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.     

Recent Firing Range Suicides in South Australia

Abstract: Two cases are reported from South Australia, where deaths occurred that were due to single self‐inflicted gunshot wounds to the head in individuals who were visiting indoor firearm ranges. Case 1: A 54‐year‐old man visiting an indoor firing range placed a .357 magnum handgun to his head and fired one shot. Case 2: A 23‐year‐old woman who was being instructed in firearm usage at an indoor firing range placed a 9 mm handgun to her head and fired one shot. In both cases, deaths were due to cerebral laceration with skull fracture. Firing ranges may be utilized by individuals who are seeking weapons for suicide attempts, and suicide may be successfully undertaken at such locations even while a victim is under direct supervision. In jurisdictions, where firearm ownership is strictly legislated, it may be that clubs can inadvertently provide access to firearms for this type of activity.     

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.     

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.     

Child Outcomes and Risk Factors in U.S. Homicide-Suicide Cases 1999–2004

Intimate partner homicide-suicide (IPHS) represents the most severe form of domestic violence, and often results in multiple fatalities. This paper examines outcomes of children in households that experience IPHS. Reports of 325 IPHS cases among adults age 18–44 in the U.S. between 1999 and 2004 were collected and examined. Results indicate children were often fatally wounded, but were most likely to witness the eventthen be absent or killed. Difficult financial conditions during times of economic downturn may increase the possibility of stress-related suicide, and subsequent familicide. Children with a suicidal parent are at increased risk of harm, so identification is of vital importance. Children are most likely harmed or killed by a primarily suicidal male perpetrator, who is usually their biological father. Firearms were used more than other methods in IPHS events. Even those perpetrators with protective orders more often utilized a firearm, which reflected a weakness in Violence Against Women Act gun ban enforcement. In this research, regions of the U.S. with less stringent firearm regulations were disproportionately likely to contain IPHS events. Findings illustrate the importance of making distinctions among perpetrators of IPHS, and assessing firearms policies, in order to improve child death prevention efforts.     

Weapon location following suicidal gunshot wounds

The location of the gun following suicidal gunshot wound was studied by reviewing 574 such deaths in which the scene was investigated by a medical examiner investigator and the body was examined at the Bexar County Medical Examiner's Office in San Antonio, Texas. The position of the gun could not be established in 76 cases. In the remaining 498 cases, the gun remained in the deceased's hand in 24% of the cases. In 69% of the cases, the gun was on or near the body but not in the hand (i.e., touching the body or within 30 cm of the body). The gun was found >30 cm from the body in the remaining 7% of cases. In the case of handguns, the gun was found in the hand in 25.7% of individuals. For individuals using long guns, the firearm was in the hand of the decedent in 19.5% of cases. The gun had a greater chance of remaining in the deceased's hand if the person was lying or sitting when the gunshot wound was received. Variables such as gender of the individual, wound location, and caliber of handgun were not significant in predicting whether the gun stayed in the hand after a suicidal gunshot wound.     

Adolescent and young adult suicide: a 10-year retrospective review of Kentucky Medical Examiner cases

The compilation of all suicidal causes of death attained the third highest ranking of mortality between the ages of 15 and 24 following unintentional deaths and homicide in the United States, accounting for approximately 4000 deaths in 2002. A variety of biopsychosocial factors may contribute to adolescent suicidal behavior, including psychiatric disorders, risk-taking behaviors, and lack of a cohesive family unit. The authors conducted a 10-year (1993-2002) retrospective review of 108 Medical Examiner cases of suicide ages 11-17 and 358 cases ages 18-24 in Kentucky, which represents two thirds of the Coroner cases in the state. The majority of victims were male and Caucasian. The major causes of death were the same for the two age groups, specifically, firearm injury (72.2% and 70.7%), hanging (22.2% and 18.7%), and drug intoxication (2.8% and 5.3%). An integrated Coroner-Medical Examiner system profits in the public health arena by providing collaborative research data for policy decisions. The prevalence of youth suicide by firearm should prompt further discussion regarding ways to better identify high-risk adolescents and young adults and restrict pediatric access to unsecured household firearms.     

