BIYOMUT 08

ODTU, Ankara Turkiye

29-31 MAYIS, 2008
MAHKEMELERDE BIYOMEKANIGIN
KULLANILMASI
Ali Erkan Engin, Ph.D., FASME, FSDPS
(Emeritus Professor, The Ohio State University)
Professor of Biomechanics & Mechanics
Mechanical Engineering Department
University of South Alabama
Mobile, AL 36688 USA
BIYOMUT 08 ODTU, Ankara Turkiye 29-31 MAYIS, 2008 MAHKEMELERDE BIYOMEKANIGIN KULLANILMASI Ali Erkan Engin, Ph.D., FASME, FSDPS (Emeritus Professor, The Ohio State University) Professor of Biomechanics & Mechanics Mechanical Engineering Department University of South Alabama Mobile, AL 36688 USA
TOPICS & RESEARCH AREAS
IN BIOMECHANICS
Basic Mechanical Properties of Biological
Materials
Analyses of Response to Internal Biological
Forces
Analyses of Response to External Forces
Analyses of Response to Replaced Parts
and Assistive Devices
BASIC MECHANICAL
PROPERTIES OF BIOLOGICAL
MATERIALS
Individual Cells
Various Tissues
Organs and Complex Body
Systems
ANALYSES OF RESPONSE TO
INTERNAL, BIOLOGICAL FORCES
Circulation and Microcirculation
Respiration
Locomotion Kinetics in Normal,
Abnormal, and Amputee Gait
ANALYSES OF RESPONSE TO
EXTERNAL FORCES
Steady-State and Transient Pressure and
Sound Applications
Various Acceleration Environments
a) Body Vibration
b) Impact and Crash Protection (head,
neck, chest and abdominal injury)
c) Hypo and Hypergravity Conditions
The Diagnostic and Therapeutic Sound and
Force Applications.
ANALYSES OF RESPONSE TO
REPLACED PARTS AND
ASSISTIVE DEVICES
External Orthoses/Prostheses
Internal Orthoses/Prostheses
Biomechanical Compatibility
of previous two items.
Forensic Biomechanics
can be defined as the
application of
biomechanics in the
court of law.
Forensic biomechanics cases may be
put into the following categories:
1. Motor vehicle accidents and related injury
cases (single and multiple vehicles involving
single and multiple vehicle occupants and/or
pedestrians),
2. Occupation related accidents and injury
cases,
3. Product failure and related injury cases,
4. Sports and recreation related accident and
injury cases,
5. Slip and fall accidents and related cases.
OFFICE CHAIR CASE
This case is about a 41 year old
female office worker who was
injured when she fell backward
from the chair to the floor after
the back support (backrest)
broke. At the time she was
moving the chair away from the
desk to open her desk drawer.
MEDICAL SUMMARY
After the fall she complained of severe
back pain. Initial diagnosis was a sprain
and irritation of one of the lumbar discs
causing mild sciatica on the left, and
physiotherapy was recommended. Pain
continued; several months later, her
myelogram showed a severe spinal stenosis
L3-4 and L4-5. Subsequently, she had to
have decompressive laminectomy L2-L5
lumbar surgery. Eventually, she was
found to be totally disabled.
COURT TESTIMONY
1. Why the back support failed

2. What the manufacturer
could (or should) have done

3. Biomechanics of the injury
For the safe operation of the chair the back support
stem, i.e., the strut which holds the backrest, must be
held 100% by the support bracket. To ensure this,
the manufacturer provided a plastic plug to be
inserted at the end of the strut.
In the event that the insertion length is less than
50% of the normal insertion length, a
catastrophic failure of the support bracket will
occur which is what happened in this case.
What the Manufacturer Could Have Done
To ensure the safe operation of the backrest,
the manufacturer had at least two options:

1. Ship the chairs in a fully-assembled state with a
final check in the assembly line, making sure
that the plastic plug is inserted.
or
2. If the backrest is shipped unassembled, make
sure that the plastic plugs are inserted in the
assembly line (i.e. separate packaging of the
plastic plugs is not acceptable). Under this
scheme a warning sticker should be placed next
to the plug.
Warning Sticker



Plastic Plug Back support stem


WARNING
Remove the plastic plug in order to insert the stem into the support
bracket. Insert the plastic plug back into its hole. FAILURE OF NOT
INSERTING THE PLASTIC PLUG CAN RESULT IN THE BREAK-
DOWN OF THE SUPPORT BRACKET AND SERIOUS INJURY!

