rule making.

Journal of the Canadian Society of Forensic Science, 1996

ABSTRACTA 58 year-old-man was found dead with three gunshot wounds of the head due to a.38 calibr... more ABSTRACTA 58 year-old-man was found dead with three gunshot wounds of the head due to a.38 calibre revolver. Post-mortem examination showed that all of the entry wounds were contact range. This observation was supported by subsequent firearms residue analysis. Only one of the wound tracks penetrated the brain. These findings and information gathered by the police and coroner regarding the scene and circumstances of the death confirmed the manner of death as suicide.Review of the literature reveals that suicides involving more than two gunshot wounds, particularly of the head, are unusual.

American Journal of Forensic Medicine and Pathology, Dec 1, 2015

Injuries of small bowel and its mesentery due to blunt trauma are uncommon. Of deaths due to dela... more Injuries of small bowel and its mesentery due to blunt trauma are uncommon. Of deaths due to delayed intra-abdominal hemorrhage, mesenteric laceration is a rare cause of hemoperitoneum. A case of a 33-year-old man, who was hospitalized with chest and retroperitoneal trauma after a forklift rollover, is presented. He died 10 days after the incident. At autopsy, he had a massive hemoperitoneum due to a small bowel mesenteric laceration, which was not diagnosed during his clinical course. Microscopic examination of the hematoma around the laceration revealed healing and ruptured pseudoaneurysms in the distal branches of the superior mesenteric artery.

American Journal of Forensic Medicine and Pathology, Jun 1, 2018

Sudden death resulting from intracardiac leiomyomatosis is rare. In this case, a 50-year-old woma... more Sudden death resulting from intracardiac leiomyomatosis is rare. In this case, a 50-year-old woman was found to have intracardiac leiomyomatosis, which originated in veins in the broad ligament. Tumor filled the entire inferior vena cava and extended into the right heart where it had embolized and occluded the right main pulmonary artery. The mechanism of death was sudden right heart failure.

Humana Press eBooks, 2007

Page 1. Forensic athology of Trauma Common Problems for the Pathologist Michael J. Shkrum, md Dav... more Page 1. Forensic athology of Trauma Common Problems for the Pathologist Michael J. Shkrum, md David A. Ramsay, Humana Press Includes Companion CD Page 2. Forensic Pathology of Trauma Page 3. FORENSIC SCIENCE ...

Journal of the Canadian Society of Forensic Science, 1990

ABSTRACTDiphenhydramine (DPH) is an antihistamine available in many over-the-counter (OTC) produc... more ABSTRACTDiphenhydramine (DPH) is an antihistamine available in many over-the-counter (OTC) products, particularly sleep-aids, and some prescription preparations. The number of reported poisonings and deaths have increased since the early 1980's. Sixteen fatalities occurred in Ontario from 1984–87 (eight additional cases from 1982–83 were reviewed). All were suicidal ingestions and the age range was 17–81 years (mean age 35 yrs). DPH was the only CNS depressant ingested (monoingestions) in four cases, all showing post mortem blood concentrations above the potentially fatal concentration (0.50 mg/100 mL). The remaining deaths involved DPH combined with ethanol and/or CNS depressant drugs and, compared to the monoingestion group, the average and minimum fatal DPH concentrations were lower. Five of these cases were at or below 0.50 mg/100 mL (range 0. 21–0.50 mg/100 mL). They were older than the average individuals and had significant cardiac disease. Sleep-aids dominated in the DPH deaths studied. Investigat...

American Journal of Forensic Medicine and Pathology, Dec 1, 2018

Reference charts for body and organ measurements of neonates and infants were derived from data o... more Reference charts for body and organ measurements of neonates and infants were derived from data on 900 investigations done by the Office of the Chief Coroner for Ontario. The statistical analyses in this new reference source addressed deficiencies in sources currently available to pathologists. The present study also considered whether organ weights differed based on the classification of infant deaths using the original definition of either sudden infant death syndrome (SIDS) or sudden unexplained death (SUDS) which considers cases occurring in an unsafe sleeping environment or under adverse socioeconomic conditions. Cases of SUDS for both sexes peaked in 5 to 16 weeks of age. The thymus in the SUDS/SIDS age groups less than 25 weeks weighed more than the control group. Adrenal weights in SUDS cases between 9 and 16 weeks weighed less than SIDS cases. This could mean that deaths in unsafe sleep environments are truly sudden in infants who may have a limited adrenal response to acute hypoxia but have been unaffected by preceding chronic stressors.