Multivariate analysis ('forensiometrics')--a new tool in forensic medicine. Differentiation between firearm-related homicides and suicides.

A forensiometric model to discriminate between homicidal and suicidal firearm-fatalities is presented. It is based on a survey of all 45 homicidal and 251 suicidal firearm-fatalities that were examined at the Department of Forensic Medicine in Stockholm, Sweden during the period 1983-92. The model used 15 variables to describe 19.8% of the variation in the data and its goodness of prediction, Q2, was 0.742. The variables ranked in falling order of covariation with homicide (i.e. correlation with or importance in the prediction of homicide) were: presence of other injuries than firearm-wounds, entrance wound in the front part of the chest except precordium, bullet path through clothes, entrance wound in upper extremity, female victim, entrance wound in abdomen, entrance wound in head except temples, central forehead and mouth, and entrance wound in back. The variables most correlated to suicide were: used firearm found close to victim's body, reported suicidal ideation, victim's age, presence of contact wound(s), male victim, presence of farewell letter and entrance wound in mouth. The model was thereafter validated on a test-set of 18 homicides and 84 suicides during 1993-95. All suicides and 16 homicides were classified by the model in agreement with the previous police and forensic medical examinations. Thus, the model's sensitivity to classify homicides is estimated to be 89% and its specificity 100%.     

Planned complex suicide: report of three cases

Three cases of planned complex suicide in a 3-year period are reported. A 40-year-old man was found dead, in his garage, hanging by his neck, with a gunshot in the head from a pen gun. A 50-year-old man was found dead in the sea with a gunshot to his head. A third man was found in a field hanging by a tree and burned. The investigation of the scenes and the methods used pointed toward a suicidal etiology. The main difference between planned complex suicide and those cases defined in medicolegal literature as combined suicides lies in the complex mechanism used by the victim as a protection against the failure of one of the mechanisms.     

Violence,Guns, and Suicide in New Orleans: Results from a Qualitative Study of Recent Suicide Decedents

Many Americans own guns to protect themselves against other people, but there is evidence that both victimization and gun access increase suicide risk. We conducted qualitative interviews with informants of 17 suicide cases in New Orleans of the 60 who died between January 2015 and April 2016 to understand the relationship between past trauma, gun access and storage, and suicide. Nine cases had experienced a past trauma, including three who had recently had a family member killed by homicide. Eight died via firearm; of those, seven owned the guns they used to take their lives and stored them locked (but loaded) at home or in their cars. Preventing community violence and addressing its sequelae may be important for reducing suicides. A multi‐pronged strategy consisting of policies, education, and marketing will likely be needed to address the risk of suicide conferred by gun access.     

Study of unusual phenomenon of contact firing on gelatine block using .38 Special revolver--forensic importance

Gunshot wounds in suicide cases are self-inflicted wounds. Self-inflicted wounds in suicide cases are usually caused by contact firing and are of great forensic significance. Evaluation of contact wound may be associated with difficulties if the bore gets obstruction prior to firing. This paper investigates the phenomenon and interprets the results of test firing conducted on 20% gelatine block at 10 degrees C, using .38 Special revolver with obstruction of a bullet in the bore. Test firings were conducted in three different muzzle-target contact conditions keeping the muzzle pressed against the gel block in each case. The physical evidence and the wound ballistic parameter namely bullet track, remaining velocity of the bullets and volume of permanent cavity have been studied. When compared with the results of contact firing conducted with the same firearm without having any bore obstruction under similar conditions, it has been found that the physical evidence and the wound ballistic parameters would be helpful for interpretation of such unusual incidents for forensic inference.     