Biomechanics of Injury
1. Angular velocity of her torso when
she hit the floor
2. Her impact velocity with the floor
3. Magnitude of the force at the lower
back just prior to floor impact
4. Magnitude of the maximum shear
force at the lower back during floor
impact
I explained to the jury that during the fall and
impact with the floor the lower back was
subjected to a very complex and severe dynamic
loads. In particular:

a) Her lumbar region was subjected to
hyperextension
b) Under this hyperextension intervertebral discs
opened up anteriorly and closed down
posteriorly, meanwhile, the facets were highly
loaded in a compressive manner,
c) At the same time the lumbar spine, the functional
spinal units were subjected to a dynamic shear
loading which was much higher than safe load
levels that can be sustained without injury.
APPLE BRUSHING
MACHINE CASE
APPLE BRUSHING MACHINE CASE
The machine is electrically powered and is approximately 9
feet long, 3 feet wide and 5 feet high. Apples are
introduced into the machine through an opening in the top
of one end.







The apples are tumbled and brushed as they move along
toward the outlet opening at the opposite end.

The apples are brushed by six rollers, each about 5 in
diameter and made with very stiff close to 1 long bristles.







When viewed from the outlet end, five of the rollers rotate
in a counterclockwise direction and the top left roller
rotates clockwise. This top left roller and the one
adjacent to it (rollers 1 & 2) form an in-running nip point
on the machine which is the mechanical equivalent of a
very fast acting quicksand.
Examples of in-running nip points
protection against such hazards is of prime
importance
The center of the outlet opening is only 1.5 feet away from the
side of the machine and its about 4 feet above the floor where
the machine is installed. Due to the machines dimensions, it is
very easy to extend a hand and come into contact with the
dangerous continuous in-running nip point along the
longitudinal axes of rollers 1 and 2.
OBSERVATIONS
1. In order for this machine to
perform its intended function,
rotating brushes and the resulting
danger points appear to be
unavoidable design feature.
2. Safe engineering design practice
requires appropriate shield and
guarding when the hazard cannot
be eliminated thorough design.
3. The National Safety Council, in their
publication on machine safeguarding, states
(in part):

The purpose of machine safeguarding is to
minimize the risk of accidents of machine-
operator contact. The contact can be either:
1. An individual making the contact with the
machine usually the moving part because of
inattention caused by fatigue, distraction,
curiosity, or deliberate chance taking.


4. OSHA regulations require machine
safeguarding to protect operators and
others in the area from hazards such
as those created by point of operation
hazards such as in-running nip points,
rotating parts, etc.

5. Safeguarding provided by the
equipment manufacturer is usually
better suited to the design and
operation of the machine than those
purchased and installed by the user.
OPINIONS
1. Manufacturer should have known of the
dangers to operators and other users of
the in-running nip point created by the
counter rotating brushes in the subject
apple brushing machine.
2. The design of this machine is defective in
that appropriate safeguarding was not
provided to keep operators and other
users from entering the machine while in
operation and thereby being exposed to
the hazards of the in-running nip points.
3. The design of the machine is defective in that
the machine lacked clear and legible warnings
concerning the dangers of the in-running nip
points of the brush rollers. Manufacturers
failure to provide these warnings deprived the
operator of necessary information concerning
his personal safety.
4. Further, the design of the machine is also
defective since the defendant manufacturer did
not provide an emergency shutoff switch at the
outlet end of the machine or instructions
directing that an emergency shutoff switch be
installed in the proximity of the outlet end.
ATV - HELMET CASE
DESCRIPTION OF THE ACCIDENT










