Atypical Suicide by Submachine Gun

In case of suicide, the presence of multiple entrance wounds is always suspicious. We report the case of a man who committed suicide by shooting himself three times in the chest and the skull with a submachine gun. The weapon seems to have been initially pointed in the precordium area with a lethal lesion of the proximal aorta. Two other projectiles were fired by the weapon and hit the neck and the skull of the deceased. The presence of three entrance wounds despite a first fatal wound could finally be explained by the characteristics of the weapon and wounds. Most suicides related to multiple gunshot wounds are explained by a first nonlethal shot but the use of an automatic weapon can also be found. In these last cases, medicolegal and criminalistics aspects become important in differentiating suicide and homicide.     

Observations and statistics relating to suicide weapons

The weapon at the scene of a suicide provides a resource in addressing such questions as frequency of blood in or on the weapon, location of the weapon with respect to the body, and evidence of firearm discharge residues on the hand. The first 195 weapons were tested for blood by a technique different from the following 202 weapons. Results were obtained which caused procedural changes in blood detection. Data are presented for frequency of blood in and on the muzzle of weapons, relative frequency of location of suicidal gunshot wound, and percent "positive" findings of gunshot residue metals on the hands. It was found that suicidal gunshot wounds were 3 times more frequent to the head than the chest, and that no significant difference was noted between males and females in this study. Scene photographs reveal that the suicide weapon is in or resting on the hand of the decedent 20% of the time with handguns and 11% of the time with long guns.     

Suicide by a power drill

This is the report of a 62-year-old man who committed suicide by drilling through his anterior chest wall with an electric power drill. Death was caused by pericardial tamponade combined with bleeding into the pleural cavity. The skin lesion at the left hemithorax was similar to a bullet entrance wound.     

Suicide with a manipulated hand grenade

Explosion injuries in civilians are rare. An uncommon case of suicide with a manipulated hand grenade is presented. The findings at the scene and on the body (i.a. massive soot blackening of the skin, singeing, size and number of splinters) gave reason to doubt the use of trinitrotoluene (TNT), the usual explosive charge in hand grenades. Further investigations showed that parts of several hand grenades and black powder from standard fire-crackers commercially available without legal restriction had been used as propelling charge. The victim, who was in a sitting position, held the hand grenade in the left hand and triggered it with the right. He bled to death due to a fracture of the right femur and lacerations of the liver. The chronological course and total circumstances of the case suggested suicide in a strongly intoxicated condition (BAC 2.5 per mille). In the flat, a larger number of unlicensed weapons and weapon parts were found.     

Suicidal Shotgun Wound Employing a Shotgun Barrel,a Shotgun Shell,and a BB*

Abstract: A vast majority of firearms‐related suicides involve the conventional use of a properly functioning, intact firearm. Occasionally, forensic investigators encounter a case wherein the firearm suicide victim employs some form of unconventional use of a weapon, or utilizes an unusual weapon type. In this case report, the authors present an unusual case in which a man committed suicide by using a shotgun shell, a shotgun barrel (separate from the rest of the gun), and a BB. Some confusion as to the cause and manner of death was present during the initial scene investigation. Examination at autopsy revealed the cause of death to be a shotgun wound of the chest and prompted further scene investigation. Therefore, this case serves as another example of the importance of cooperation between scene investigators and forensic pathologists when investigating a death. A review of suicidal firearm cases using unconventional means and/or firearms is presented.     

Influence of ballistic and autopsy parameters on the manner of death in case of long firearms fatalities

A retrospective study was carried out on 132 fatalities due to gunshot wounds secondary to long firearms. One group of suicide (n=72) and one group of homicide (n=60) were statistically compared regarding age and sex of the victim, number of shots, range of fire, direction of the projectile(s), anatomical distribution of entrance sites, weapon and ammunition types and the nature of eventual associated traumatic lesions. The frequency of suicide was higher when the victim's age increased. Females constituted about 43% of the homicide victims and about 8% of the suicide victims. 51.5% of the homicide victims and about 10% of the suicide victims had sustained more than one gunshot wound. Close range was respectively found in 53.5% of the homicide cases and in all suicide cases. Most of the suicide cases (85% of the cases) showed typical entrance sites. Entrance sites in the limbs and lateral or posterior wall of the chest were only encountered in homicide cases. Associated traumatic lesions were found in about 23% of the homicide cases and in 18% of the suicide cases. In case of suicidal gunshots to the left chest, both upwards and downwards directions, and also both right-to-left and left-to-right directions can occur. From 22 suicide cases showing entrance wound in the mouth, a downwards direction was found in only one. This study underlines the importance but also the limits of the autopsy findings (including direction of the projectile(s) related to the entrance site) for giving an indication of the manner of death (homicide vs. suicide).     

