ArticleLiterature Review

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

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  • Section Legal Medicine
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Abstract

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%).

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... With regard to homicides, the findings of the few publications differ greatly between regions and between countries. On the European continent, a study carried out in Bari, Italy [4] between 1988 and 2003 reported 634 homicides and 82 suicides: 221 homicides had a single wound, 127 had 2 wounds and 91 had 3 wounds. The number of cases with more than 7 wounds was relatively low: 24 cases had between 7 and 10 wounds, 15 between 11 and 17 wounds, while in a single case 30 entrance wounds were reported. ...
... With regard to suicides, series in the literature report a single entry wound, in accordance with our findings [4,5,8,9]. Only two cases of complex suicide presented with several wound complexes, as was also described by Myint et al. in 2014 [8]. ...
... Anatomic locations of injury also differ depending on the studies. Depending on the series, the head was involved in between 24% and Depending on the series, the abdomen was involved in 2.4% to 18% of homicides [4,5,7,8], and in 0% [7] to 9% of suicides [4,5,8]. ...
Article
The regions of Provence-Alpes-Côte d'Azur and Corsica in south-east France are regularly affected by firearm deaths, and a large amount of data has been collected by our forensic institute. We carried out a single-center retrospective descriptive study of the records of our institute between January 1, 2011, and 31 December, 2018, relating to firearm deaths (homicides and suicides). There were 302 cases (218 homicides and 84 suicides). The anatomic locations most frequently involved were the thorax, abdomen and head, in that order, in homicides and the head in suicides. More than 80% of the homicides in our series had more than one wound complex and nearly one in four homicides had more than 7. The weapon most frequently used in suicides was a hunting smooth bore gun, followed by the 9mm Luger and then by the .22 Long Rifle. In homicides, the caliber most frequently used was the 7.62 × 39 (29.6%), followed by the 9mm Luger (29%) and lastly by hunting calibers (27%). More than 10% of cases involved two weapons of two different calibers. Our study, which used a dual forensic and ballistic approach, was carried out in one of the most heavily populated regions of metropolitan France. We observed very few similarities with the literature regarding type of caliber and wound complexes. This may be explained, among other factors, by differences in political, societal or cultural contexts.
... In agreement with the present work was the study in Edirne, Turkey also reported that 54% of firearm victims were aged between 20 and 40 years (Azmak et al., 1998). Also in Bari (Italy) most of victims in firearm fatalities were males which represented 93% (Solarino et al., 2007). Similar results obtained in Faisalabad (India) where 28.19% of victims were in age groups 20-29 and 77.66% victims were males (Bashir et al., 2007). ...
... Males are also more exposed to daily stress activities. Males are also more affected than females as they are expected to have the moral prestige of the family and any threat to it can lead to violence (Kohli and Aggarwal, 2006;Solarino et al., 2007). ...
... In the present work most of inlet wounds were multiple which represented 57.6% and 66% of total in years 2010 and 2011 respectively. In agreement with the present work the study of fatal firearm injury in Bari (Italy) where multiple entrance wounds were more common than single entrance wounds (Solarino et al., 2007). Also the study of homicidal cases from firearm injury at autopsy in Adana, Turkey, it was found that multiple injury in 53. ...
... This results from the fact that a bullet, although a blunt-edged object, is a rather untypical tool that may inflict various injuries (10,18). On the other hand, studies of gunshot wounds in people are carried out with regard to the whole population or to selected social groups (5,6,21,25,28,29,31). Keep (13) carried out an analysis of animals, similar to that presented in this study. ...
... The variable percentage of gunshot injuries in animals demonstrated in our studies in particular years has also been reported for men. This fact has not yet found any reliable explanation (3,5,25) and requires further studies. ...
... According to Desmarchelier et al. (8), shootings of predatory birds were usually recorded in autumn. In humans, as well, the highest number of gunshot victims is recorded in autumn months (5) or in early winter (25). ...
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A widespread availability of firearms makes animals the victims of both intentional and accidental shootings by man. In Poland, statistical surveys on gunshot cases in animals are not carried out. The present authors attempt to assess the frequency and character of gunshot injuries in animals on the basis of their observations from 2000-2009, taking into account changes in the law regulating the availability of firearms. The material involved 171 study protocols of patients whose radiological evaluation revealed the presence of bullets. The analysis covered different species of animals, taking into account the number of fatal and nonfatal injuries. Besides, gunshot wounds were classified according to their direct effect on the animals’ clinical status. During the radiographic assessment, the type of ammunition was also evaluated. The majority of gunshot victims were dogs (78.36%), followed by cats (15.20%), hares (2.34%) and roe deer (1.17%). The study also revealed the presence of bullets in the bodies of birds (2.92%) (one great egret, one golden eagle, one buzzard, one raven and one jackdaw). Additionally, the animals` medical history was obtained from the owners (especially of dogs and cats) to determine whether the owners were aware of gunshot wounds in their pets. The amendment of the general provisions regulating the availability of firearms has affected the character of gunshot injuries and the number of victims.
... Einwohner/Jahr [2][3][4][5]. In Europa ergaben retrospekti ve Auswertungen beispielsweise jährlich 12,6 Schusstodesfälle in Brescia (Nord italien) und 44,8 Schusstodesfälle in Ba ri (Süditalien, [5,6]). Eine Auswertung für Stockholm (Schweden) zeigte jähr lich 28,8 Schusstodesfälle, während für London über 11,6 Schusstodesfälle/Jahr berichtet wurde [7,8]. ...
... Die Mehrzahl der Schusstodesopfer im untersuchten Kollektiv war männlich (90 %). Auch dies deckt sich mit bereits publizierten Beobachtungen [5,6,8,9,[11][12][13]. Geschlechterunabhängig fanden sich am häufigsten Schusstodesfälle in den Al tersgruppen "31 bis 40 Lebensjahre", "51 bis 60 Lebensjahre" und "61 bis 70 Le bensjahre". ...
... In einer süditalienischen Ar beit ermittelten die Autoren die häufigs ten Schusstodesfälle in den Altersgruppen "21 bis 30 Jahre" und "31 bis 40 Jahre". Der Unterschied wird mit einem hohen Akti vitätsgrad jüngerer Menschen im organi sierten Verbrechen begründet [6]. Während Männer überwiegend Suizid begangen (85 %), überwogen bei Frau en Homizide. ...
