Firearm Deaths by Law Enforcement

Abstract:  The use of deadly force during law enforcement is a matter that compels public scrutiny. There were 42 gunshot deaths caused by police over a 4-year period in New York City. The decedents' average age was 31 years and ranged from 17 to 64 years. There were 41 males and one female; and 26 Black, nine Hispanic, and seven White decedents. Ethanol and/or drugs of abuse were detected in 78% (31/40) of the decedents. The vast majority of shootings occurred with the police responding to a crime and 90% of the decedents were armed (26 handguns, six knives, one axe, one metal pipe, and one toy gun). Vehicles were used as weapons in two incidents. A total of 177 bullets struck the 42 decedents. Fourteen decedents sustained single gunshot wounds (GSWs), and the remainder had multiple GSWs ranging from 2 to 21. In the majority of the cases in this study, the number of GSWs of the body was three or fewer. Thirteen decedents had at least one GSW of the back or buttocks, accounting for 25 of the total 177 wounds, and four of the 13 had GSWs of only the back. With the exception of the upper extremities, GSWs of all locations were more likely to penetrate than perforate. Although these deaths may be high profile, the certification is typically straightforward and the cause (i.e., GSW) and manner of death (homicide) are readily apparent. Although police shootings in which the decedent was unarmed and/or sustained numerous GSWs are widely reported by the lay press, these types of shootings were not typical in our study.     

Characteristic Features of Pediatric Firearm Fatalities—Comparisons Between Australia and the United States

Abstract:  Gunshot deaths in children less than 17 years of age from Adelaide, SA, Australia (1969–2005) and from San Diego County, CA, United States (1988–2005) were compared. Forty-two pediatric gunshot fatalities occurred in South Australia (1.1 cases/year; M:F = 30:12). There were 6 accidents (14%), 14 suicides (33%), and 22 homicides (52%). In San Diego there were 185 cases ( c. 10 cases/year; M:F = 148:37). There were 6 accidents (3%), 42 suicides (23%), 130 homicides (70%), and 7 undetermined cases (4%). The incidence of homicide was significantly higher in San Diego County compared to Adelaide ( p  < 0.001), with a higher proportion of murder–suicides occurring in Adelaide. There were markedly more accidents and suicides involving males in Adelaide and a far higher number of male homicide victims in San Diego County compared to females. Rifles of 0.22-caliber were preferred weapons in South Australia, compared to handguns in San Diego County.     

An Unusual Suicide Inside a Grave with Two Gunshot Wounds to the Head—The Psychological Approach

Abstract: In this report, the authors present a case of suicide committed by a 66-year-old man, inside a grave at the local cemetery, with two gunshot wounds to the head. A multiple-paged, handwritten suicide note was found in an army type bag inside the victim’s car, while a second one was found in his house. Medicolegal examination of the body revealed two typical contact gunshot entrance wounds and one exit wound to the head. Toxicological analysis of the femoral blood was negative for alcohol and drugs. The history, scene and autopsy findings, along with further police investigation, indicated an obvious case of suicide. The literature is reviewed and discussed. We report this case as the place of suicide is extremely uncommon and as there is no mention of a gunshot suicide inside a grave in the current literature.     

Trends in Officer‐involved Firearm Deaths in Oklahoma from 2000 to 2015

The purpose of this study was to collect data and disseminate trends in officer‐involved firearm deaths in Oklahoma from 2000 to 2015. The Oklahoma Office of the Chief Medical Examiner (OCME) database was searched for civilian decedents with gunshot wounds inflicted by law enforcement officers and officer decedents with gunshot wounds inflicted by civilians. Five decedents were law enforcement officers, while 274 decedents were civilians. The number of civilian decedents throughout the study followed a quadratic trend. Civilian decedents were most commonly males (95%) between the ages of 20 and 39 (64%), had one or two gunshot wounds (46%), and had an increasing number of gunshot wounds over time. Postmortem toxicology testing most commonly detected ethanol, methamphetamine, cocaine, and PCP. Efforts toward increased tracking by various agencies and more scientific studies like this are needed to facilitate future analysis of trends in officer‐involved firearm deaths.     

A distant-range, suicidal shotgun wound of the back

The case being reported is one of a shotgun fatality with a thoracic back wound. A 23-year-old man was shot from a distance with trajectories going from back to front and on a nearly horizontal level. These findings observed in the autopsy could represent homicide, but scene investigation and police records were interpreted and it became clear that the case was suicide. Thus, this case shows that the determination of the manner of death requires a careful forensic investigation including autopsy findings, scene investigation, and reconstruction of the events.     

Suicide by Shotgun in Southeastern Minnesota

Suicide by shotgun is a common method of suicide with high regional variation. We sought to describe their distinct, challenging features and provide demographic and risk characteristics. We reviewed 228 gunshot wounds autopsied at Mayo Clinic from 1994 to 2014; of these, 75 (32.9%) were shotgun wounds. All were suicides and contact range. Ages ranged from 14 to 92 years old; of these, 97% were men. The majority involved the head (70.9%), were intraoral (48.2%), and had upward (73.2%) and backward (73.2%) directionality. Next most common was the chest (21.5%), with backward (94.1%) and downward (64.7%) directionality. Four involved multiple wounds. Wadding was recovered in 16 (21.3%) cases. Six (8.0%) had a survival period. Most (66.7%) took place at home. Seventy‐one percent had a known psychiatric history; 32.4% had positive toxicology. Although contact range shotgun wounds cause severe destruction, entrance wound and other characteristic are identifiable with thorough scene, autopsy, and radiographic documentation.     

