Exsanguination from a puncture wound to arteriovenous fistula as the method of suicide in a chronic kidney disease patient

  • Vladimir Živković
  • Danica Cvetković
  • Slobodan NikolićEmail author
Images in Forensics
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In this paper we present a case of a 65-year-old man, with chronic kidney insufficiency treated with hemodialysis, found dead by his wife, lying in his bed. Based on autopsy findings, toxicological analysis, the police report and circumstances of death, it was concluded that the death was suicidal and that the cause of death was hemorrhagic shock due to fatal blood loss through a small puncture wound in an arteriovenous fistula of the left forearm, inflicted by a small Swiss Army knife. Similarly to occupation-related suicides, the victim had used his knowledge about chronic kidney disease and the relatively high pressure in an arteriovenous fistula to inform his suicidal actions, and, thus, this case might be considered a disease-knowledge-related or medical-knowledge-related suicide.


Suicide Exsanguination Arteriovenous fistula Chronic kidney insufficiency Occupation-related suicide 


Funding information

This work was supported by the Ministry of Education, Science and Technical Development of Republic of Serbia, Grant No. 45005.

Compliance with ethical standards

Conflict of interest

The authors hereby declare that they have no conflict of interest.

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Institute of Forensic MedicineUniversity of Belgrade – School of MedicineBelgradeSerbia

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