This accident involved two teenagers (driver and passenger) who were
riding on an all terrain vehicle (henceforth ATV). According to
testimonial evidence both boys were wearing helmets when they were
riding the ATV. As the ATV proceeded forward on a dirt and gravel
road which had a slight downgrade and entered a moderate left hand
curve, the driver was unable to negotiate the curve and was unable to
bring the ATV back onto the path.
The ATV's solid rear axle design
combined with narrow track width,
short wheel base, and high center of
gravity made the machine inherently
unstable and difficult to steer. This
inherent instability and difficulty in
steering was a substantial factor
causing problem for the driver of the
ATV to properly steer and negotiate
the curve.
According to the testimony of the driver, the
ATV was traveling at 15 to 20 mph (24.1 -
32.2 km/hr) when the vehicle veered out of
control off the pathway. The ATV traveled
approximately 200 feet (61 m) down a grassy,
unimproved terrain, and eventually stopped
by striking a tree. The investigating officer
identified three segments of the path the ATV
took; the first one was 75 feet (22.9m) from
the road to the grassy area.










The next segment which was also about 75 feet was more
rough and included broken branches and one fallen tree
branch, the last segment was 50 feet (15.2 m) from the
fallen tree to the tree that the ATV eventually impacted.

The driver of the ATV was separated from the
vehicle when the ATV hit a fallen tree branch
on the ground. He sustained a brief loss of
consciousness, multiple abrasions and
contusions in the right upper and lower
extremities, moderate swelling and tenderness
of the right knee, and wrist with fractured right
distal radius. These injuries were consistent
with the driver leaving the ATV from the right
side of the vehicle, and breaking his fall with
his right arm. His helmet provided sufficient
protection for this fall and he had no cerebral
concussion.

The passenger who was sitting behind the driver
on a long banana shape seat was most likely
holding the grab bar on the rack, rather than the
shoulder or waist of the driver, since the vehicle
was on a rough and downward slope after
leaving the pathway. The testimonial evidence
suggested, at the instant of driver's separation
from the ATV after hitting a tree branch or log,
on the ground, the ATV's speed was about 20
mph (32.2 km/hr). At least with this speed the
ATV struck the tree about 1.7 seconds after
hitting the log on the ground.
According to the final rest position, and the
damage done on the vehicle, the ATV struck
the tree slightly eccentric manner (right of
the centerline) with its front bumper bar
and frame, causing the ATV to pitch as well
as yaw clockwise. The pitching motion
accelerated the passenger's body in the
vertical direction, and upper portion of his
body rotated while the whole body moved
toward the tree.













Note that, at the vicinity of the tree, the terrain had two
slopes, one forward down slope, the other left to right slope
with respect to the longitudinal axis of the ATV.
Thus, at the moment of impact the passenger
separated from the ATV with a momentum
vector which had a vertical component (due
to pitching motion of the ATV), a lateral
component (due to clockwise yaw motion of
the ATV), and a predominant longitudinal
component (due to linear velocity of the
ATV). With this kind of motion he had a
direct head impact with a horizontally
positioned large tree branch.
Since this was a litigation case in the USA, the
defendant's expert witness presented
arguments suggesting that the rider of the
ATV was non-helmeted, and the helmet,
which was found at the accident site, was not
subjected to any impact. I will next present
sections dealing with observations on the
subject helmet as well as biomechanical
foundations dealing with how one can get a
head injury even wearing a DOT
(Department of Transportation) certified
helmet.

OBSERVATIONS ON THE HELMET





























The helmet has a movable (rotatable about the mediolateral
axis) plastic face shield which is connected to a support base
which is press-buttoned to the helmet shell . Initial (partial)
impact occurred when the casing of the plastic shield made a
contact with the tree branch.
Under compressive dynamic load, the top plastic casing which has a ring
shape went to a large radial deformation causing large tensile stresses in
the interior surface of the casing which removed a chunk of the material.