Characteristics of Backspatter on the Firearm and Shooting Hand—An Experimental Analysis of Close‐range Gunshots

Contact and close‐range gunshot injuries can produce bloodstains on the shooting hand and weapon. In this study, backspatter was analyzed in experimental horizontal pistol shots into blood‐filled sponges. The shooting distances were set between 0 and 45 cm. With increasing shooting distance, there was a significant decrease in the degree of backspatter. Microspatter could be detected on the weapon and shooting hand up to a shooting distance of 40 cm. They were predominantly located on thumb and index finger as well as the radial dorsal aspects of the hand. Fine spray of microspatter combined with elongated droplets in the shape of exclamation marks was found at contact and 2‐cm distance shots. An angular calculation based on the shape of the bloodstains was possible up to a shooting distance of 2 cm. No bloodstains were detected beyond 45 cm.     

Self‐inflicted Firearm Discharge from Heating Using a Gas Burner

A male in his 70s was found lying dead in the living room of his house. A gunshot entrance wound was observed in the left orbit, with a lead slug and wadding left in the skull, which exhibited fatal cranio‐cerebral trauma. A cartridge had been discharged from a handmade launcher, or zip gun, that had been fixed to a spare gun barrel on a pipe chair, by heating the launcher from the side using a gas burner. The deceased had owned guns for hunting in the past and had returned the license, but he had retained a spare barrel and live cartridges at home. In this unique case of suicide, a zip gun was discharged by heating with a gas burner.     

Comparing Homicide‐Suicides in the United States and Sweden

Research on homicides followed by suicides has largely relied on very localized samples and relatively short time spans of data. As a result, little is known about the extent to which patterns within cases of homicide‐suicides are geographically specific. The current study seeks to help fill this gap by comparing twenty years of homicide‐suicide data for Sweden and a large U.S. county. Although some of the underlying patterns in the two countries are similar (e.g., decreasing rates), a number of important differences emerge, particularly with respect to incidence, weapons used, perpetrator age, and relationship of the perpetrator to the victim.     

Fatal Firearm Injuries in Tennessee: A Comparison Study of Tennessee's Two Most Populous Counties 2009–2012

Firearm injuries are a leading cause of violent death in Tennessee. This study was designed to compare the demographic and epidemiologic features of fatal firearm injuries in Shelby County and Davidson County, Tennessee between 2009 and 2012. We identified 1081 gunshot fatalities for the study period in these two counties. Shelby County had a higher overall, age‐adjusted gunshot mortality rate, a higher male age‐adjusted gunshot mortality rate, and a higher age‐adjusted gunshot homicide rate than Davidson. Age groups 25–34 years and 35–44 years had higher crude mortality rates for gunshot deaths in Shelby County than Davidson County. Both counties had higher age‐adjusted gunshot mortality rates for black males than white males, higher homicide rate for black race than white, and higher suicide rate for white race than black. Homicide was the most common manner of death, and handguns were the most common type of firearm used in both counties.     

An Unusual Method of Suicidal Ligature Strangulation

This article reports a case of suicidal strangulation by ligature of a 51‐year‐old woman with a psychiatric disorder. She had been suffering from depression with a history of previous suicidal attempt. The deceased accomplished self‐strangulation using two ligatures, with one placed above the other and consisting of a satin fabric and a shoelace. The underlying shoelace ligature was fastened by a secure fixed square knot at the back of the neck. The overlying fabric piece was tied with a half‐knot under the chin and was tightened around the neck manually. A detailed investigation and autopsy examination strongly suggests suicide. The case is of interest due to its rarity and uncommon method of execution.     

Prison Suicides in South Australia: 1996–2010

Forty‐eight deaths occurring in prisons in South Australia were identified between January 1996 and December 2010, including 25 cases of suicide (mean age = 37 years; median age = 34 years; age range = 24–70 years). Most suicides were due to hanging (23/25; 92.0%) with victims using bedding, belts, or shoelaces attached to cell shelves, air vents, doors, or other accessible projections. There were no suicides attributed to drug overdose or sharp force injury. Over a third of all suicides (39.1%) occurred during the first month of confinement, with 26.1% of cases occurring within the first week. There was one suicide reported after 2 years of imprisonment. Given that suicide in state prisons currently occurs at a rate approximately eight times that of the general South Australian community, it appears that the subset of incarcerated individuals represents a group in need of effective preventive strategies to enable more appropriate provisions of existing prisoner resources.     

