So-called accidental firearm fatalities in children and teenagers in Tennessee, 1961-1988.

Tennessee State medical examiner reports of firearm fatalities classified as accidents involving victims aged 19 year or less from 1961 through 1988, were reviewed to evaluate circumstantial and contributing factors. A total of 225 were analyzed. The peak age for victims was 17 years, and there were more than five times more male than female victims. In Shelby County (Memphis), the racial distribution of fatalities was approximately that of the general population. Playing with a gun was the most frequent circumstance. The person responsible for pulling the trigger was equally likely to be a friend, a family member, or the victim. Head or neck were injured in most cases. The urban mortality rate was nearly twice that of the rural rate. More than half of the deaths in urban counties occurred indoors and involved handguns, whereas in rural counties only a third were due to handguns and the location was more often outdoors. Deaths in rural counties showed a seasonal variation that corresponded with the hunting season; by contrast, a peak in early summer was noted in the urban deaths. Defective guns or guns unsafe in design caused several deaths. (Semiautomatic pistols, which can be fired after unloading the ammunition magazine, are conspicuous examples of guns unsafe in design.) An important observation of this study is that medical examiners vary considerably in their classification of accidental manner, particularly when children are involved. Furthermore, medical examiner reports need to include much more information than is currently recorded if they are to be useful in guiding public policy to reduce firearm injuries.     

Adolescent suicide. A review of 87 cases of completed suicide in Shelby County, Tennessee

Suicide among adolescents is reported to be on the increase recently, and much attention from the news media to medical circles has been focused on this problem. This paper presents a comprehensive study of 87 completed adolescent suicides occurring between January 1, 1970, and January 31, 1985, in Shelby County, Tennessee. Factors including age, sex, race, and manner of death are examined as well as psychological, sociological, familial, and other environmental influences related to the deaths. In our series, the older white male adolescent dominated the statistics by far, and the most frequent mode of death was by firearm injury to the head. A brief discussion of studies related to suicide in general, and especially to adolescent suicide, is included.     

Shooting Through Clothing in Firearm Suicides

Abstract: There is a longstanding empirical rule that people who commit suicide rarely shoot through their clothing, but rather put it aside to expose the nude skin. Signs of shots through clothing have always been considered suspicious, raising presumptions of the presence of an abettor. Our report, based on a retrospective study of fatal suicidal firearm injuries from the years 1980 to 2007, points out that suicide victims only rarely remove clothing from the site of the future entry wound. The report covered 43 cases with fatal gunshot wounds in the area of the thorax, with only four persons (9%) removing the clothing present in the area of the subsequent self‐inflicted wound. Defects present on the clothing of a victim cannot, therefore, be understood as an absolute criterion for disproving the possibility of suicide, and nor do they necessarily indicate an unfortunate accident or homicide. If, however, the suicide victim removes the clothing from the area of the future wound, then this is almost always an indication of suicide.     

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.     

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.     

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.     

YOUNG GUNS: EXAMINING ALTERNATIVE EXPLANATIONS OF JUVENILE FIREARM HOMICIDE RATES*

In recent years, youth firearm homicide has become a topic of great public concern in the United States. However, few macrolevel studies have examined intercity variation in juvenile firearm homicide. In the current study, we address this gap in the literature by examining whether intercity variation in firearm‐related homicide rates among black and white juveniles is explained by three prominent structural factors: concentrated disadvantage, racial inequality, and the youth illicit drug market activity. Our findings suggest partial support for the concentrated disadvantage and juvenile drug market explanations of homicide. However, contrary to expectations, these relationships are only significant in models for white juveniles.     