Patterned imprint mark due to the folded shoulder stock: A possible finding in contact shots from submachine guns

The muzzle imprint (barrel mark) is a pressure abrasion typically associated with contact shots. Apart from the contours of the actual muzzle profile, other constructional parts such as the front sight and/or the recoil spring guide of semiautomatic pistols may be imprinted next to the bullet entrance wound. In some types of submachine guns the shoulder stock can be folded forward so that its end partly encircles the muzzle. If such a weapon was in contact with the skin at the instant of discharge, a corresponding contusion mark is to be expected. The imprint configuration may point to the type of weapon and to the way in which the gun had been held when firing the shot. The paper presents the injury pattern in a 36-year-old man who committed suicide with a Scorpion SA Vz 61 submachine gun cal. 7.65 mm Browning from former Czechoslovakia.     

Fatal stun gun injury using a modified animal sedation gun

A 54-year-old butcher attempted to commit suicide with a manipulated "humane killer". He removed the recoil spring, the rubber bush and also the screw forming the muzzle end, which to our knowledge has never been described in a case report before. Due to this manipulation the entire bolt left the weapon, as a free projectile, penetrated the forehead and lodged inside the skull, from where it could not be removed neurosurgically. The patient died from the consequences of the severe cerebral injury 3 days later.     

An unusual homicide case with subsequent suicide

In the medicolegal literature reports on homicides followed by suicide, especially in elderly people, are rare. In the present case, the victim, a 79-year-old woman, showed a rather unusual injury pattern: 3 gunshots to the head (with only 2 entrance wounds and 3 intracranial projectiles) and 2 stabs from a knife. The tools used for inflicting the stab wounds (a hunting knife and a double-edged dagger) were left in the victim's body after the offense. The 89-year-old husband hanged himself with an aerial cable after killing his wife. The police investigations and the autopsy findings suggested a combined homicide-suicide. The motive for the offense could be a so-called delusion of poverty associated with symptoms of depression.     

The cutaneous ink sign: a tipoff to suicide or suicide notes

The presence of smeared or unsmeared ink on the skin resulting from the writing process has been observed in a number of suicide victims who have left suicide notes. The authors report a case of a palmar "cutaneous ink sign" and discuss its forensic science import.     

Sweat testing in addicts under methadone treatment: an Italian experience

In determining the possibility that a specific weapon was responsible for a specific injury it is often valuable to examine the damage marks left on any clothing worn by a victim. Correlating this damage both to the skin and clothing with the dimensions of the suspect weapon (if available) may help in determining these possibilities. In this work four different types of knives were used to produce damage marks on various different fabrics both stretched and loose over skin. Statistically significant differences were found between the length of wound on the skin and the corresponding damage to the fabrics when the fabric was stretched over the skin while no statistically significant differences were observed when the fabric was loose over the skin. This was true for all of the knives examined.     

An Unplanned Complex Suicide by Multiple Blank Cartridge Gunshots and Cutting

Blank firing guns are readily accessible in most countries due to an absence of legal regulations. These weapons are capable of causing lethal injuries. We report a rare case of secondary (unplanned) complex suicide committed with a knife and blank cartridge pistol. A 59‐year‐old man was found dead with three superficial incisions in his neck and a gunshot wound to the chest. The external examination revealed an entrance wound in the left chest region consistent with contact shooting. The appearance of a muzzle imprint suggested two discharges. The autopsy showed a slightly hemorrhaged but otherwise intact pericardium, blood in the pericardial sac, and a channel‐like defect in the anterior wall of the left cardiac ventricle. The cause of death was attributed to cardiac tamponade. To the best of our knowledge, this is the first reported case of unplanned complex suicide involving an unmodified blank firing gun.     

Suicide by Close-Range Gunshot Wound to the Bridge of the Nose

Suicidal gunshot wounds to the nasal bridge are rare, particularly at close range (defined as muzzle of the weapon not touching the skin surface, but near enough to deposit soot and stippling). Previously reported suicidal gunshot wounds to the nose have been through the left nostril (Forensic Sci Int 1995;71(1):25–31; J Forensic Radiol Imag 2013;1(2):63–7). The death of a 26-year-old man with a close-range gunshot wound to the bridge of the nose was deemed suicide due to history, scene, and autopsy findings. These findings included previous suicidal ideation, texted and written notes, the decedent's cross-legged position seated on the floor, the trajectory of the bullet through his head and into the ceiling fan and roof above him, and acute alcohol intoxication. This decedent may have been intending a hard contact forehead location but inadvertently fired the gun into the bridge of his nose while bending forward, prior to contact.     

Characteristics of firearms and gunshot wounds as markers of suicide.

Data from a total of 1,200 cases that the Medical Examiner of Dallas County, Texas, ruled as suicide with a firearm have been compared with the results of forensic laboratory examinations and tests; 75% are with handguns and 25% are with long guns. The incidence of suicides by gender yields 82% males and 18% females, with the most common entrance site being the head. With regard to racial distribution of persons committing suicide, > 88% are white in the study population group, which is 76% white. Data are presented for the incidence of blood detected inside and on the muzzle end of the barrel of the firearm, and for the persistence of blood inside the barrel even after the weapon was discharged to obtain test bullets. The analysis of handwipings for primer residues shows that "positive" results are obtained for approximately 50% of the revolvers and approximately 32% of the pistols when the caliber is > 22. Other projects such as transfer of gunshot residues to the hand by simply handling the weapon, the incidence of single-contact wounds in homicide versus suicide cases, and the percent of positive identification of bullets with weapons submitted are described.     