Murder Followed by Suicide: A Newspaper Surveillance Study Using the New York Times Index

Abstract: Murder–suicide is a relatively uncommon event but as reported by the New York Times, it has occurred and continues to occur yearly. Previous research has indicated that those who commit murder–suicides tend to be men, are in or have been in an intimate relationship with the victim, victims tend to be women, and a firearm is most likely to be used. This study uses a newspaper surveillance methodology to examine such cases. Articles from the New York Times as found in the New York Times Index were coded, analyzed, and examined. The cases, 166 in total, support the findings from prior research. The trend data was examined by cross tabulations and chi‐square analysis. The findings suggest that murder–suicides are rare events and when they occur they usually involve a male perpetrator and an intimate partner victim who is either a wife or girlfriend with the event occurring in a private home. A firearm is the most commonly used method for both murders and suicides, particularly if there was more than one murder victim. The authors conclude by suggesting that future research should focus on using the forthcoming data resource in the CDC’s National Violent Death Reporting System (NVDRS) to examine the occurrence of murder–suicide.     

Planned complex suicide by self-poisoning and a manipulated blank revolver: remarkable findings due to multiple gunshot wounds and self-made wooden projectiles

A remarkable case of complex suicide with poisoning and multiple self-inflicted gunshot wounds to the head is reported. After ingestion of a liquid insecticide, the victim shot himself twice in the head, once in each temple. Self-manufactured wooden dowels were used as projectiles in combination with conventional blank cartridges. The dowels had been glued on top of the blank cartridges and expelled by propellant gases. Moreover, the blank revolver used had been extensively manipulated in a rarely observed manner. Several occlusive devices had been removed from the barrel and the cylinder chamber to enable the expulsion of the wooden projectiles. The investigation of the methods used and the circumstances found at the scene pointed towards a planned complex suicide. A remarkable case with unusual projectiles, i.e., wooden dowels, fired by an extensively manipulated blank gun is reported, emphasizing the importance of close collaboration between the police firearm laboratory and forensic pathology in practical casework.     

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).     

Suicide by jumping from buildings

A study of 82 suicides during 1982-1986 that were committed by jumping from buildings was performed using the case files of the Office of the Medical Examiner of Metropolitan Dade County in Miami, Florida, U.S.A. The analysis involved the age, race, and sex of the victim along with the results of toxicologic studies and the cause of death. Additionally, the decedent's place of residence, location of the suicide, height of the building, and the reason for the suicide were investigated. Whether or not a note was left by the decedent was also ascertained. The suicidal "jumper" most commonly was a white man who was greater than 60 years of age who died from the resultant multiple injuries. The victim commonly was sober and drug free at the time of the incident. In approximately two-thirds of the cases, the location of the suicide was the victim's residence, which frequently was an apartment or condominium-type dwelling that was seven floors or higher from the ground. The victim often had experienced depression prior to the incident and did not usually leave a suicide note. This article compares the Dade County cases with others that have been studied and discusses the reasons why jumping from a building may have been chosen as the suicidal mechanism.     

Fatal firearm accidents in Sweden

According to Swedish law, it is prohibited to possess and use firearms without a special permission (license), which is given only after a detailed personal investigation. This restrictive legislation accounts for the fact that deaths due to firearms in Sweden are rare in an international comparison. The number of accidental firearm fatalities in Sweden is 0.074/100,000 living persons. We have previously published a series of accidental firearm fatalities during hunting, and now we present an investigation on the non-hunting fatalities. The mean age of the victims was 27 years, and males predominated. Handguns, military rifles, and shotguns caused most of the accidents. The first published case of fatal thoracic airgun wound is also included. Slightly more than half of the accidents were caused by another person and were inflicted at close range. Unsafe handling of the guns, especially "playing" with the gun or during military training caused most of the accidents. It is doubtful that one could further decrease the low number of fatal firearm accidents in Sweden by even more restrictive legislation. Instead, it is concluded that the most important factor to stress is the safer handling of weapons.     