Article
Hintergrund Tödliche Schussverletzungen stellen einen kleinen, aber hochrelevanten Anteil des rechtsmedizinischen Untersuchungsguts dar. Material und Methode Es wird eine retrospektive rechtsmedizinische Studie aus dem Sektionsgut der 3 Berliner rechtsmedizinischen Institute des Zeitraums 2000-2009 vorgestellt. Die Auswertung erfolgte im Hinblick auf rechtsmedizinisch sowie demografisch relevante Merkmale und deren Bezüge zueinander. Weiter wurde die Überlebenszeit nach Schussverletzungen analysiert. Ergebnisse Es wurden 332 Schusstodesfälle ausgewertet (90 % Männer, Durchschnittsalter 54,3 Jahre). In mehr als drei Vierteln der Fälle wurde Suizid begangen, mehrheitlich mit illegal besessenen Waffen. Die Schusshand des Suizidenten konnte in 59 % der Fälle identifiziert werden. Am Ereignisort bzw. auf dem Weg ins Krankenhaus verstarben 86 % der Opfer (mediane Überlebenszeit 2 h 27 min 30 s). Lag Alkoholkonsum vor, waren die Opfer in 54 % der Fälle stark alkoholisiert [Blutalkoholkonzentration (BAK) > 1,5 mg/g]. Kurzwaffen (Pistolen 53 %, Revolver 18 %) fanden am häufigsten Verwendung. Nahschüsse waren in 81 % der Fälle zu verzeichnen; Durchschüsse überwogen (62 %). Durchschnittlich wurden 1,39 Schüsse/Todesfall abgegeben. Am häufigsten war der Kopf des Opfers betroffen (66 %; Kopfdurchschüsse 55 %, Kopfsteckschüsse 21 %). Die meisten Schusswaffensuizide ereigneten sich in den Sommermonaten. Tötungen durch Schusswaffen fanden sich in 20 % der Fälle; im Beobachtungszeitraum ereignete sich lediglich ein tödlicher Unfall mit Schusswaffen. Schlussfolgerung Schusstodesfälle stellen insbesondere im Hinblick auf Suizid und illegalen Waffenbesitz weiterhin ein relevantes Problem dar. Jeder Schusstodesfall erfordert eine interdisziplinäre Aufarbeitung, da einzelne morphologische Aspekte nicht allein als für Suizid, Homizid oder Unfall beweisend angesehen werden können. Die Zahl der Schussverletzungen bedingt nicht die Überlebenszeit.
... In most countries with https://суицидология.рф/ Научно-практический журнал Том 11, № 2 (39), 2020 Суицидология Однако их применение не всегда ведёт к ожидаемому результату с первой попытки. Приводятся описания погибших от самоубийств с количеством огнестрельных ранений в голову от двух [68] до восьми [66], что вполне вероятно, с одной стороны, может быть обусловлено неопытностью стрелка, испытываемым им стрессом, а с другой, указывает на степень выраженности желания умереть. В любом случае определение способности действовать после огнестрельного ранения в голову необходимо при реконструкции места преступления и при разграничении убийства и самоубийства [66]. ...
... However, their application does not always lead to the expected result on the first try. Descriptions of those who died from suicides with two [68] to eight [66] gunshot wounds to the head are given, which on the one hand, may be due to the shooter's inexperience and stress, and on the other hand, the degree of expression of the desire to die. In any case, determining the ability to act after a gunshot wound to the head is necessary when reconstructing a crime scene and when distinguishing between murder and suicide [66]. ...
... Looking at the distribution of cases by gender; of the 114 cases, 79 (69,3%) were male and 35 (30,7%) were female, and the M/F rate was 2,25. The average age of cases was detected as 14,04 ± 4,23 (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18) years. Looking at the distribution of cases according to age groups, 74 cases (64,9%) were found to be in the 15-18 age group in the first place (Table 1). ...
... When the cases are evaluated according to their origin (Figures 3 and 4), it was observed in the study that homicide was the first in 37 cases (32,5%), suicide was the first in 34 cases (29,8%), and accidental deaths were the first in 22 cases (19,3%). In other studies, all age groups in Turkey and abroad were examined for deaths with firearms; In the study of Gören and et al (18), 66,7% of cases were murder, 27% were suicide, 6,3% were accidents, In Toka's (2) study, 55,3% of cases were homicide, 37,6% were suicide, 5,7% were accidents; and also the study conducted by Solarino et al (19) found that 88,4% of cases were homicide, 11,5% were suicide, 0,1% were accidents. Compared all age groups and deaths as a result of firearm injuries in the 18-year-old and under age group in our study; the origin of murder ranks first in both groups, and as with all age groups, the tendency to commit murder with firearms is more likely in childhood age groups. ...
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Giriş ve Amaç: Bu çalışmada 01.01.2006-31.12.2015 tarihleri arasında İzmir ili ve çevre illerde meydana gelen 18 ve altındaki yaş grubunda ateşli silah yaralanmasına bağlı ölüm olaylarının sosyodemografik özeliklerinin incelenerek elde edilen verilerin ülkemizde ve dünyada yapılan benzer çalışmalarla karşılaştırılması amaçlanmıştır. Gereç ve Yöntem: Çalışmamızda İzmir ve çevresinde meydana gelen ateşli silah yaralanmasına bağlı ölümler retrospektif olarak taranmış ve bu olguların 114’ünün (%6.07) 18 ve daha küçük yaşta olduğu görülmüştür. Olgular ölümün meydana geldiği yer ve zaman, cinsiyet, yaş, orijin, mevsim, ay, yıl, silahın türü, mermi giriş sayısı, atış mesafesi, elde edilen mermi çekirdeğinin yapısı, mermi giriş yeri, olayda kullanılan silahın kime ait olduğu, alınan örneklerin toksikoloji sonuçları ve ölüm nedeni ile failin kim olduğu gibi özellikler açısından değerlendirilmiştir. Bulgular: Olguların yaşları 1 ile 18 arasında değişmekte olup, 79'u (%69.3) olgu erkek, 35'i (%30.7) kadın bulundu. 39 olguda (%34.2) tabanca, 75 olguda (%65.8) av tüfeği kullanıldığı tespit edildi. Orijinlere bakıldığında; 37 olgu (%32.5) ile cinayetler ilk sırada yer aldığı görüldü. Ölümlerin en sık kış mevsiminde (n:32, %28.1) oluştuğu tespit edildi. Olguların en fazla (n:48, %42.1) köy/kasaba gibi kırsal bölgelerde ve olayın gerçekleştiği yerin en fazla (n:54, %47.4) ev olduğu görüldü. 35 olguda (%30.7) olayda kullanılan silahın kişinin babasına ait olduğu görüldü. Sonuç: Evlerde bulundurulan ateşli silahların çocukluk çağı ölümlerine yol açtığı görülmektedir. Toplumumuzun, çocukların ateşli silahlara kolayca ulaşmaları halinde yaralanma ve ölüm olaylarının kolayca meydana gelebileceği, bu nedenle çocuklu evlerde mümkün olduğunca ateşli silah bulundurulmaması gerektiği, çocukların oyuncak dahi olsa silahlara özendirilmemesinin bu konuda faydalı olacağını düşünmekteyiz.
... This finding is similar to the reports from Enugu, [14] Port Harcourt, [24] Lagos, [13] Maiduguri, [16] Nigeria, and other parts of the world such as South Africa, [11] Pakistan, [10] and Italy. [9] The higher on investment because of the ease with which it can be executed. [34] This could be attributed to the fact that the unwary and prospective victims of kidnapping do not move about with security unlike armed robbery which involves breaking into houses, banks or business premises with security where armed robbers may encounter security challenges and confrontations. ...
