A single gunshot (or multiple) does (do) not necessarily lead to immediate loss of consciousness or rapid neurological deficits, so the victim may be able to repeatedly pull the trigger before achieving the lethal effect. Despite multiple gunshot wounds can lead to the suspicious participation of other person to the death of the victim, in the medico-legal literature suicides with multiple gunshot wounds are reported, demonstrating the ability of the victim to act after two or more gunshots. In this case, a 47-years-old man was found dead in a pool of blood in the kitchen of his house. According to findings and analysis, the victim modified a single-shot, pneumatic toy gun branded “Condor” Cal. 7 mm (a gun that is made mainly with “ZAMAK” zinc-based alloy, designed to shoot one soft-polymer bullet at a time, with an initial kinetic energy lower than 1 Joule) into an improvised firearm weapon. With this gun, the victim achieved shooting of two bullets into his head, both entering from the right temporal region of his head, with one stopped in the left occipital lobe and the other one in the left temporal lobe. His death was caused by cranium-meningo-encephalic gunshot wounds. The conditions supporting the hypothesis that the victim was able to fire two shots to his head before the onset of incapacitation (the type of bullets used, the location of injuries and their consequences) and the characteristics that typically allow to distinguish the manner of death (suicide vs homicide) were evaluated. Based on all the collected elements, it was possible to confirm that suicide was the manner of death. This case underlines the importance of evaluating all available elements (post-mortem imaging, autopsy and toxicological findings, ballistics and neuropathological evaluations) to distinguish suicide from homicide and to prevent incorrect conclusions.
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Karger B (1995) Penetrating gunshots to the head and lack of immediate incapacitation. I. Wound ballistics and mechanisms of incapacitation. Int J Legal Med 108:53–61
Aesch B, Lefrancq T, Destrieux C, Saint-Martin P (2014) Fatal gunshot wound to the head with lack of immediate incapacitation. Am J Forensic Med Pathol 35:86–88
Newgard K (1992) The physiological effects of handgun bullets: the mechanisms of wounding and incapacitation. Wound Ballistics Rev 1(3):12–17
Karger B, Brinkmann B (1997) Multiple gunshot suicides: potential for physical activity and medico-legal aspects. Int J Legal Med 110:188–192
Arunkumar P, Maiese A, Bolino G, Gitto L (2015) 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. J Forensic Sci 60(5):1373–1379
Karger B, Billeb E, Koops E, Brinkmann B (2002) Autopsy features relevant for discrimination between suicidal and homicidal gunshot injuries. Int J Legal Med 116:273–278
Stone CI (1992) Characteristics of firearms and gunshot wounds as markers of suicide. Am J Forensic Med Pathol 13:275–280
Eisele JW, Reay DT, Cook A (1981) Sites of suicidal gunshot wounds. J Forensic Sci 26:480–485
Di Maio VJM (2016) Gunshot wounds, practical aspects of firearms, ballistics and forensic techniques, 3rd edn. CRC Press, Boca Raton, FL
Hejna P, Safr M, Zátopková L (2012) The ability to act - multiple suicidal gunshot wounds. J Forensic Legal Med 19:1–6
Boxho P (1999) Fourteen shots for a suicide. Forensic Sci Int 101(1):71–77
Racette S, Sauvageau A (2008) Suicide by drowning after two gunshots to the head: a case report. Med Sci Law 48:170–172
Hejna P (2010) Multiple suicidal injuries with shotgun slugs. Int J Legal Med 124:79–82
Introna F, Smialek JE (1989) Suicide from multiple gunshot wounds. Am J Forensic Med Pathol 10:275–284
Karger B (1995) Penetrating gunshots to the head and lack of immediate incapacitation. II. Review of case reports. Int J Legal Med 108:117–126
Marnerides A, Zagelidou E, Leontari R (2013) An unusual case of multiple-gunshot suicide of an alcohol-intoxicated cancer sufferer with prolonged physical activity. J Forensic Sci 58:537–539
Levy V, Rao VJ (1988) Survival time in gunshot and stab wound victims. Am J Forensic Med Pathol 9(3):215–217
Karger B, Puskas Z, Ruwald B, Teige K, Schuirer G (1998) Morphological findings in the brain after experimental gunshots using radiology, pathology and histology. Int J Legal Med 111(6):314–319
Strassmann G (1935) Uber Lebensdauer und Handlungsfohigkeit Schwerverletzer. Deut Ztschr f d Ges Gerichtl Med 24:393
Hudson P (1981) Multishot firearm suicide – examination of 58 cases. Am J Forensic Med and Pathol 2(3):239–242
Oehmichen M, Meissner C, König HG, Gehl HB (2004) Gunshot injuries to the head and brain caused by low-velocity handguns and rifles. A review. Forensic Sci Int 146:111–120
Guareschi G (1935) Studio per quattro colpi di pistola al capo. Arch Antropol Crim Psichiatr Med Leg 58:558–562
Karger B, Nüsse R, Schroeder G, Wüstenbecker S, Brinkmann B (1996) Backspatter from experimental close-range shots to the head. I. Macrobackspatter. Int J Legal Med 109:66–74
Sellier K (1986) Death: accident or suicide by use of firearms. Forensic Sci Prog 1:91–115
Durmic T, Radnic B, Bogdanovic M, Atanasijevic T (2019) Two cases of firearm-related murder-suicide: forensic implications of the ability to act. Med Sci Law 59(2):78–82
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Maghin, F., Antonietti, A., Farina, D. et al. A case of suicide by double gunshot wounds to the head: the ability to act after the first shot. Int J Legal Med 133, 1469–1476 (2019). https://doi.org/10.1007/s00414-019-02085-2
- Forensic science
- Multiple gunshot wounds
- Ability to act