Case ReportsSecondary Missile Injury From Lightning StrikeBlumenthal, Ryan, MBChB, MMedAuthor Information From the Department of Forensic Medicine, University of Pretoria, Pretoria, South Africa. Manuscript received December 29, 2010; accepted February 25, 2011. The author reports no conflict of interest. Reprints: Ryan Blumenthal, MBChB, MMed, Department of Forensic Medicine, University of Pretoria, Pretoria, PO Box 2034, South Africa. E-mail: firstname.lastname@example.org. The American Journal of Forensic Medicine and Pathology: March 2012 - Volume 33 - Issue 1 - p 83-85 doi: 10.1097/PAF.0b013e31823a8c96 Buy Metrics Abstract A 48-year-old-woman was struck dead by lightning on October 24, 2010, in Pretoria, South Africa. The cause of death was due to direct lightning strike. Examination showed secondary missile injury on her legs. This secondary missile (shrapnel) injury was caused by the lightning striking the concrete pavement next to her. Small pieces of concrete were located embedded within the shrapnel wounds. This case report represents the first documented case of secondary missile formation (shrapnel injury) due to lightning strike in the literature. © 2012 by Lippincott Williams & Wilkins.