... This finding is lower than that in previous reports in Nigeria: 34.8% was reported in Port Harcourt, [24] 69.7% in Irrua, [23] 80.0% in Lagos, [13] and 89.2% in Maiduguri. [16] These findings are at disparity with reports from other parts of the world such as Sri Lanka, [8] Italy, [9] and United States of America [7] where gang-related violence was the main motive behind GSIs. The lower frequency in the armed robbery-related GSIs in the study area could be a reflection of the change in the motive behind GSIs resulting in the downward trend of armed robbery-related GSIs and emergence of kidnapping-related GSIs. ...
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Background : Gunshot injuries (GSIs) though a rarity in Nigeria before the Nigerian civil war have now become rampant with variable epidemiology. It is emerging as a common cause of trauma-related emergency hospitalizations. Aim: The study was aimed at reviewing the epidemiology of gunshot injuries in the emergency department (ED) of a Nigerian tertiary hospital over a 5-year period. Materials and Methods: This was a retrospective study of GSIs seen at the ED of Federal Medical Centre, Umuahia, Nigeria using data from medical records, patients′ case notes, ED admission registers, and nurses′ report books. The data collected included age, sex, place of the incidence, time of the incidence, time of presentation to the hospital, anatomic sites, and etiology of the injury. Results : The age ranged from 14 years to 80 years with mean age of 47 ± 8.1 years. There were 95 males and 22 females with a male to female ratio of 4.3:1. The three most common causes were armed robbery (31.6%), kidnapping (21.3%), and police brutality (17.9%). The incident predominantly affected the middle age group (57.3%), occurred mostly during the day time (72.6%), affecting mainly the lower limbs (65.8%) and majority (84.6%) of the victims presented 1 hour after the injury. None of the victims received prehospital care. Conclusion: There was variability in the epidemiology of GSIs with kidnapping and police brutality emerging among preeminent contributors and downward trend of armed robbery-related GSIs. The incident occurred predominantly during the day time and most victims presented late to the ED. Interventional strategies including the responsible security apparatus system are advocated.
... Radiology and ballistics provided critical insights that were essential for an accurate reconstruction of the incidents. This approach is supported by literature advocating interdisciplinary collaboration to enhance the accuracy and reliability of forensic investigations [39]. ...
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Background: Firearm wounds tend to have a precise pattern. Despite this, real-world case presentations can present uncertain elements, sometimes deviating from what is considered standard, and present uncommon features that are difficult for forensic pathologists and ballistic experts to explain. Methods: A retrospective analysis of autopsy reports from the Institute of Legal Medicine, University of Catania, covering 2019–2023, included 348 judicial inspections and 378 autopsies performed as part of the institute’s overall activities. Among these, seventeen cases of firearm deaths were identified, with three atypical cases selected for detailed analysis. An interdisciplinary approach involving forensic pathology, radiology, and ballistics was used. Results: The selected cases included: (1) A 56-year-old female with a thoracic gunshot wound involving three 7.65 caliber bullets, displaying complex trajectories and retained bullets; (2) A 48-year-old male with two cranial gunshot injuries, where initial evaluation suggested homicide staged as a suicide, later confirmed to be a single self-inflicted shot; and (3) A 51-year-old male was found in a car with two gunshot wounds to the head, involving complex forensic evaluation to distinguish between entrance and exit wounds and determine trajectory. The findings showed significant deviations from standard patterns, underscoring the critical role of radiological imaging and ballistic analysis in understanding wound morphology and projectile trajectories. Conclusions: This case series highlights the necessity for standardized yet adaptable protocols and cooperation among forensic specialists. A flexible approach allows forensic investigations to be tailored to the specific circumstances of each case, ensuring that essential examinations are conducted while unnecessary procedures are avoided. Comprehensive data collection from autopsies, gross organ examinations, and, when needed, radiological and histological analysis is essential to accurately diagnose injuries, trace bullet trajectories, retrieve retained projectiles, and determine the fatal wound, particularly in complex cases or those involving multiple shooters.
... Some studies highlight the frequent involvement of the upper limbs in firearm injuries. An Italian study demonstrated that a high percentage of limb injuries (21.5%) (both upper and lower limbs) were associated with other lethal firearm wounds in homicide fatalities [15]. A more recent American study confirmed that the upper extremities are more frequently involved in homicides than in suicides [16]. ...
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Defense wounds generally occur when a victim attempts to protect vital organs and blood vessels during an assault, and are therefore typically located on the forearms or hands. Gunshot-induced defense wounds are less frequent compared to stab wounds, which have been extensively described in the literature. We present three cases where victims unsuccessfully attempted to defend themselves from gunshots, and where the detailed description of injuries played a key role in the reconstruction of the crime scenes. In the first case, a man was shot with a smooth-bore shotgun, presenting a "through-and-through" gunshot wound on the lateral surface of the left forearm and a large gaping wound on the posterior surface of the same forearm. The second and third cases involved two men who were shot with handguns. The first displayed an entrance wound on the dorsal surface of the right hand, with burned edges and smoke soiling, and an exit wound on the palmar surface. The second case involved two wounds on the left hand: one on the dorsum and the other on the palm. To the best of our knowledge, few studies in the literature emphasize the role of gunshot defense wounds in aiding the reconstruction of crime dynamics. The cases presented in this study highlight the importance of precisely defining the pathological and morphological features of the wounds, as well as the bullet trajectories, to accurately identify defense wounds. These findings are valuable for reconstructing the dynamics of the assault and providing critical information to the public prosecutor.
... As outlined in the National Association of Medical Examiners Guide for Manner of Death Classification, if a hunter voluntarily discharges his weapon and kills a human being, the event can be classified as homicide; however, assuming he fires a rifle and the bullet hits an animal, ricochets, and then kills a human being, the event could be categorized as accidental. [9] Numerous publications report autopsy findings of homicides and suicides involving firearms or injuries during hunting expeditions, while the literature on accidental deaths and hunting accidents is limited [10][11][12][13][14]. ...
... J. Vilalta et al., 2020) or genderbased approaches (Massa Roldan et al., 2021) has been developed. However, there are a few works that have a national focus (Farrell et al., 2018;Krüsselmann et al., 2023), and most of the existing are often out of the Latin American context (Frei et al., 2006;Solarino et al., 2007;Sturup et al., 2018), although there exist any exceptions (Carcach, 2015;Sosa et al., 2023). Nevertheless, these contributions do not utilize comparable cross-national boundaries because of changing data sources, definitions, or considerations on diverse modalities of homicides (Krüsselmann et al., 2021). ...
Article
Mexico has steadily increased homicide rates over the past few decades. To better understand this phenomenon, we examine homicides, victims, socioeconomic context, and weather conditions by focusing on two critical dimensions of crimes: space and time. We implement diverse regression models considering spatial (Geographically Weighted Regression) and spatio-temporal (Geographical and Temporal Weighted Regression) perspectives. These models are compared to general linear regression models (Ordinary Least Squares Regression, Generalized Least Squares, and Weighted Least Squares). Our findings highlight the importance of specific socioeconomic factors (e.g., educational backwardness, food insecurity, or poor-quality housing) and weather conditions in accounting for differences in homicides and victims. Furthermore, our experiments demonstrate that spatio-temporal models provide a better fit compared to general regression models. Our results provide valuable insights into the issue of homicides in Mexico. This work can help perform evidence-based interventions and policy-making at national and state levels. The outcomes emphasize the necessity of addressing socioeconomic disparities and considering weather conditions when tackling homicide issues in Mexico.