Unplanned Complex Suicide—A Consideration of Multiple Methods

Detailed death investigations are mandatory to find out the exact cause and manner in non‐natural deaths. In this reference, use of multiple methods in suicide poses a challenge for the investigators especially when the choice of methods to cause death is unplanned. There is an increased likelihood that doubts of homicide are raised in cases of unplanned complex suicides. A case of complex suicide is reported where the victim resorted to multiple methods to end his life, and what appeared to be an unplanned variant based on the death scene investigations. A meticulous crime scene examination, interviews of the victim's relatives and other witnesses, and a thorough autopsy are warranted to conclude on the cause and manner of death in all such cases.     

Postmortem Computed Tomography in Firearm Homicides: A Retrospective Case Series,

Postmortem computed tomography (PMCT) is integrated into the evaluation of decedents in several American medical examiner offices and medicolegal death investigative centers in many other countries. We retrospectively investigated the value of PMCT in a series of firearm homicide cases from a statewide centralized medical examiner’s office that occurred during 2016. Autopsies were performed or supervised by board-certified forensic pathologists who reviewed the PMCT scans prior to autopsy. PMCT scans were re-evaluated by a forensic radiologist blinded to the autopsy findings and scored by body region (head–neck, thoracoabdominal, and extremities). Injury discrepancies were scored using a modified Goldman classification and analyzed with McNemar’s test. We included 60 males and 20 females (median age 31 years, range 3–73). Based on PMCT, 56 (79.1%) cases had injuries relevant to the cause of death in a single body region (24 head–neck region, 32 thoracoabdominal region). Out of these 56 cases, 9 had a missed major diagnosis by PMCT outside that region, including 6 extremity injuries visible during standard external examination. Yet all had evident lethal firearm injury. We showed that PMCT identifies major firearm injuries in homicide victims and excludes injuries related to the cause of death in other regions when a single body region is injured. Although PMCT has a known limited sensitivity for soft tissue and vascular pathology, it can be combined with external examination to potentially reduce or focus dissections in some of these cases depending on the circumstances and medicolegal needs.     

Intravascular bullet embolism to the right atrium

Bullet embolism is a relatively unusual complication of gunshot wounds. Embolism to the right atrium comprises <5% of all reported intravascular bullet emboli. We report an additional case of bullet embolus to the right atrium of a 0.38-caliber bullet following a gunshot wound to the chest. The intracardiac bullet was recognized radiologically on presentation, but the patient was hemodynamically stable and managed conservatively, with the bullet left in place. The missile remained within the heart without clinical significance for several years and was recovered from the right atrium only at the time of autopsy. To the best of our knowledge, this is the first documented case of a 0.38-caliber bullet which embolized to the right atrium and remained inconsequential for an extended period of time.     

An Unusual Zip Gun Suicide—Medicolegal and Ballistic Examination

Abstract:  Home-made guns are imitations of typical firearms and usually have handgun characteristics. This article presents an unusual case of a suicide carried out by means of a fatal gunshot wound to the head using a home-made zip gun. A 49-year-old male, with a history of paranoid psychosis was found dead in the dwelling place of a family house. The investigation at the crime scene did not lead to suspicion of a gunshot wound because of the unusual nature of the firearm used. A medical examiner diagnosed an opened head injury as the primary cause of the victim's death. The autopsy findings provided immediate grounds for further inspection of the crime scene. Subsequently, a simple zip gun, which had been overlooked during the scene investigation, was discovered. An undeformed projectile recovered from the victim's head was consistent with the use of the home-made firearm. Following the completion of the investigations and autopsy, the death was classified as a suicide.     

Suicides in the young people of Geneva, Switzerland, from 1993 to 2002

Suicides in Geneva in those less than 25 years old, from 1993 to 2002, were reviewed. Scenes investigations, autopsy findings, toxicology results, and psychiatric history (when available) were examined. There were 65 cases. The average annual suicide rate was 11/100,000. Seventy-seven percent were male, and 23% were female. The youngest was 12 years old and most of the victims were 18 years old and over (89%). For men, the use of firearms was the most common method (38%), followed by fall from height (16%) and drowning (10%). For women, fall from height was the most frequent (40%), followed by firearms and medication overdoses (20% each), hanging (13%), and drowning (7%). Toxicological analysis was performed in 41% of the cases and showed that alcohol was present in 26% and other drugs in 67% of these cases. The most common drugs present were benzodiazepines, cannabis, and cocaine.     

The Homicide–Suicide Phenomenon: Findings of Psychological Autopsies

Homicide–suicide represents a single episode of violence which may decimate an entire family. This study aimed to further describe motives and context of these tragedies. Psychological autopsies were completed for 18 homicide–suicide cases in Dallas, Texas. This included postevent interviews with surviving family members and review of police and coroner records. Two‐thirds of perpetrators had made either verbal or written threats prior to the homicide–suicide. A simplified typology describing victim–perpetrator relationship and motive type is suggested for future studies and clinical ease. Two‐thirds of perpetrators fell into the category of Intimate‐Possessive, most of whom were depressed men who were abusing substances and undergoing separation. Additional categories included Intimate‐Ailing, Filial‐Revenge, Familial‐Psychotic, and Friend‐Psychotic. Further, implications from this psychological autopsy study regarding risk assessment include use of collateral interviews regarding threats and past violence.