Journal of Forensic Sciences, Aug 12, 2016

Hanging deaths from investigation standpoint are rarely problematic. Unusual circumstances can on... more Hanging deaths from investigation standpoint are rarely problematic. Unusual circumstances can on occasion raise suspicion of foul play. Associated neck injuries are reported in the literature with variable frequency (from 0% to 76.8%). This study retrospectively analyzed 755 hanging deaths in Ontario (Canada) to evaluate the demographic features and circumstances of hanging fatalities, and the frequency of hanging-related neck injuries. A number of cases showed unusual/special circumstances (e.g., complex, double suicides, restraints). Among 632 cases with complete autopsies, hyoid and larynx fractures were present in 46 cases (7.3%) with the most common being isolated hyoid fractures. The incidence of cricoid fractures was 0.5% and cervical spine injuries, 1.1%. A higher incidence of neck injuries occurred among males, long drop hangings, and in cases with complete suspension. There was a tendency for the number of fractures to increase with increasing age and weight of the deceased.

Pathology, 1992

A spontaneous tear of the ascending aorta, with or without medial dissection, can cause sudden de... more A spontaneous tear of the ascending aorta, with or without medial dissection, can cause sudden death from hemorrhage due to aortic rupture. Two representative cases are described. Review of the clinical history and pathological changes showed that the terminal event was delayed allowing healing and reactive changes to occur in the aortic wall. A pathologist confronted with a fatal case of aortic rupture should be aware that death is not always immediate. Recognition of this has medicolegal importance, particularly if medical management is questioned because of a missed clinical diagnosis.

Journal of Forensic Sciences, Mar 1, 1991

The azygos vein ascends along the thoracic spine through the mediastinum and drains into the supe... more The azygos vein ascends along the thoracic spine through the mediastinum and drains into the superior vena cava at the level of the fourth thoracic vertebra. Fracture-dislocation of the mid-thoracic spine, as a result of blunt thoracic trauma, can tear the azygos vein. Four such fatal cases (three motor vehicle accidents and one fall) were studied, only one of which was recognized prior to death. The vein can also be torn, in the absence of skeletal injuries, by horizontal acceleration/deceleration forces. The pathologist must consider azygos vein laceration as a possible cause of either hemothorax or hemomediastinum or both in a victim of a blunt chest trauma, if that individual had persistent hypotension during the few hours before death and no identifiable source of hemorrhage can be found postmortem in sites such as the heart, great vessels, lung, and chest wall. A fracture-dislocation of the thoracic spine may not necessarily be present. Azygos vein laceration seems to be an uncommon cause of hemothorax and hemomediastinum; however, this injury is probably more frequent than is implied by the few cases described in the medical literature.

American Journal of Forensic Medicine and Pathology, Mar 1, 2000

Journal of Forensic Sciences, Mar 1, 1996

Journal of the Canadian Society of Forensic Science, 1999

ABSTRACTInfective endocarditis can rarely present as a sudden or unexpected death occurring outsi... more ABSTRACTInfective endocarditis can rarely present as a sudden or unexpected death occurring outside of hospital. Two such cases were studied and the diagnosis was determined only after autopsy examination. A 36-year-old male intravenous drug abuser had staphylococcal and enterococcal septicemia and endocarditis of the mitral valve. He died in jail five days after presenting with nausea and vomiting. The other case was an asymptomatic 30-year-old male with a bicuspid aortic valve and a coarctation of the aorta who developed Streptococcus viridans endocarditis and was found dead at home one hour after last being seen alive. Both had left ventricular failure from valve perforation and subsequent valve incompetence. The drug abuser had evidence of disseminated infection. Infective endocarditis was confirmed by appropriate histopathological examination and microbiological culture.