... [13] Similarly, a study by Solarino et al. on fatal firearm injuries found that adult males were more often the victims. [14] The causes of fatal THIs may differ based on the habits of various populations such as the prevalence of firearm use in social life or preferences for individual vehicle use during travel. ...
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Background: Traumatic head injuries (THIs) are one of the major causes of death in forensic cases. The aim of this study was to investigate the characteristics of patients with fatal THIs. Methods: In this study, a total of 311 patients with fatal THIs, who underwent postmortem examinations and/or autopsies, were retrospectively analyzed. Cases were evaluated based on sex, age group, incident origin, cause of the incident, presence of skull fracture, type of fractured bone (if any), fracture localization and pattern, presence and type of intracranial lesion (if any), and cause of death. Results: Out of the patients, 242 (77.8%) were male and 69 (22.2%) were female. Accidents accounted for 235 (75.6%) of the incidents, with in-vehicle traffic accidents causing 117 (37.6%). In 221 cases (71.1%), intracranial lesions and skull fractures were observed together. The most common fractures were base fractures (171 cases) and temporal bone fractures (153 cases). The rate of intracranial hemorrhage was lower in the adult age group (69.7%) compared to the older age group (92.6%). Conclusion: The results obtained in this study indicate that the cause of the incident, type of fracture, presence of skull base fracture, and multiple skull fractures increase the likelihood of fatalities. The occurrence of skull fractures reduces intracranial pressure, thereby decreasing the incidence of intracranial lesions. The development and effective enforcement of road traffic safety policies and regulations will reduce the incidence of fatalities.
... Amiri et al. [29], in a study in Tehran, found that 60.7% of cases were homicides, 30.3% were suicides, and 4.5% were accidental. Similarly, Solarino et al. [30] in Italy, Khetran et al. [31] in Baluchistan, and Kohli et al. [32] in India all reported that the majority of firearm fatality cases were attributable to homicidal incidents. ...
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The global concern regarding the involvement of firearms in acts of violence, criminal activities, and terrorism has escalated, emerging as a leading cause of mortality and morbidity worldwide. The Kingdom of Saudi Arabia (KSA), with its rich cultural history, presents a unique backdrop characterized by diversity and distinctiveness. Recognizing the significance of addressing this issue within diverse demographics, we have undertaken a study to establish a database of firearm injury cases. This review is rooted in analyzing all published articles on firearm injuries in the KSA over the past three decades. The literature encompasses a substantial number of studies with diverse objectives, covering a range of parameters, including the types of cases (homicide, suicide, and accidental), the weaponry involved, the location of gunshot wounds, victim demographics (such as age), the timing of gunshot-related fatalities, and more. Studies consistently indicate that the lower extremities are the most frequently affected body regions, followed by the upper extremities and chest. This information will be a scientific, evidence-based resource to educate the public about firearm-related risks. In addition, it will aid in planning appropriate interventions and formulating stricter laws to regulate the issuance of firearm licenses and impose severe penalties for carrying firearms in public spaces. The ultimate goal is to prevent the loss of life and mitigate the lifelong disabilities resulting from firearm-related incidents.
... This increase in female victims is also observed in European countries. Sweden had 35% 14 , Denmark had 29.43% 15 , and Italy had 7.6% 16 female gun violence victims. America with its controversial gun violence policies had 13.56% 17 female deaths. ...
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Introduction: The use of firearms is a well-recognized method of committing a homicide. In Sri Lanka, the use of firearms was prominent among terrorists and underworld criminals. The analysis of the injury pattern will help to find the trends related to firearm injuries. Deaths that deviate from the routine pattern of injuries will be highlighted.Objectives: The objective of the study was to identify injury patterns in firearm-related deaths and the methods used to identify the range.Methods: The data from 40 firearm-related autopsies conducted at Offices of the Judicial Medical Officer at Colombo North Teaching Hospital, Colombo South Teaching Hospital, and Office of the Judicial Medical Officer, Colombo from 2000 to 2019 were collected from the post-mortem reports using pre-formed questionnaires and entered into the SPSS statistical package for analysis.Results: The majority were between 21 and 40 years of age (75%) and male (97.5%). Head alone was involved in 25% of deaths and head in combination with other regions was involved in 45% of the deaths. Cause of death (COD) in 50% of cases was head injuries alone and in 12.5% of cases, COD was from head injuries in combination with other injuries. The commonest circumstance was homicide in 72.5% of cases. Rifled firearm was the most common weapon used (90%). Range or the distance of fire was in the distant range in 65% of cases followed by close range in 17.5% of cases. Distance of fire was decided by the history, if available, the appearance of the entry wound, and other observations.Conclusions: Scientific evaluation of deaths following firearm injuries demands proper assessment of the range or the distance of fire based on modern technology. This becomes more relevant if there is an incompatibility with the history and the appearance of the wound, especially when deciding the circumstance of death.
... The highest number of suicide (32) was found among Police/Army personnel (Table XII). The present study was in agreement with studies conducted by references [5], [9], [10], [12]- [14], [16], [21], [25], [36], [38], [42], [45], [49]- [52]. (Table XIII). ...
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Firearmwound characteristics vary a lot depending upon type of firearmand firearm ammunition used, site of entry or exit, range and direction of firing, presence or absence of interposing wearing apparels etc. Depending upon the availability and accessibility of firearm, the pattern of firearm injuries and deaths vary from country to country, region to region and locality to locality. Lady Hardinge Medical College & Associated Hospitals, New Delhi primarily deals with medico-legal works pertaining to New Delhi District which is the most sensitive and VVIP zone of India. Hence, the crime rate is controlled in comparison to other parts of Delhi and NCR of Delhi. However, suicidal firearm fatalities by police personnel engaged insecurity, homicidal firearm fatalities and, firearm fatalities due to terrorist activities and counter-terrorism operations do happen occasionally. A 20-year retrospective study from the year 2007 to 2016 revealed that rifled firearms were commonly used. Pre-autopsy X-Ray examination was done only in few cases. Detailed description about wound characteristics, wearing apparels, recovered firearm projectiles were found missing on many autopsy reports.
... As a result, there is a lacuna of information, specifically concerning the characteristics of firearm homicides. In addition, there are two main shortcomings of existing studies: First, the few existing European studies mainly focus only on one particular national context (Frei et al., 2006;Solarino et al., 2007;Sturup et al., 2018). Due to varying data sources and definitions, such studies are often not comparable cross-nationally (Krüsselmann et al., 2021). ...