An Unusual Case of Multiple‐Gunshot Suicide of an Alcohol‐Intoxicated Cancer Sufferer with Prolonged Physical Activity

Multishot firearm suicides are relatively rare and suggest the possibility of homicide. Physical activity following gunshots to the head, the neck, and the thorax does occur, and immediate incapacitation does not occur in every fatal gunshot wound that penetrates the head or perforates the heart. Cancer patients appear to be at increased suicide risk, but alcohol intoxication is less common in such cases. We present—to the best of our knowledge for the first time—a case of a 54‐year old, male, liver cancer sufferer, who under the influence of alcohol, discharged his revolver three times, suffered, among other wounds, a heart‐perforating wound, and died after c. 1.5 h, being able to talk until just before he died. Our case underlines the importance of keeping an open critical mind when dealing with multiple‐gunshot fatalities, especially when posttraumatic physical activity might be crucial in differentiating homicide from suicide.     

Fatal firearm wounds: a retrospective study in Bari (Italy) between 1988 and 2003

Fatal gunshot injuries are routinely encountered by forensic pathologists practicing in Southern Italy. Bari, the capital city of the Italian region known as Apulia, is a leader with regard to the number of firearm deaths in Italy. This is mainly attributable to local organized crime groups which control a variety of illicit activities. This retrospective study analyzes autopsy data related to fatal firearm wounds, handled by the Institute of Legal Medicine [University of Bari], between 1988 and 2003. A total of 717 cases were selected and classified as follows: firearm homicides (634); suicides (82); and accidental death (1). A significant number of variables have been reviewed such as: month in which the violent event took place; the victims' nationalities; gender and age of victims; site and number of entrance wounds; weapon type used; and manner of death (i.e. homicide; suicide; accidental). Analysis has revealed a homicide versus suicide ratio of almost 8:1. Victims were mostly male with a lower mean age than in other similar studies. Homicides with multiple gunshot wounds were more common than ones with single entrance wounds. For example, in one case, 30 entrance wounds were identified in the murder of a gang boss. Four suicides with two entrance gunshot wounds were identified. Handguns were the most frequently used weapon in all groups (i.e. homicide, suicide, and accidental), with 7.65 mm and 9 mm being the most common calibres. This study revealed a very low incidence of suicide among females. Mental and other types of illness, as well as financial stress were the apparent motives which prompted most of the suicide victims. The homicide cases described were most often related to continual, ongoing fights among local criminal gangs (75%).     

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.     

Determined to Die! Ability to Act Following Multiple Self‐inflicted Gunshot Wounds to the Head. The Cook County Office of Medical Examiner Experience (2005–2012) and Review of Literature

Cases of multiple (considered 2+) self‐inflicted gunshot wounds are a rarity and require careful examination of the scene of occurrence; thorough consideration of the decedent's psychiatric, medical, and social histories; and accurate postmortem documentation of the gunshot wounds. We present a series of four cases of multiple self‐inflicted gunshot wounds to the head from the Cook County Medical Examiner's Office between 2005 and 2012 including the first case report of suicide involving eight gunshot wounds to the head. In addition, a review of the literature concerning multiple self‐inflicted gunshot wounds to the head is performed. The majority of reported cases document two gunshot entrance wound defects. Temporal regions are the most common affected regions (especially the right and left temples). Determining the capability to act following a gunshot wound to the head is necessary in crime scene reconstruction and in differentiation between homicide and suicide.     

Controversial Suicide Case Using a Submachine Gun with a Sound Suppressor—The Need of Team Work of Forensic Chemistry and Firearm Examiners

Evidence materials in a presumed suicide case were studied by a firearm examiner and a forensic chemist. The victim's body with double gunshot wounding in his forehead, a machine gun in the sustained fire mode with a silencer, and four cartridge cases were found. Examinations of the evidence, the case file studies, and experiments dedicated to the case were carried out. Relationships between the placement of cartridge cases and the gun were established using a fast camera. The distributions of gunshot residues on the evidence materials and within the comparative gunshot patterns were studied by means of optical and electron microscopy, X‐ray microanalysis, and infrared spectroscopy. The shooting distance was assessed to be 30 cm or more, whereas the greatest distance that could have been achieved by the victim himself was about 11–13 cm. The obtained results supported the version of homicide rather than suicide.     