Sodium azide is the primary propellent used to generate the nitrogen gas that inflates automobile... more Sodium azide is the primary propellent used to generate the nitrogen gas that inflates automobile air bags. The combustion process also produces an alkaline aerosol containing a small quantity of sodium hydroxide and sodium carbonate. Alkaline substances are well known for their ability to penetrate the eye and cause serious ocular injury. This paper reports the results of a multidisciplinary investigation into a high-severity, offset-frontal impact involving air bag deployment. The 52-year-old, female driver of the case vehicle survived the collision with no life-threatening injuries due to the protection provided by her seat belt and air bag. However, she sustained a serious alkali injury to her left eye presumably from exposure to the aerosol released through the air bag vents. She also sustained multiple fractures of her upper and lower extremities (MAIS-3) due to occupant compartment intrusion. (A)

Humana Press eBooks, 2007

Evaluations of crash protection safety features require measures for quantifying impact severity.... more Evaluations of crash protection safety features require measures for quantifying impact severity. Velocity change (delta-V) is the major descriptor of collision severity used in most real-world crash databases. One of the limitations of delta-V is that it does not account for the time over which the crash pulse occurs (delta-t). Late model GM vehicles equipped with event data recorders capture the cumulative delta-V in 10 ms intervals over the crash pulse. Deceleration can be readily calculated from these data and provides a complementary measure of severity that has not previously been available for real world crashes. The relationship between maximum delta-V and deceleration was examined for different vehicle platforms involved in real world frontal impacts and frontal crash tests. Maximum deceleration was observed to be closely correlated to the maximum delta-V.

PubMed, 1989

A 64-year-old woman, who was taking long-term enteric-coated aspirin therapy for rheumatoid arthr... more A 64-year-old woman, who was taking long-term enteric-coated aspirin therapy for rheumatoid arthritis, was prescribed approximately twice her normal dosage (7.1 g daily) during a ten-day convalescence following surgery. Although she presented with features mimicking sepsis, biochemical analysis, ie, a spuriously high carbon dioxide content, suggested salicylate intoxication (admission salicylate concentration, 5.13 mmol/L). She died on the third day after admission. Autopsy showed no major source of infection except for bronchopneumonia. Long-term users of a high-dose aspirin are at risk for potential salicylate intoxication. The metabolism of salicylate, particularly its excretion kinetics, can make small upward dosage adjustments hazardous. Salicylate has widespread metabolic effects that can mimic other medical conditions, leading to delayed diagnosis of salicylate intoxication. Increased mortality and morbidity may result.

PubMed, 1989

Extra-adrenal myelolipomas are rarely reported lesions, with only 18 cases found in the world lit... more Extra-adrenal myelolipomas are rarely reported lesions, with only 18 cases found in the world literature. We report a series of three cases, all occurring in women in an age range of 68 to 83 years (mean, 77 years). One patient presented with a pelvic mass while the other two cases were incidental findings at autopsy. All lesions were presacral in location, encapsulated, and not attached to adjacent structures. Sizes ranged from 6 to 12 cm in greatest dimension and from 72 to 330 g. Color was a variegated yellow to red-brown. Microscopically, all were composed of mature fat and focal collections of normal hematopoietic elements. The nature of these lesions is not known but most authors favor a choristomatous origin. They must be distinguished from extramedullary hematopoietic tumors seen in patients with severe anemias, myeloproliferative disorders, and skeletal disease.

American Journal of Forensic Medicine and Pathology, Dec 1, 1996

This study investigated the role of the front airbags in two moderate severity single vehicle fro... more This study investigated the role of the front airbags in two moderate severity single vehicle frontal impacts where there were unusual fatal outcomes. In both cases, either trauma from the collision or airbag involvement was hypothesized to be involved. In one case, the front airbags did not deploy and the belted male driver was found dead at the scene. Post-mortem evidence indicated that the occupant had a bicuspid aortic valve and sudden aortic dissection likely precipitated by the collision. In the other case, a belted elderly female front passenger sustained severe head and neck injuries due to interaction with the first stage of the advanced passenger's airbag, and subsequently died in hospital. The elderly female had an underlying arthritic degenerative cervical spinal disc and facet disease which contributed to the injuries. In-depth investigation and reconstruction, including linking crash and injury data was critical for understanding occupant injury mechanisms, and determining the role of the front airbags in these two cases.

More than thirty years ago, the Road Safety and Motor Vehicle Regulation Directorate of Transport... more More than thirty years ago, the Road Safety and Motor Vehicle Regulation Directorate of Transport Canada began establishing multidisciplinary accident research teams across Canada. Historically, these teams have been located in universities under the direction of one or more professors who have an interest in, and a commitment to, road traffic safety. The motivation for this data collection project is to provide the ministry with the necessary field research data that will identify important safety issues and monitor responses to government rule making.