Article
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Detailed, comparative research on firearm violence in Europe is rare. Using data from the European Homicide Monitor, this paper presents the prevalence and characteristics of firearm homicides in Denmark, Finland, the Netherlands, Sweden and Switzerland between 2001 and 2016. Furthermore, we compare firearm to non-firearm homicides to assess the degree of uniqueness of firearms as modus operandi. We find that the firearm homicide rate varies across our sample of countries. We also identify two country profiles: in Denmark, the Netherlands and Sweden, most firearm homicides take place in public and urban areas, involving male victims and perpetrators. In these countries, the use of firearms in homicides is largely concentrated in the criminal milieu. In Finland and Switzerland, firearms are mostly used in domestic homicides, with a higher share of female victims. We explore these findings in relation to firearm availability in each country.
... These ammos were the most powerful semi-automatic caliber used by private citizens with firearms licenses in the historical period considered. This is in agreement with other Italian retrospective study (Solarino et al.) [20] where firearm injuries by 7.65 mm Parabellum and 9 mm were also the most common ballistic defects observed in a homicide series. 9 mm ammo is cheap and readily available round with a high lethality [21]. ...
Article
From 1981 to 2011, 200 firearm deaths were autopsied in Naples, at the Institute of Legal Medicine of the University of Campania "Luigi Vanvitelli". 188 cases were homicides and most of them (116) were related to the local organized crime. The majority of victims were young Italian males in the 20-39 age fired in outdoor environments. The reason for choosing outdoor environments can be related to the opportunity for the killer run from the crime scene immediately after the murder. Only 11 of the bodies autopsied were suicide victims, mostly older individuals, over 50 years -old with history of mental illness. All the suicides occurred in indoor environments in order to protect their domestic intimacy. Only two female victims were accounted in this historical series which is quite impressive if compared to recent phenomenon of feminicides occurring mostly in domestic environments. A total of 772 entry wounds were observed: 658 fired from single-charge handguns and 114 from multiple-charge firearms. 9x21 pistol cartridge was the most common ammo used, followed by the 7.65 Parabellum. The head was the most common anatomical site injured (in 81,8% of the suicides cases and in 68,6% of homicides). Most of the victims of homicide died before arriving at an Emergency Service. Only a minority of victims lived from few hours up to less than a week, after being shot, and very few victims remained alive up to a couple of months.
... Dieses Phänomen wurde auch bereits für ein europäisches Land, nämlich Italien gezeigt [5]. Hier ist der Anteil von Homiziden an allen Schusstodesfällen in mafiös geprägten [2]. ...
Thesis
Die vorliegende Arbeit ist eine retrospektive Analyse der Schusstodesfälle aus dem Sektionsgut des Instituts für Rechtsmedizin der Universität Würzburg aus dem Zeitraum 2002-2017. Bei 173 Schusstodesfällen kam es zu 209 registrierten Einschüssen. Hierbei entfielen 83,2 % der Schusstoten auf Suizide, 10,4 % auf Homizide und 3,5 % auf Unfälle. Rund 80 % der Opfer waren 30-79 Jahre alt und zu 91,9 % männlich, zu 8,1 % weiblich, ein Verhältnis von 11:1. Schusstreffer fanden sich zu 75,1 % in der Kopfregion gefolgt von Brust (12,9 %) und Extremitäten (4,8 %). Zu über ¾ ist die Todesursache ein zentrales Regulationsversagen infolge eines Kopfschusses. Der Schusswaffensuizident ist zu 98,6 % männlichen Geschlechts. Der Schusstod wird zu 95,9 % durch einen Nahschuss (meist absoluter Nahschuss) herbeigeführt. In 91,3 % ist die Einschussregion der Kopf in 8,7 % die Brust. Der Suizident ist zu 70,8 % 40-79 Jahre alt. Psychische Erkrankungen stellen das führende Tatmotiv dar. Die Tat findet zumeist im Frühjahr oder Sommer statt. Wenn die Blutalkoholkonzentration des Opfers erhoben wurde, war diese zu rund 50 % positiv. In 61,1 % aller Homizide waren Frauen das Opfer. Die Schussabgabe erfolgte in 90,9 % seitens eines Familienmitgliedes, meist dem Partner bzw. Ex-Partner. Klammert man die Tötungen im Polizeieinsatz (4 Fälle) aus, waren 92,9 % aller Homizide Beziehungstaten, auf die eine schusswaffenbedingte Selbsttötung des Täters folgte. Das Homizidopfer war zu 77,8 % 5-49 Jahre alt. Bei den weiblichen Homiziden überwog zu 63,6 % der Nahschuss, bei den männlichen Opfern der Tötung von fremder Hand lag in den meisten Fällen ein Fernschuss vor. In 26,1 % bestand nachweislich ein beruflich- oder freizeitbedingter Waffenbezug. Zu 64,2 % fand die Schussabgabe im häuslichen Umfeld statt. In 68,2 % aller Fälle wurde eine Kurzwaffe, meist Pistole (59,3 %) benutzt, in 32,8 % war das verwendete Munitionskaliber 9 mm/.357. 85,0 % aller abgegebenen Schüsse waren Nahschüsse, 63,2 % aller Schüsse waren Durchschüsse. In 89,0 % wurde ein einzelner Schuss abgegeben. Die erhobenen Ergebnisse dieser Arbeit weißen viele Parallelen mit bereits bestehenden Publikationen, insbesondere aus dem deutschsprachigen Raum und dem nordeuropäischen Ausland auf, grenzen sich aber vor allem in Hinsicht auf den Todesumstand von anderen Ländern teils deutlich ab.
... Concernant les homicides, la première chose à noter est une disparité entre les effectifs ; allant de 59 dans le groupe Brescia [2], à 634 dans le groupe Bari [8]. La première tendance est que les sujets sont beaucoup plus jeunes dans les homicides versus les suicides, comme déjà abordé supra. ...
Article
Résumé But de l’étude Réaliser une revue épidémiologique des décès par armes à feu (homicides et suicides) autopsiés à Marseille en 8 ans. Patients et méthodes On présente une étude descriptive, rétrospective, mono centrique à partir des données recueillies au sein de l’Institut Médico-Légal de Marseille entre le 1er janvier 2011 et le 31 décembre 2018 des morts (homicides et suicides) par arme à feu. Résultats On dénombre sur la période 302 dossiers (218 homicides pour 84 suicides). Près de la moitié des victimes d’homicides est âgée d’une vingtaine d’années. Le pic de survenue des suicides apparaît entre 51 et 60 ans. L’âge moyen des homicides était de 32 ans et des suicides 60 ans. Environ 96 % des homicides concernaient les hommes et 10 % des suicides les femmes. La quasi-totalité des homicides étaient imputables à une rixe ou un règlement de compte. Plus de la moitié des homicides avaient lieu la nuit, environ 10 % des homicides étaient associés à une carbonisation au moins partielle. Trois homicides sur quatre survenaient sur la voie publique, à l’inverse des suicides où c’était dans la sphère privée. La proportion de femme reste faible dans les deux groupes. Certains arrondissements de Marseille ou communes des Bouches du Rhône semblaient plus impactés. L’évolution des homicides semble régulièrement à la hausse entre 2011 et 2018. Conclusion Cette étude unique portée sur les décès par arme à feu dans l’un des territoires les plus peuplés de France métropolitaine permet une analyse chiffrée et documentée des données actuelles.
