Autoamputation of the left arm--a bizarre suicide

A 24-year-old woman committed suicide by amputating her left arm immediately below the shoulder joint with a small kitchen knife. No references to such a suicide were found in an extensive literature search.     

A case of disguised suicide

A case of disguised suicide is presented. A 77-year-old man had made technical arrangements so that the pistol with which he shot himself was thrown aside by the elasticity of a rubber band, to which it was tied, and was thereby hidden. After the shot the man fell and crushed his head, which initially concealed the bullet wound. A scrutinizing technical investigation at the scence of the death with close collaboration between the experts involved, revealed the true circumstances. No explanation for the attempt to conceal the suicide was found.     

A peculiar case of suicide

A young woman was found dead on the floor of an abandoned office in the center of the city. The body showed numerous wounds on the front, a piece of wood was caught in the mouth and the opening of the larynx was completely obstructed by a piece of glass. At the beginning it was thought to be a homicide but later resulted to be a suicide through numerous and unusual means. Before the suicide, the woman tried to kill her young 5 year old son, but the child managed to get away.     

A case of suicide disguised as natural death.

A case report describing the suicide of a physician classified initially as a natural death. Faced with the vehement protest of the family of the deceased the magistrate decided to request a 'preventive' forensic autopsy. Forensic investigations revealed the cause of death as being a pentobarbital intoxication and the circumstances favoured the hypothesis of a genuine suicide. This case illustrates that the tendency of magistrates to request or not an autopsy is related to their experience or intuition.     

A case of suicide by ingestion of sodium nitroprusside.

The study reports a case of suicide by ingestion of sodium nitroprusside which resulted in acute cyanide poisoning. Analyses carried out on body fluid yielded the quantitation of total (5.00 mg/L) and free (3.30 mg/L) cyanide in blood and of methemoglobin (blood = 10.5%). At the scene, some solid reddish-brown material was found in a glass, which on toxicological analysis was found to contain sodium nitroprusside; about 9 g of the same substance was identified in stomach contents. The detection and quantification of cyanide and methemoglobin in biological samples from the case indicated that the lethal effect was due to both metabolic products (cyanide and methemoglobin).     

An unusual case of railway suicide

A rare case of suicide in which the victim had been lying along the railway track in a supine position and with extended extremities is described. The wheels of a train caused longitudinal hemisection with complete evisceration. Epidemiological data on train suicides are given and the relationship between this method of suicide and mental illnesses and consumption of alcohol are discussed.     

A case of Munchausen syndrome by proxy with subsequent suicide of the mother

Munchausen syndrome by proxy is a subtle and difficult to diagnose form of child abuse in which the carer (usually the mother) simulates, manipulates or produces symptoms of illness in the victim. In most cases the detrimental effect is caused by applying foreign substances or by airway obstruction. In the presented case a 20-month-old girl developed a spreading soft-tissue infection resistant to treatment on the left upper arm after vaccination, which required a number of surgical interventions. Repeatedly, microorganisms from the intestinal flora were isolated from the wound secretion. After the girl suffered respiratory and circulatory arrest, which required resuscitation measures, chemical toxicological tests revealed not medically prescribed benzodiazepines in serum and urine. When the mother, a trained nurse, was confronted with the allegation to have manipulated the symptoms of the illness she committed suicide. The forensic autopsy of the suicide produced numerous hints suggesting chronic self-damaging behaviour described as Munchausen syndrome. This case shows a number of manipulation forms with the maintenance of a chronic skin and soft tissue infection belonging to the rarer forms of inflicting damage to the child. It also illustrates that confrontation with the allegation of Munchausen syndrome by proxy creates a very stressful emotional situation that may lead to a suicidal act.     

Planned complex suicide: an unusual case

Abstract:  We report an unusual case of planned complex suicide. The victim was a woman aged 67 years, who was found dead in her bath in a state of advanced putrefaction. A plugged-in hairdryer was submerged in the water and the electrical fuses in the room had short-circuited. A kitchen knife lay below the body of the victim, whose left forearm bore incisions suggestive of wrist-cutting. At autopsy, no sign suggesting electrocution could be observed because of the advanced state of putrefaction of the body. Toxicological analysis revealed massive ingestion of tianeptine (blood concentration 15.5 mg/L). Although the exact cause of death could not be determined because of the state of the corpse, meticulous examination of the scene and information obtained from the victim's relatives led to the conclusion of suicide.     