Radiodense bullet wipe around osseous entrance gunshot wounds

“Bullet wipe” is the material deposited by a bullet on any surface with which it comes into contact after it is fired and may contain debris from the gun barrel, including particles of primer and metal fragments from previously fired bullets. X‐ray analysis is a non‐destructive method by which traces of metallic elements can be visually detected. The analysis of osseous defects for radiodense bullet wipe (RBW) assists in determining the presence or absence of perforating gunshot wounds, especially in fragmented, skeletonized remains. The aim of our current study was to determine the frequency of RBW around entrance firearms injuries that perforated bone. We prospectively analyzed entrance gunshot wounds for RBW over a three‐year period using digital X‐ray analysis (n = 59). We retrospectively reviewed the corresponding autopsy reports to determine the frequency of RBW by biologic sex, reported ancestry, age‐at‐death, location of wound, manner of death, range of fire, bullet caliber, and presence of bullet jacket. Data were analyzed by Fisher's exact test or Chi‐square test with significance levels accepted at p < 0.05. RBW was present in 66% (n = 39) of examined cases. Decedent characteristics did not significantly alter RBW distribution, including biologic sex (p = 0.75), reported ancestry (p = 0.49), and age‐at‐death (p = 0.43). Additionally, the location of the osseous entrance gunshot wound, manner of death, range of fire, and cartridge caliber did not affect RBW detection. All cases involving non‐jacketed rounds (n = 5) showed RBW (p = 0.30). To our knowledge, this study is the first to report the frequency of RBW detection from osseous entrance gunshot wounds.     

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.     

CROSS-NATIONAL VARIATION IN HOMICIDES: IS RACE A FACTOR?

J. P. Rushton has done research indicating that predominantly black nations have higher rates of violent crime than predominantly white nations, which have higher rates than predominantly Asian nations. He attributes these differences to constitutional, inheritable factors on which the races vary. This article discusses the numerous problems with Rushton's use of international crime data and analysis, foremost of which are his use of one-way analysis of variance and lack of consideration of other causes of variation. Regression analysis-including dummy race variables and other relevant explanatory variables-indicates no significant association between race and cross-national homicide rates, the best and probably only valid indicator of cross-national variation in violent crime. This is the case whether reanalyzing Rush-ton's data or analyzing properly adjusted, inspected, and selected homicide rates.     

INDUSTRIAL SHIFT,POLARIZED LABOR MARKETS AND URBAN VIOLENCE: MODELING THE DYNAMICS BETWEEN THE ECONOMIC TRANSFORMATION AND DISAGGREGATED HOMICIDE*

Industrial restructuring marks the removal of a manufacturing and production‐based economy in urban areas, which had served as a catalyst in concentrating disadvantage and polarizing labor markets since the 1970s. Although scholars have established a relationship between concentrated disadvantage — poverty, joblessness, racial residential segregation — and urban violence in cross‐sectional studies, this literature has yet to estimate whether economic restructuring contributed to the change in urban homicide over time. Modeling this relationship requires an analytical strategy that incorporates specific indicators of (race and gender) polarized labor markets, separate from indicators of urban disadvantage, on disaggregated homicides while taking into account the growing dependency of urban cities on formal social control (via police presence and rise in incarceration). In this study I provide a theoretical rationale for linking industrial restructuring to urban homicide. Using a multivariate strategy to capture the shift in labor market forces and disaggregated homicides from 1980 to 1990, I also estimate the impact of this relationship. The results provide evidence of the industrial ship and documents both the decline in Manufacturing jobs for black males and black females and a growth in the service sector opportunities for white males only. I also find that industrial restructuring had a unique impact on disaggregated homicide beyond what has previously been established in cross‐sectional studies.     