Journal of the Canadian Society of Forensic Science, 1996

ABSTRACTA 58 year-old-man was found dead with three gunshot wounds of the head due to a.38 calibr... more ABSTRACTA 58 year-old-man was found dead with three gunshot wounds of the head due to a.38 calibre revolver. Post-mortem examination showed that all of the entry wounds were contact range. This observation was supported by subsequent firearms residue analysis. Only one of the wound tracks penetrated the brain. These findings and information gathered by the police and coroner regarding the scene and circumstances of the death confirmed the manner of death as suicide.Review of the literature reveals that suicides involving more than two gunshot wounds, particularly of the head, are unusual.

American Journal of Forensic Medicine and Pathology, Dec 1, 2015

Injuries of small bowel and its mesentery due to blunt trauma are uncommon. Of deaths due to dela... more Injuries of small bowel and its mesentery due to blunt trauma are uncommon. Of deaths due to delayed intra-abdominal hemorrhage, mesenteric laceration is a rare cause of hemoperitoneum. A case of a 33-year-old man, who was hospitalized with chest and retroperitoneal trauma after a forklift rollover, is presented. He died 10 days after the incident. At autopsy, he had a massive hemoperitoneum due to a small bowel mesenteric laceration, which was not diagnosed during his clinical course. Microscopic examination of the hematoma around the laceration revealed healing and ruptured pseudoaneurysms in the distal branches of the superior mesenteric artery.

American Journal of Forensic Medicine and Pathology, Jun 1, 2018

Sudden death resulting from intracardiac leiomyomatosis is rare. In this case, a 50-year-old woma... more Sudden death resulting from intracardiac leiomyomatosis is rare. In this case, a 50-year-old woman was found to have intracardiac leiomyomatosis, which originated in veins in the broad ligament. Tumor filled the entire inferior vena cava and extended into the right heart where it had embolized and occluded the right main pulmonary artery. The mechanism of death was sudden right heart failure.

Humana Press eBooks, 2007

Page 1. Forensic athology of Trauma Common Problems for the Pathologist Michael J. Shkrum, md Dav... more Page 1. Forensic athology of Trauma Common Problems for the Pathologist Michael J. Shkrum, md David A. Ramsay, Humana Press Includes Companion CD Page 2. Forensic Pathology of Trauma Page 3. FORENSIC SCIENCE ...

Journal of the Canadian Society of Forensic Science, 1990

ABSTRACTDiphenhydramine (DPH) is an antihistamine available in many over-the-counter (OTC) produc... more ABSTRACTDiphenhydramine (DPH) is an antihistamine available in many over-the-counter (OTC) products, particularly sleep-aids, and some prescription preparations. The number of reported poisonings and deaths have increased since the early 1980's. Sixteen fatalities occurred in Ontario from 1984–87 (eight additional cases from 1982–83 were reviewed). All were suicidal ingestions and the age range was 17–81 years (mean age 35 yrs). DPH was the only CNS depressant ingested (monoingestions) in four cases, all showing post mortem blood concentrations above the potentially fatal concentration (0.50 mg/100 mL). The remaining deaths involved DPH combined with ethanol and/or CNS depressant drugs and, compared to the monoingestion group, the average and minimum fatal DPH concentrations were lower. Five of these cases were at or below 0.50 mg/100 mL (range 0. 21–0.50 mg/100 mL). They were older than the average individuals and had significant cardiac disease. Sleep-aids dominated in the DPH deaths studied. Investigat...

American Journal of Forensic Medicine and Pathology, Dec 1, 2018

Reference charts for body and organ measurements of neonates and infants were derived from data o... more Reference charts for body and organ measurements of neonates and infants were derived from data on 900 investigations done by the Office of the Chief Coroner for Ontario. The statistical analyses in this new reference source addressed deficiencies in sources currently available to pathologists. The present study also considered whether organ weights differed based on the classification of infant deaths using the original definition of either sudden infant death syndrome (SIDS) or sudden unexplained death (SUDS) which considers cases occurring in an unsafe sleeping environment or under adverse socioeconomic conditions. Cases of SUDS for both sexes peaked in 5 to 16 weeks of age. The thymus in the SUDS/SIDS age groups less than 25 weeks weighed more than the control group. Adrenal weights in SUDS cases between 9 and 16 weeks weighed less than SIDS cases. This could mean that deaths in unsafe sleep environments are truly sudden in infants who may have a limited adrenal response to acute hypoxia but have been unaffected by preceding chronic stressors.