Firearms fatalities in Denmark 1970-1979

In the 10-year period from 1970 to 1979 933 firearm fatalities occurred in Denmark which represent an increase of 45% during a little more than 10 years. Eighty-eight per cent were suicides, 8% homicides, and 4% accidents. Accidental shootings have decreased from 8% to 4% and the fall seems to be a result of fewer accidents in connection with hunting, probably due to a more restrictive legislation about hunting. An increasing share of the total number of deaths, now responsible for 57% of the fatalities, are by shotgun. There has been a remarkable increase in the use of sawn-off long barreled weapons. Still considering the marked increase of firearm fatalities, fatal shootings are of very limited importance in Denmark, especially homicidal shootings of which there are 2-3 per year. Shotguns are at the present time the only procurable dangerous weapons which have led to an increased share of the total firearm fatalities. Restrictions in the use of shotguns during hunting seem to have had positive effects on the reduction of hunting accidents. As mentioned above, the most valuable method of bringing the firearm fatalities under further control seems to be increased control over the procurement and possession of shotguns.     

Toxicologic findings in suicide: a 10-year retrospective review of Kentucky medical examiner cases

Toxicologic analysis is an integral component in the investigation of suicide and requires correlation with a detailed scene inspection, with an extensive exploration into the decedent's medical and social background to uncover suicidal ideation or intent and a postmortem examination of the body. In this review, the authors analyzed 2864 cases classified as suicide upon autopsy and toxicologic examinations between 1993 and 2002 in the Kentucky Division of Medical Examiner's Services. Blood and urine were collected in 95.0% and 72.3% of cases, respectively. A total of 32.5% of the victims had negative blood toxicologic results, and 52.7% of urine toxicology screens yielded no drugs. Analysis of the data indicated that 3 times as many women had taken antidepressants and more than twice as many had consumed opioids. Drug toxicity ("overdose") ranked as the third (9.9%) leading cause of suicide after firearm injury (67.5%) and hanging (13.7%). Women succumbed to drug toxicity more than men (27.5% versus 5.9%). Of the overdose deaths, 66.5% had a negative blood alcohol concentration (BAC), while antidepressants, opioids, and benzodiazepines were detected in blood in 54.4%, 37.4%, and 29.2% of the subjects, respectively. The collection of these data serves the goals of public health and clinicians in devising strategies for suicide prevention.     

Suicide by Cop Among Officer-Involved Shooting Cases

Abstract: The frequency and characteristics of suicide by cop cases (SBC) among a large (n = 707) nonrandom sample of North American officer-involved shootings (OIS) were investigated. “Suicide by cop” is when a subject engages in behavior which poses an apparent risk of serious injury or death, with the intent to precipitate the use of deadly force by law enforcement against the subject. Thirty-six percent of the OIS in this sample were found to be SBC with high interrater agreement (intraclass correlation coefficient = 0.93) for category classification. SBC cases were more likely to result in the death or injury of the subjects than regular OIS cases. Most SBC cases were spontaneous, but had clear verbal and behavioral indicators that occurred prior to, and during the event. Findings confirm the trend detected in earlier research that there was a growing incidence of SBC among OIS. SBC individuals had a high likelihood of possessing a weapon (80%), which was a firearm 60% of the time. Half of those with a firearm discharged it at the police during the encounter. Nineteen percent simulated weapon possession to accomplish their suicidal intent. Other findings highlight the histories and commonalities in this high risk group.     

Shotgun wounds: a review of range and location as pertaining to manner of death

Shotguns are used in a considerable number of homicides and suicides, and while gunshot wounds are extensively reported in the literature, there is a paucity of shotgun deaths. To specifically study deaths by shotguns, all deaths due to shotguns examined at the Bexar County Medical Examiner's Office between 1988 and 2005 were reviewed. The cases were evaluated by age and sex of the victim, wound location, wound range, and manner of death. Three hundred eighty-seven cases were evaluated, composed of 343 males and 44 females, with 180 homicides, 203 suicides, 3 accidents, and 1 undetermined manner of death. Contact wounds were the most common range in suicides and the head was the most common location. For homicides, the most common range of fire was distant, and the most prevalent distributions of wounds were head, chest, and multiple wound locations. Statistical analysis showed significant differences between homicide and suicide wound locations and ranges, and then odds ratios were generated. Knowledge of the statistical distribution of shotgun wounds in a large series with respect to range of fire and wound location may be of assistance to the medical examiner in evaluating the circumstances of an individual case to arrive at a manner-of-death opinion.