STRUCTURAL INEQUALITY AND HOMICIDE: AN ASSESSMENT OF THE BLACK‐WHITE GAP IN KILLINGS*

This paper examines the relationship between race and violent crime by directly modeling the racial gap in homicide offending for large central cities for 1990. We evaluate the role of black‐white differences in aspects of both disadvantage and resources in explaining which places have wider racial disparities in lethal violence. The results show that where residential segregation is higher, and where whites' levels of homeownership, median income, college graduation, and professional workers exceed those for blacks to a greater degree, African Americans have much higher levels of homicide offending than whites. Based on these results, we conclude that the racial homicide gap is better explained by the greater resources that exist among whites than by the higher levels of disadvantage among blacks.     

RACIAL ANIMOSITY AND INTERRACIAL CRIME*

The primary objective of this study is to determine the effect of a victim's race on the likelihood of him or her being seriously injured during the commission of an interracial crime. We also assess the probability of a homicide occurring during an interracial crime. A multilevel city analysis shows that black offenders are no more apt than white offenders to injure their victims seriously during an interracial robbery or rape. A black offender also does not have a greater proclivity to kill his or her victim during the commission of an interracial crime. Some evidence suggests that white victims are more likely than black victims to suffer serious physical harm during an aggravated assault. Results also reveal that contextual factors related to racial animosity, such as residential segregation, white‐to‐black economic inequality, and black‐to‐white unemployment, fail to have any moderating effect on either the severity of victim injury or the likelihood of a homicide occurring during an interracial crime. Overall, the results generated in this study tend to cast doubt on the validity of racial animosity theory. Our findings also lead us to question the veracity of the oftenmade claim that black‐on‐white crimes are punished more severely because these types of offenses are somehow more heinous in circumstance. At least in regard to serious victim injury and victim death, black‐on‐white crime is no more violent than white‐on‐black crime.     

The prevalence of drugs in carbon monoxide-related deaths: a retrospective study, 2000-2003

The objective of this study was to review demographic characteristics and drugs detected in carbon monoxide (CO)-related deaths from cases received by the Office of the Cuyahoga County Coroner in Cleveland, Ohio, from 2000-2003. Postmortem reports were reviewed, and decedents for which CO was listed as the cause of death were included. The data were compiled into 3 groups according to the official coroner's verdict as to the manner of death: accident, suicide, and homicide. Included in this study were 122 cases: 84 (69%) accidental, 31 (25%) suicide, and 7 (6%) homicide. Accident decedents were typically white males, aged 40-59 years, residing in Cleveland. Suicide decedents were also middle-aged, white males but residing in the suburbs. Homicide decedents under the age of 6 were characteristically black (N=2), while decedents over the age of 39 were predominately white (N=3). Carboxyhemoglobin (COHb) levels in suicide cases were higher than concentrations measured in accidental deaths. The highest percentage of suicide decedents (36%) had a COHb level>70% saturation, accident decedents (36%) between 50% and 69% saturation, and homicide decedents (71%) below 50% saturation. Ethanol (N=34) was detected in 28% of deaths, and therapeutic and/or abused drugs (N=50) were detected in 41% of deaths. Illicit drugs were detected in 11% of cases (cocaine/metabolites; THC/metabolites), other drug positives were therapeutic medications. The most common drugs detected were antidepressants and antihistamines in suicides and pain medications and antihistamines in accidents.     

STRUCTURAL FACTORS AND BLACK INTERRACIAL HOMICIDE: A NEW EXAMINATION OF THE CAUSAL PROCESS*

This study evaluates the assumption that deprivation among African Americans and racial inequality lead to black interracial homicide due to racial conflict and antagonism. Using refined race‐adjusted Supplemental Homicide Report data, Uniform Crime Report data and census data, we test an alternative hypothesis that draws on the macrostructural opportunity theory to assess and more accurately specify the relationship between structural characteristics and black interracial homicide. We find that first, the relationship between economic factors and black interracial homicide can be explained in large part by high rates of financially motivated crime such as robbery, and second, that economic factors are associated with financially motivated but not expressive black interracial killings. Analyses of black intraracial killings are performed for comparison purposes. Collectively, the findings suggest that conflict‐based explanations rooted in racial antagonism and frustration aggression may be premature.