... In medicolegal casework, distant civilian gunshot wounds are most frequently seen in homicide victims [17][18][19][20]. Combat casualties are not taken into account in the context of this study. ...
Article
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The aim of the present study was to establish whether the size (diameter and area) of bullet entrance holes in skin varies between distant shots to the anterior and posterior trunk, respectively, when using the same ammunition (in concreto pistol cartridges 9 mm Luger). For that purpose, specimens of porcine skin from the belly region and the back were taken (10 samples each) and shot at from a distance of 1.6 m. The entrance holes were photo-documented under standardised conditions. After image processing for contrast enhancement, the maximum diameter and the area of each skin defect were measured automatically by means of an image analysis system. Both size parameters differed significantly depending on the body region affected. On the back with its comparatively thick dermis, the skin defects were considerably smaller than those on the ventral trunk where the corium is less thick. This difference can be explained by the fact that the elastic properties of skin are strongly determined by the connective tissue which is especially rich in fibres. The study results were consistent with the authors’ casework experience and support the assumption that the entrance site of gunshot wounds has a major influence on the size of the bullet hole in skin.
... Among cases of shotgun suicide, 5.3% of them involved more than one shot [5]. The most common targets are head and chest, less frequently neck and abdomen, also related to the type of weapon used: handguns show higher easiness of use than a long weapon [6,7]. ...
Article
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Multiple suicidal gunshot wounds are rare and often present a challenging issue for forensic pathologists in determining the manner of death. We describe three cases of suicidal multiple gunshot wounds in which crime scene investigation, cadaveric examination, and autopsy were provided. In all cases, integration of circumstantial data and crime scene investigation suggested a suicidal event. Firstly, we describe the self-infliction of two gunshots to the chest and head in a 90-year-old man by a revolver with wounds to the left lung and lethal wound to both frontal and temporal lobes. The second case concerns a 97-year-old man found dead with two gunshot wounds to the chest by a semi-automatic weapon and bullets penetrated to the left lung and heart. The last case, exceptional in literature, is a 41-year-old man with three self-inflicted gunshots, all-penetrating the left lung and the heart, using a revolver. This paper illustrates that immediate incapacitation can lack even in case of multiple fatal gunshot wounds on instantaneously lethal targets. Therefore, a complete investigation is required for a correct interpretation of the manner of death. An extensive review of literature is also provided.
... [7][8][9] The increasing availability of automatic weapons has resulted in multiple injuries in victims of firearm deaths. 10 The chest, head and abdomen are the areas primarily involved in deaths due to firearms. 6,11,12 Before starting any prevention programs, it is imperative to know the various dimensions of a problem in the society. ...
... This finding is consistent with previous research. 9 Statistical analyses showed that compared to those who died by suicide, subjects who died by homicide were generally younger ( Table 3). ...
Article
The autopsy features of gunshot wounds can be useful in understanding the manner of death. This research aims to provide concrete data to help to discriminate between homicide and suicide based on specific autopsy findings. A search of the database of the Cook County Medical Examiner's Office from August 2014 through April 2019 identified 3491 deaths due to gunshot wounds. Deaths due to complication from delayed fatal gunshot wounds, subjects who received hospital care prior to death, and decomposed bodies were identified and excluded. The following data were recorded: manner of death, demographic data, firearm and bullet type, number and location of gunshot wounds, range of fire, toxicology, and additional injuries. The study primary focused on the analysis of the bullet trajectory. A course leftward-upward-backward was the most frequent observed trajectory in suicides; a course rightward-upward-frontward was the most frequent observed trajectory in homicides. When the internal trajectory of a bullet is interpreted in the light of all available evidence it can impeach or corroborate witness statements and highlight consistencies as well inconsistencies in investigative reports and scene examinations.
... The incidence of GSI was highest in 2003 (17.82%), followed by 2008 (14.85%) and 2007 (13.46%). Most of these years corresponded to general elections, times of exacerbated kidnapping, armed robbery and conflicts among local criminal gangs[7,14,16,31]. ...
... In the present study, it was found that homicide accounted for the maximum number of cases (92.06%) of fatal firearm injury followed by suicide and accidents. Similarily, Solarino et al. [20] in Italy, Khetran et al. [13] in Baluchistan, Amiri et al. [21], and Kohli et al. [17] reported that the majority of cases of firearm fatalities were homicidal. However, a study conducted in the USA by Lemaire et al. [22] on firearm fatalities found more use of firearms in suicidal cases. ...
Article
Abstract This study was done to assess the pattern of firearm injuries in Allahabad amongst medicolegal autopsies in the mortuary of Swaroop Rani Nehru Hospital, MotiLal Nehru Medical College, India. It was a descriptive study including fatal cases of firearm injury which underwent autopsy from 1st of January 2015 to 30th July 2016. The demographic information regarding the victims was obtained from the inquest report, person accompanying the victim, their friends and relatives. Autopsy reports were also used to gather additional information. Parameters studied included age and sex of the victim, site of firearm injury and manner of death. In our study, out of 4,445 autopsies, 63 were cases of firearm injury. From these cases, 58 were homicidal, 3 were suicidal, and 1 was accidental. The results show that the age group most commonly affected was 31-40 years (26.98%). Male to female ratio was 6.9:1. The most common targeted part of the body was the chest (61.0%).
... The respondents' perceived means of committing suicide is presented in Table 5. Results showed that hanging (99.72%), use of firearms (94.87%), poisoning (62.96%), and drug overdoses (31.91%) were the principal means identified by respondents used by suicidal victims in killing themselves. This result agrees with other findings of many scholars the world over who asserted that Control and Prevention 2005;Khalid 2001;Kanchan et al. 2009;Sarma and Kola 2010;Solarino et al. 2007;Large and Nielssen 2007;Gac 2006;Khan and Hyder 2006;Gunnell et al. 2011). Drug overdoses (31.91%) was also used by some to commit suicide ...
Article
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The study examined rural folks’ perception of suicide drivers in rural communities of Delta state, Nigeria and the resultant implications for societal and agricultural security. The objectives of the study are to: describe the socio-economic characteristics of the respondents, ascertain the perceived suicide rates in rural households; identify the main causes (or drivers) of suicide in rural communities, ascertain the means of committing suicide, and determine respondents’ perception of the effect of suicide on agricultural production and their families. A multi-stage sampling procedure was used in composing 351 respondents who furnished information on suicide situation in the study area. Results indicated some cases of suicide in the area; several perceived suicide drivers were identified by the respondents, and the respondents identified some perceived deleterious effects of suicide as illness among family members, depression of surviving members, loss of income and output of agricultural production and scattering of family of suicide victim. Logistic regression of relationship between perceived social economic characteristics and suicidal death indicated that marital status, education, family size, family income, membership of association and extension contact were significant in preventing suicide. From the findings, it was recommended that all stakeholders including the government, private sector, religion organizations, health and welfare institutions, rural communities, and individuals have crucial role to play in curbing suicidal deaths in rural communities.
... In homicides, this rate was 82.8%, coinciding with the assertion that several gunshot wounds in a single victim strongly suggest homicide. 4,5,29 The case of a man murdered by 59 gunshots distributed in craniofacial and body regions on a public road was called attention, leading him to death on the spot. Long distance shots were common (54.3%) among homicides, also considered as suggestive of this type of death. ...