Suicides by starter's pistols and air guns

We report the case of a 25-year-old depressed woman who committed suicide with a starter's pistol loaded with CS tear-gas ammunition. The propellant gases of the contact shot entered her chest through the left sixth intercostal space. Exsanguination was caused by perforations of the pericardium and apex of the heart. Autopsy did not reveal any metallic or other foreign bodies that might have originated from the propellant, the cartridge, or any bulletlike material. Her injuries were thus caused by the propellant alone. 0.5 mg L-1 of the CS degradation product cyanide was detected in the cardiac blood. We also report the case of a 54-year-old man, suffering from depressive psychosis, who committed suicide with an air rifle. The lead-pointed Diabolo bullet entered his brain through the right large wing of the sphenoid bone, traversed the right temporal brain pole, damaged the right middle cerebral artery and the right optic tract, and finally lodged in the left central ganglia. There was extensive basal subdural hemorrhage and tamponade of all cerebral ventricles. Death was attributed to cerebral failure. We furthermore list another 26 cases of suicide by rarely used weapons from 1947 to 1989.     

The mechanism of fatal cardiopulmonary injury caused by a blow from a golf club

In the course of a scuffle, a youth of 18 years was struck a single blow across the chest with a golf club. He collapsed dead on the spot. At autopsy, a precisely located and highly distinctive patterned imprint abrasion of the precordial region was revealed providing an excellent match with the weapon. The heart showed multiple internal ruptures and there was a laceration of the lingula of the left lung. Injury to the chest wall was confined to the soft tissues, the rib cage and sternum being intact. We postulate a novel mechanism to explain the cardiac rupture.     

Suicidal shot in the mouth with a rubber shot shell

The purpose of weapons designed for self-defence and their ammunition is to allow effective defence without causing serious injury provided that the recommended minimum firing distance is observed. However, close-range and contact shots to vulnerable body regions may cause severe or even fatal injuries. The authors report on a suicide who fired a fatal shot in his mouth with a weapon for self-defence. The weapon used was a double-barrelled SAPL break-action gun, mod. GC 54, from which a Mini Gomm-Cogne, cal. 12/50 rubber shot shell was fired. The wound findings and ballistic characteristics of the weapon are presented and discussed.     

A Ten‐year Study of Suicides from a Rural/Suburban County

This study will discuss trends in suicide data compiled over 10 years in Dutchess County, NY, from 2004 to 2013. These data were based on reporting and examination standards recommended by the National Association of Medical Examiners and Department of Justice death investigation standards. Almost 300 cases were analyzed in terms of the deceased's gender, age, race, method of suicide, and weapon used. Results from this study agree with other reports showing significant differences for method of death both in terms of age and gender, with men more likely to choose firearms and women more likely to choose overdose. Furthermore, older persons were more likely to commit suicide by firearms, and the younger persons were more likely to commit suicide by overdose. However, other areas, such as method of suicide, differ from national statistics.     

Secondary combined suicide viewed by the wife]

A 47-year-old man was found dead at the bottom of a wall outward the door of the cellar of his house. Preliminary physical examination at the scene of the death revealed a laceration of the scalp, an incised wound in front of the neck and several stab wounds in the left chest penetrating through the clothing. Questioned by the police his wife told that her husband who suffered from severe depression had inflicted the incised and the stab wounds himself, had made an unsuccessful attempt at self-strangulation and had finally jumped down from the wall beside the stairs declining to the cellar of their house. As the circumstances of the scenario were suspicious and as the pattern of injuries arose doubts concerning self-infliction homicide was taken into consideration as well. Autopsy showed additional hesitation marks adjacent to the left end of the incised wound in front of the neck. The stab wounds of the chest were restricted to the region of the heart and displayed only minimal penetration of the chest-wall, findings characteristic of self-infliction. As a consequence the manner of death could be determined as prolonged suicide, and exact reconstruction was possible with the help of the wife's testimony.     

Suicide by hara-kiri: a series of four cases.

The authors describe four cases of suicide by hara-kiri. This very painful form of suicide consists of self-inflicting a wound in the abdomen using a sharp instrument. It was first reported in 988 A.D. in the East but has now become rare in both the East and West. These four cases occurred over a 40-year period in the Trieste and Bari medicolegal area. In two of our cases the victims were afflicted with mental illness, whereas the other two suffered from depression. In cases of death by hara-kiri, it is important to establish a differential diagnosis between suicide and homicide; the presence of trial wounds (inflicted by the victim as a form of practice to overcome any hesitation before stabbing the abdomen with the cutting weapon) can prove very helpful.