Journal of Forensic Sciences, Aug 12, 2016

Hanging deaths from investigation standpoint are rarely problematic. Unusual circumstances can on... more Hanging deaths from investigation standpoint are rarely problematic. Unusual circumstances can on occasion raise suspicion of foul play. Associated neck injuries are reported in the literature with variable frequency (from 0% to 76.8%). This study retrospectively analyzed 755 hanging deaths in Ontario (Canada) to evaluate the demographic features and circumstances of hanging fatalities, and the frequency of hanging-related neck injuries. A number of cases showed unusual/special circumstances (e.g., complex, double suicides, restraints). Among 632 cases with complete autopsies, hyoid and larynx fractures were present in 46 cases (7.3%) with the most common being isolated hyoid fractures. The incidence of cricoid fractures was 0.5% and cervical spine injuries, 1.1%. A higher incidence of neck injuries occurred among males, long drop hangings, and in cases with complete suspension. There was a tendency for the number of fractures to increase with increasing age and weight of the deceased.

Pathology, 1992

A spontaneous tear of the ascending aorta, with or without medial dissection, can cause sudden de... more A spontaneous tear of the ascending aorta, with or without medial dissection, can cause sudden death from hemorrhage due to aortic rupture. Two representative cases are described. Review of the clinical history and pathological changes showed that the terminal event was delayed allowing healing and reactive changes to occur in the aortic wall. A pathologist confronted with a fatal case of aortic rupture should be aware that death is not always immediate. Recognition of this has medicolegal importance, particularly if medical management is questioned because of a missed clinical diagnosis.

Journal of Forensic Sciences, Mar 1, 1991

The azygos vein ascends along the thoracic spine through the mediastinum and drains into the supe... more The azygos vein ascends along the thoracic spine through the mediastinum and drains into the superior vena cava at the level of the fourth thoracic vertebra. Fracture-dislocation of the mid-thoracic spine, as a result of blunt thoracic trauma, can tear the azygos vein. Four such fatal cases (three motor vehicle accidents and one fall) were studied, only one of which was recognized prior to death. The vein can also be torn, in the absence of skeletal injuries, by horizontal acceleration/deceleration forces. The pathologist must consider azygos vein laceration as a possible cause of either hemothorax or hemomediastinum or both in a victim of a blunt chest trauma, if that individual had persistent hypotension during the few hours before death and no identifiable source of hemorrhage can be found postmortem in sites such as the heart, great vessels, lung, and chest wall. A fracture-dislocation of the thoracic spine may not necessarily be present. Azygos vein laceration seems to be an uncommon cause of hemothorax and hemomediastinum; however, this injury is probably more frequent than is implied by the few cases described in the medical literature.

American Journal of Forensic Medicine and Pathology, Mar 1, 2000

Journal of Forensic Sciences, Mar 1, 1996

Journal of the Canadian Society of Forensic Science, 1999

ABSTRACTInfective endocarditis can rarely present as a sudden or unexpected death occurring outsi... more ABSTRACTInfective endocarditis can rarely present as a sudden or unexpected death occurring outside of hospital. Two such cases were studied and the diagnosis was determined only after autopsy examination. A 36-year-old male intravenous drug abuser had staphylococcal and enterococcal septicemia and endocarditis of the mitral valve. He died in jail five days after presenting with nausea and vomiting. The other case was an asymptomatic 30-year-old male with a bicuspid aortic valve and a coarctation of the aorta who developed Streptococcus viridans endocarditis and was found dead at home one hour after last being seen alive. Both had left ventricular failure from valve perforation and subsequent valve incompetence. The drug abuser had evidence of disseminated infection. Infective endocarditis was confirmed by appropriate histopathological examination and microbiological culture.

Sodium azide is the primary propellent used to generate the nitrogen gas that inflates automobile... more Sodium azide is the primary propellent used to generate the nitrogen gas that inflates automobile air bags. The combustion process also produces an alkaline aerosol containing a small quantity of sodium hydroxide and sodium carbonate. Alkaline substances are well known for their ability to penetrate the eye and cause serious ocular injury. This paper reports the results of a multidisciplinary investigation into a high-severity, offset-frontal impact involving air bag deployment. The 52-year-old, female driver of the case vehicle survived the collision with no life-threatening injuries due to the protection provided by her seat belt and air bag. However, she sustained a serious alkali injury to her left eye presumably from exposure to the aerosol released through the air bag vents. She also sustained multiple fractures of her upper and lower extremities (MAIS-3) due to occupant compartment intrusion. (A)