Article
Firearms injuries have a legal and medico-legal importance, and are especially lethal when they reach the craniofacial regions of the victim. The present study aims to identify the characteristics of craniofacial lesions resulting from firearm projectiles, to register the most affected craniofacial regions by this type of injury and to verify the demographic profile of the victims. A retrospective study was carried out on the autopsy records produced in the first semester of 2015, in five Institutes of Legal Medicine in Porto Velho, situated in the cities of João Pessoa, Vitória, Porto Alegre and Brasília. Data extracted included sex, skin color and age of the victim, craniofacial region reached, shooting distance, shape and size of the injuries and manner of death (homicide, suicide or accident). Based on the 868 reports analyzed, it was possible to observe 1700 entrance lesions of firearm projectiles in craniofacial regions. Among cases of known manner of death, homicides were the most frequent (97.0%). It was observed a higher frequency of male victims (93.3%), mixed race (62.0%), between the ages of 12 and 29 years (59.4%). In all cases considered as suicide or accident there was only one entrance wound, but in 82.8% of the homicides there were multiple gunshot wounds. The craniofacial most affected regions were temporal (25.2%) and occipital (19.8%). The most common sites of projectiles exit were the temporal (25.3%) and parietal (16.1%). All cases of suicide were related to contact shot (69.2%) or close-range shot (30.8%), and among the homicides the distant range shots were more frequent (54.0%). The shape of entrance wounds was mostly circular (56.8%) and oval (31.3%), and among the exit injuries, the lesions were irregular (43.3%) and starry (24.1%). The entrance wounds showed smaller sizes than the exit lesions (p < 0.0001). The data obtained are useful for guiding research that takes into account craniofacial trauma caused by firearm projectiles, makes it possible to compare this data with those of other countries and can base investigative conclusions based on the analyzes discussed in the present work.
... In Italy, the highest number of deaths by gunshot happens in the south: a retrospective survey conducted at the Institute of Forensic Medicine of Bari (Puglia) from 1988 to 2003 found 717 deaths from gunshot injuries, 82 of which were suicides (11.5%), with 81 men (98.7%) and just one woman [2]. ...
... Nowadays, mass production of advanced firearms and their availability in worldwide result in increased rate of death and injuries by these weapons. In developing countries, illegal firearms and locally made or country guns are available without licensing 3 . These guns are commonly used in criminal cases. ...
Article
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Firearm injury (FI) is one of the most important causes of death among military personnel. According to the World Health Organization, firearms are used in two thirds of all homicide cases and one fifth of suicide cases. In our study a total of 115 cases were included who admitted in the Hillah Teaching Hospital from 1st October 2016 to 30th Mach 2017. The highest numbers of firearms injuries cases were in the age group of 21-30 years, that was 71(61.74%) followed by 31-40 years 16(13.91%). Our study also distributed all cases according to marital status (married and single) and age groups (8-10, 11-20, 21-30, 31-40, 41-50, 51-60, and 61-70) were 82(71.30%) in married and 33(28.69%) in single. Distribution of firearms injuries cases according to age groups and education status (Primary, Secondary and College) that there were 41(35.65%) in primary status, 57(49.56%) in secondary status and 17(14.78%) in college status. Distribution of firearms injuries cases according to age and Precipitating Factors (Political Protest, Psychiatric Illness, Family Quarrels, Marital Disharmony, Love /Friendship Affairs) were 52(45.21%), 4(3.47%), 4(3.47%), 3(2.60%) and 4(3.47%) respectively. Also have been distributed according to gender: 113(98.26%) in male and 2(1.73%) in female. Distribution of firearms injuries cases according to age groups and causes (fights, accidents, stray bullet and suicide) recorded 58(50.43%), 46(40.00%), 9(7.83%), and 2(1.74%) respectively. This study also included distribution of firearms cases according to number of cases and months during period 2010-2016.
... The incidence of gunshot wounds is increasing in the United States, Africa and in some European countries [1][2][3][4]. The buttock has been reported as an entry point in 8% of all gunshot wounds to the extremities [4]. ...
... A study in Germany found that most acts were 27 conducted to conceal crime followed by personal conflicts. Study at Alabama, USA cited 23 robbery was the motive behind the crime while study in Ireland suggested arguments followed by domestic quarrel being the chief cause. Indian scenario on this also varies. ...
... From then onward, firearms fatalities started to rise for both men and women [3]. Handguns are the most frequently used weapons in suicides, mainly by contact shot to the head (81%), the chest (17%), and the abdomen (2%); the most common location is the right temple region [4,5]. The mortality of the related cranial injury is very high, ranging from 20% to 90%, with a poor outcome in bilobar lesions [6]. ...
Article
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Suicide using a firearm is the most commonly used method of committing suicide for men and women. In this paper, we present and discuss a suicide case in which an 86-year-old man shot himself using a .320 caliber pocket revolver. Proper crime scene investigation, recovery of the weapon used, and precise interpretation of autopsy findings play a fundamental role in determining the exact cause and manner of death. Accurate analysis of the injuries and a thorough knowledge of weapons and ballistics are essential for an adequate investigation in these unusual cases. To the best of our knowledge, this is the first report of a cranial gunshot inflicted by a .320 caliber pocket revolver.
Article
This study analyzes the distribution of gun violence cases over a specied period, categorizing the data based on various parameters. The year-wise breakdown reveals uctuations in case prevalence, with 2018 accounting for 38% (N=12), 2019 for 29% (N=9), 2020 for 6% (N=2), 2021 for 16% (N=5), and 2022 for 9% (N=3) of the total cases. A gender-specic analysis demonstrates a consistent absence of reported female cases in 2019, 2020, 2021, and 2022, with varying percentages of male cases. Furthermore, age group distinctions highlight the prevalence of cases in the "Less than 20" (100% male, N=5) and "20-40" (4.34% female, N=1; 95.65% male, N=22) categories. In the "More than 40" age group, all cases were male (N=4). The anatomical distribution of injuries across regions such as the "Head," "Chest," and others is detailed, providing percentages and frequencies for each. This comprehensive examination offers valuable insights into the dynamics of gun violence, emphasizing the signicance of year, gender, age, and anatomical considerations in understanding and addressing this societal issue.
Thesis
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Large-scale criminal violence (LCV) as a phenomenon has had little academic discussion despite its large effects in the lives of thousands of people around the world, with regions such as Latin America being particularly affected by it. Despite the extensive literature on civil conflicts on one hand, and criminal and gang behavior on the other, there is still an important gap on the causes of violence perpetrated by organized criminal actors. This thesis contributes to this research gap by asking under what conditions do criminal actors trigger large-scale violence? Through a quantitative cross-country study focused on Latin America, this thesis explores the role that territorial availability plays in the onsetof LCV. Empirical findings were not conclusive due to a lack of statistical significance; however, data seems to suggest that higher levels of territorial availability could be associated with an increased likelihood of LCV onset, especially when controlling for factors such as equal resource distribution and when adjusting the sample size to include only state with no active conflicts. Finally, this research points to the imperious need of better data regarding criminal violence, and criminal-related homicides to gain better knowledge of LCV patterns and to build evidence that supports pathways towards reducing it.