Meanwhile, due to excessive radial deformation, at the symmetrically
opposite side (5 cm left of the centerline), high tensile stresses on the outer
surface of the casing cracked not only the casing but also the plastic shield.
Scuff marks on the helmet were consistent with the color of the tree bark
according to the observations made by the investigating officer.
BIOMECHANICS OF INJURY

The CT scan of the head revealed closed head
injury lesions and hematoma which are consistent
with deceleration and contre-coup injury. What we
have here is a three-collisions situation. The first
collision is the impact of the helmet with the tree
branch, the second collision is the collision between
skull and the liner of the helmet, the third one is
the (pile-up) motion of the brain toward the skull
interior. Note that there is always a certain
amount of mismatch between the local geometries
(curvatures) of the liner and the skull.
Partially because of this mismatch, and
partially because of the magnitude of
deceleration, at the impact site scalp is loaded
locally between the skull and the liner. It is this
reason the ATV rider also had a frontal scalp
hematoma with no associated depressed
calvarial fractures were seen. If the ATV
rider were non-helmeted, as suggested by the
defendants expert witness, he would have
received not only massive depressed calvarial
fractures and external bleeding but also distal
linear skull fractures.
Although helmets provide some energy
absorbing and the peak-impact-force
reduction capabilities, they do not
completely eliminate energy transfer to
the head. In fact, a good helmet
designed according to ANSI Z90.4-1984
standards can only absorb about 100 ft-
lb (135.6 J) of energy. Anything above
that amount has to be absorbed by the
head and neck.
If we accept a 22 ft/sec (6.7 m/s) impact for
the head of the ATV rider with the tree
branch, and also consider only the body
masses above L5/S1 level are associated with
this impact, the total available energy will be
466 ft-lb (631.9 J) which is much above the
helmets protective range. This implies that
more than 496 J of energy must be absorbed
by the head and neck region. This level of
energy is certainly much above the tolerable
range. A more precise analysis should be
based on continuum mechanics approach.
Theoretical foundations of coup and contre-
coup injuries in the brain for locally impacted
head and impulsively loaded head were initially
introduced by this author (Engin, 1969, 1971).
For the helmeted head, deceleration of the brain
matter toward the skull interior is essentially
controlled by the thickness and crushing strength
of the liner. Thus, collision of the helmeted head
with an immovable solid object such as a tree can
be modeled by a fluid-filled spherical shell
traveling with a speed of V and brought to a stop
with a constant deceleration within time t
o
.
During deceleration phase the liquid occupying the interior
space of the shell is subjected to a global axisymmetric pulse on
its boundary and the resulting excess pressure distribution is
given by





where


, are the unit step functions, O
m
are fluid-shell
natural frequencies, c
s
= [E/
s
(l - u
2
)]
1/2
wave speed on the shell
in terms of E (Youngs modulus) ,
s
(mass density of shell), u
(Poissons ratio); s = c/c
s
and c is the compressional wave speed
in the fluid.
( ) ( ) ( )
( )
| |
p r g r u u
o
m
s
m
m
1 1
0
1
2
2
, , , sin | t | t t t
t
=

=
O
( )
}
+
|
\

|
.
| u
o
m
s
m
s
o
t t
t
t
t
sin sin
O
O
2 2
( )
g r
V
c
x
m
s o
|
t
| , cos =

(
(
4
( )
| |
( ) ( )
| |
( )
| |
3
1 1 1
1
2
2
1 3
2
sin cos sin sin cos
sin sin cos
O O O O O O O
O O O O O O O
m m m m m
r
m
r
m
r
r
m m m m m m m