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.     

抑郁症患者间接自杀1例

自杀是抑郁症常见的临床表现之一.然而,有的抑郁症患者在轻生观念的支配下,采用间接的方式自杀.患者杀死无辜者,希望以此受到极刑而身亡.现报道我们在司法精神医学鉴定中遇到的一个案例,并对其责任能力的判定进行讨论.     

A gas chromatographic analysis of phosphine in biological material in a case of suicide

In a suicide committed using aluminium phosphide (AlP) the liberated toxic phosphine gas was detected in post-mortem specimens using a headspace gas chromatographic procedure with a nitrogen-phosphorous detector (HS-GC/NPD). At autopsy a direct sampling into airtight headspace vials for a later analysis is recommended. AlP has to be considered a potent pesticide and its use and availability should be restricted as much as possible.     

Satanism and suicide in adolescence--2 case reports

Death cases--suicides as well as homicides--within the context of satanism are meanwhile becoming routine casework for forensic pathologists. Therefore the investigators should be aware of satanic signs and items associated with the occult to identify a satanic background. Based on two suicides of young persons, satanic signs helpful for classification are pointed out.     

An unusual case of child abuse homicide/suicide

This case report examines a child abuse homicide in which the perpetrator committed suicide a few hours after the infant's death. At the time of the perpetrator's suicide he was not under investigation, nor was he a suspect in the death of the child. Although the literature does not contain reports of similar cases, we are sure they exist. This report raises the question of the degree of social stigma attached to the accusation of child abuse. It also serves as a warning to those who must deal with the potentially suicidal child abuser.     

Murder and robbery by vehicular impact: true vehicular homicide

True vehicular homicides are defined as those occurrences in which a motor vehicle is intentionally used as a weapon in taking of a life. A case is presented in which the deceased was traveling in the front passenger seat of a motor car that was deliberately rammed by a heavy jeep that came in the opposite direction, resulting in a serious frontal collision. Immediately after the impact, while the occupants of the car were lying in a dazed condition, the two persons riding in the jeep escaped with a bag containing money that was in the car, leaving the jeep behind. The impact mainly involved the driver's sides of both vehicles. The driver of the car sustained serious injuries but was found to be alive, whereas the front-seat passenger, who did not show any serious external injuries, was found to be in a collapsed state and was pronounced dead on admission to the hospital within 30 minutes of the accident. The autopsy revealed that death was caused by closed hemopericardium from a ruptured right atrium. The evaluation of the external and internal injuries confirmed that the fatal injury and a few serious internal injuries were caused by the seat belt (tertiary-impact injuries). The ruptured right atrium was attributed to blunt abdominal trauma by impacting against the lap belt. The case was a true vehicular homicide in which a motor vehicle had been used as a weapon to kill a person. Various aspects pertaining to road accidents, the safety of the occupants, and the advantage and disadvantage of the safety devices are discussed.     

An unusual suicide case by combination of choking and hanging

ABSTRACT: A 40-year-old man was found dead in his prison cell, hanging on a twisted bandage tightened around his neck. His permanent metal tracheostomy tube was completely corked with a piece of paper wrapped with transparent cellophane from a cigarette case. After police investigation and complete autopsy, suicide was determined as the manner of death. Although suicides by 1 form of asphyxia are relatively common, combination of several different forms of asphyxia is far less frequent. We present this unusual and very rare case of suicide by combination of 2 forms of asphyxia, that is, choking and hanging, along with autopsy findings and discussion.     

An unusual case of suicide caused by electric current]

The authors describe a suicide case of a 37 year old master joiner caused by electricity. One wire was put around a neck and the other around the left wrist.     

Medicolegal aspects of 3 cases of bizarre self-mutilation

Three cases of bizarre self-mutilation are reported because of the unusual methods used and the unexpected good sequel in one of them.