+ +
( )
u
o
t t ( ) u t
The figure above presents a three dimensional plot of the excess pressure
distribution for various values of nondimensional radius r
1
(r/a) and
nondimensional time t (ct/a). For a 22 ft/sec (6.7 m/s) impact velocity and
0.01 sec deceleration time, this analysis gives a maximum negative contre-
coup pressure of 24 psi (165.5 k Pa) which is more than sufficient to cause
contre-coup injuries in a helmeted head.
HARD HAT CASE
A construction worker was struck on the
head by a piece of falling concrete
masonry block weighting approximately
20 pounds. The piece is about one third of
a whole masonry block weighing 60
pounds. The initial impact point of the
block was about 2 right of the center line
of the hard hat and about 1.5 anterior to
the frontal plane. The worker was
unconscious for about 15 minutes. After
regaining consciousness he was able to
stand and walk.
MEDICAL SUMMARY
Although initial neurological examination
suggested a closed head injury with its related
symptoms along with cervical herniated disk, a
subsequent CT scan of the cervical spine
indicated essentially no abnormal intraspinal
or paraspinal soft tissue density to suggest disk
herniation. However, patients headaches,
frequent upper and lower extremity pain and
related lower back pain continued. As a result
of his accident the worker (the plaintiff) was
totally disabled from employment since the
date of the accident.
ANALYSIS
When the concrete block struck him, the worker
was sitting on a cinder block and grinding a
cement wall. Thus, the reported height of the fall
of 14 gives delta-h of 10, which results in 200
lb-ft of impact energy. Assuming a trapezoidal
impact force profile, and total impact time
duration of 15 milliseconds we obtain a maximum
impact force of 1576 lbs.

Further biomechanical analysis of the head
impact yields maximum head acceleration of
157gs and the SI (Severity Index) value of over
4466 units. These values are much beyond the
tolerable limits.
According to the ANSI test procedures
(ANSI Z89.1-1997) the helmets are
subjected to impact kinetic energies at the
following levels: a) 40.24 lb-ft for force
transmission tests, b) 22.6 lb-ft for impact
attenuation tests, c) 18.07 lb-ft for apex
penetration tests. In this case, the impact
energy of a piece of concrete block is an
order of magnitude higher, thus, caused
puncture and partial penetration of the
hard hat.

OPINIONS
1. In general, the helmets provide
limited head injury protection by
resisting penetration via outside
shell, absorbing impact energy via
inside liner, and extending impact
duration to reduce the maximum
value of the impact force.
2. In this particular case, the hard hat that meets ANSI
Z89.1-1959 standards has no inside liner; however, it has
a suspension which is a portion of the harness with crown
straps designed to act as an energy-absorbing mechanism.
3. Finally, severity of impact was such
that it was transmitted with some
attenuation through vertebral
column. This was appropriately
stated by the plaintiff It felt like it
went right through me, not just my
head (p.21 of EBT).
SCOOP TRACTOR CASE









A coal miner was injured while he was operating his low
profile scoop tractor (scoop) when it ran over a 6 x
6 wooden beam (crib block).
The miner sustained
a neck injury when
he was propelled
vertically into the
overhead canopy
made of thick, non-
yielding, steel plate
after the scoop
dropped 6 from
the crib block it ran
over in the under-
ground mine. The
helmet he was
wearing cracked
with the impact.
MEDICAL SUMMARY
The coal miner had a significant injury
to his cervical spine, failed conservative
treatment, had a C6-7 fusion and
cervical diskectomy which provided
minimal relief of his symptoms. More
than two years after the accident his
chronic pain continued and he had
difficulty turning his head repeatedly.
ISSUES
Plaintiff claimed cervical spine injury was
caused by impacting the overhead canopy
as a result of scoop tractors lack of
suspension system or seatbelt, i.e. the scoop
tractors inability to effectively reduce
shock to the operator.

Defendant claimed that the miner was not
injured when the scoop ran over the crib
block. His pre-existing condition was
aggravated during the mishap.
ANALYSIS
In a systematic way
I determined:
a) scoops wheel
drop velocity as a
function of vehicle
velocity, wheel
radius, and
obstacle height,
b) corresponding
velocity for the
operators location
and related
average
acceleration,
c) maximum
value of head-
canopy impact
force,
d) normal and
shear forces at
C6 disk level,
e) stress on the disk surface, nucleus
pulposus pressure, and the
maximum circumferential tensile
stress on the inner edge of the
annulus fibrosus. I showed that
this crucial stress is much higher
than the allowable annulus fibrosis
rupture stress which resulted in C6
disk herniation.
SUMMARY OPINION
Subject product/machine is unreasonably
dangerous because the hazard it provided
was not open and obvious to the operator.
Furthermore, the subject hazard of the
machine can be very economically and
feasibly corrected. A simple lap-type
seatbelt, requiring no sensing devices, is
all that is needed to remove the defective
nature of this machine.
TAILGATE EJECTION CASE
At an intersection of two roads a SUV (Sports
Utility Vehicle) was side impacted at its right
quarter panel by a pickup truck.
During the SUVs clockwise yaw
motion, two children (8 year old boy
and 7 year old girl), who were sleeping
in the cargo space (extended by folded-
down bench seat) were ejected from the
SUV as a direct consequence of the
failure of the tailgate. After the
accident, the boy was found crawling
and crying; the girl was lying on the
ground in comatose state.
MEDICAL SUMMARY
Although the boy came out of the accident with
only a few bruises and scratches the girls
situation was critical. According to medical
records the girl had the following injuries:
a) Large open scalp wound with a large scalp flap
b) Underlying skull fracture with missing segments
of bone
c) Protruding CNS tissue
d) Fracture of the left distal radius and ulna
e) Multiple contusions and abrasions
f) Comatose state
Injuries (a) (c) occurred in the left fronto-
parietal area of the head.
ANALYSIS

After reviewing all relevant
documents and examining the
SUV, I performed the following
analysis:
1. Determined kinematics of the
SUV and children during
accident,
2. Calculated the ejection speed of
the children from the tailgate,


3. Carried out a computer simulation of
the ejection process,


4. Calculated the girls maximum head
impact force, the maximum head
acceleration and the SI, severity index.
OPINIONS
1. This was a relatively low-level side
impact with delta-V less than 15
mph. The tailgate, because of its
lack of structural integrity coupled
with poor choice of material, was
defective in design and failed in
three areas under a relatively low-
level side impact.
2. As a direct consequence of the failure
of the tailgate, two children who were
sleeping in the extended cargo space
were ejected from the vehicle. In a
rotational motion, the interior
surfaces, in particular the tailgate, can
serve as a restraining device for the
occupant just like the seat belts do in
the linear deceleration situation.
Thus, failure of the tailgate destroys
this safety aspect of the vehicle.
3. Based on her initial position in the cargo space
along with the computer simulation of the ejection
process, I determined that the girl was ejected in a
head first mode. In fact, her initial impact with the
ground was with her left arm and left fronto-
parietal area of her head. Her head was subjected
to approximately 2176 lb. of maximum normal
force and a similar magnitude of tangential force
which caused a large open scalp wound with a large
scalp flap. The combination of high-level normal
and tangential forces fragmented the skull and
exposed the brain matter.
4. As expected, the severity index, SI,
that I computed was 7120 which is
much higher than the tolerable
level, i.e. 1500. Her head was
subjected to a maximum
deceleration of 362g which is also
much higher than suggested limits
of 140g for the threshold of
concussion, and 200g for the skull
fracture.
5. In contrast to the girl, her brother was
ejected feet first, and did not impact the
ground head first. When he was found,
he was crawling in the grass and crying.
Whereas, his sister was lying on the grass
without any motion and sound.

6. In conclusion, if the child was not ejected
from the vehicle as a consequence of the
failure of the tailgate, she would not have
sustained the severe injuries which
resulted from her head impact with the
ground.
CONCLUDING REMARKS
In personal injury and product
liability litigation cases forensic
biomechanics is now a recognized
science by the officers of the state
and federal courts of the United
States.

Forensic biomechanics expert
witness must perform essentially
three tasks:
1. Thorough investigation of the
case, which may involve an
accident reconstruction,
inspection of broken part or
failed device or product,
reading depositions and
examining the medical records,
site visits and gathering
relevant data,
2. Analysis phase which should
include determination of the
mechanism of injuries and factors
responsible for the causation of
the accident. Analysis should be
based on sound scientific
principles accepted by the
experts peers and should be void
of any theories which include
speculations and conjectures,
3. Formal written expert report
which, at a minimum, should
include sections dealing with
materials reviewed, description
of the accident or event,
summary of the experts
opinions, and a brief resume of
the author at the end of the
report.
QUESTIONS?