Article
Wads are components of shotgun cartridges used for transferring to pellets or slugs the kinetic energy produced during the combustion chain which takes place as the trigger is pulled by the shooter. The hull of the cartridge falls in the vicinities of the gun, so it is easy for a malicious shooter to cancel this particular trace from a crime scene. However, the wad is projected to an intermediate point between the shooter and the victim, it is easily lost, and so it can be useful as a trace containing information on the type of ammunition used by a shooter and possibly a convenient item for comparison with analogous objects found in the premises of a suspect. In this paper, various analytical approaches, such as thermal analysis, infrared spectroscopy and X-ray diffraction were employed in order to discriminate apparently similar commercial wads. Samples that had previously been fired and pristine samples were examined, verifying that the energy, temperature and pressure associated to the combustion of the powder in the bore does not bring about appreciable changes in the polymer structure, thus allowing to use this approach in casework.
Article
The muzzle imprint mark characteristically associated with contact or near contact entrance gunshot wounds exemplifies one of the most informative external findings in forensic medical practice. The presence of the muzzle imprint mark on the body’s surface proves ballistic trauma, point of entry, and range of fire. Moreover, its appearance and configuration may indicate the type of the involved weapon and the way the firearm had been positioned and held at the time of discharge. In this paper, we present the contact shot wound pattern of an 83-year-old man who committed suicide with a Frommer Stop 12 M autoloading pistol of caliber 7.65 mm Browning. Initially, the muzzle imprint mark configuration in relation to the entrance gunshot defect in the victim’s right temple indicated an unusual application or orientation of the pistol’s barrel during discharge, thus, strongly suggesting a non-suicidal act. However, a critical confrontation of postmortem findings along with the results of ballistic expertise provided a clear explanation, which comprised the remarkable construction and unique muzzle design of the used handgun.
Article
Obtaining a firearm is not always easy, which is why some firearms that are antique or whose use is not intended to kiss are modified for suicide purposes. The two cases report a suicide with an original historical firearm as the canegun, a walking stick which conceals a firearm and a suicide with a modified alarm cannon, which is a small cannon, which fires blanks to scare away garden animals. The aims of the study were to describe the scene, the corpse external examination and the autopsy to understand the death mechanism. We wish to highlight the importance of the forensic pathologist's fieldwork, especially in complex or atypical suicides.
Article
In case of suicide, the presence of multiple entrance wounds is always suspicious. We report the case of a man who committed suicide by shooting himself three times in the chest and the skull with a submachine gun. The weapon seems to have been initially pointed in the precordium area with a lethal lesion of the proximal aorta. Two other projectiles were fired by the weapon and hit the neck and the skull of the deceased. The presence of three entrance wounds despite a first fatal wound could finally be explained by the characteristics of the weapon and wounds. Most suicides related to multiple gunshot wounds are explained by a first nonlethal shot but the use of an automatic weapon can also be found. In these last cases, medicolegal and criminalistics aspects become important in differentiating suicide and homicide.
Article
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Death due to firearm is more common in countries with higher gun ownership such as United States of America compared to countries with restrictive gun ownership such as European countries and Malaysia. However, the increasing number of shooting cases in Malaysia recently should not be overlooked. This study was carried out to investigate the incidence of firearm-related deaths and epidemiology in Klang Valley for 11-year period. The demographic data on the incidence of firearm-related deaths from 2006 to 2016 was collected retrospectively from four government hospitals in Klang Valley. 204 cases of firearm-related deaths were reported with irregular trend of the incidence throughout the 11-year period. The results revealed that most victims were male, aged between 30 to 34 years old and Malaysian citizen. Firearms fatalities were higher among Malaysian specifically Indian, as compared to non-Malaysian. Most firearms fatalities were homicides and took place during late night between 12.00 am to 5.59 am. The highest cause of death was head injury due to gunshot wound. It is hoped that this study will raise awareness to Malaysian citizen regarding firearm-related cases and to develop strategies to overcome the issue of gun violence in Malaysia with appropriate authorities.
Article
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Death due to firearm is more common in countries with higher gun ownership such as United States of America compared to countries with restrictive gun ownership such as European countries and Malaysia. However, the increasing number of shooting cases in Malaysia recently should not be overlooked. This study was carried out to investigate the incidence of firearm-related deaths and epidemiology in Klang Valley for 11-year period. The demographic data on the incidence of firearm-related deaths from 2006 to 2016 was collected retrospectively from four government hospitals in Klang Valley. 204 cases of firearm-related deaths were reported with irregular trend of the incidence throughout the 11-year period. The results revealed that most victims were male, aged between 30 to 34 years old and Malaysian citizen. Firearms fatalities were higher among Malaysian specifically Indian, as compared to non-Malaysian. Most firearms fatalities were homicides and took place during late night between 12.00 am to 5.59 am. The highest cause of death was head injury due to gunshot wound. It is hoped that this study will raise awareness to Malaysian citizen regarding firearm-related cases and to develop strategies to overcome the issue of gun violence in Malaysia with appropriate authorities.
Article
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Our aim in this study is to discuss the differences and the causes between the death cases due to gunshot wounds which happened in Aydin and the studies that are done about this same subject in our country and worldwide. In our study gender, age, occupation, crime scene, origin, season, month, year, type of weapons, number of rounds in and out, shooting range, whether there is additional evidence of trauma, cause of death, therapeutic presence, bullet entry side of the autopsies of 146 deaths due to gunshot wounds that were done by our department between 2004 and 2009 were evaluated, all the data obtained was processed to the program SPSS 14.0 for Windows and put into the charts. There were a total of 146 death cases due to gunshot wounds determined. These cases make up 8.8% of all forensic autopsies. 91.8% of the cases were male, and 8.2% were female. In the distribution of age groups 31-40 age group was the highest with the rate of 30.1%.In the distribution of the type of weapon used; it was determined that 58.2% gun, 40.4% hunting rifle and 1.4% war weapons were used. According to the origin of the cases; homicides take the first place with 52.7%, suicides comes next with 37%, following deaths due to accidents with 2.7%, and the origins of 7.5% cases weren’t determined. And in the area of entry lesions on the body; head comes first with 41.8%. As in the world and in different regions of our country, deaths due to gunshot wounds take an important place in forensic autopsy cases in Aydin also. It shows us that more precautions should be taken about the control of gunshots and public awareness. Key words: Gunshot, origin, death, autopsy
Chapter
Injuries inflicted by gunshot trauma result from different kinds of firearms and similar devices. Ballistic trauma can produce damage to tissues that is quite similar to that inflicted by other types of instruments involved in mechanical trauma, but because of the transfer of a large amount of energy, firearm injuries can be extremely destructive. Additionally, some specific questions relate to the investigation of gunshot injury cases. The following features are important for forensic reconstruction of the event: locating and distinguishing the entrance and exit wounds, the range of fire, the bullet course through the body (trajectory), and remaining projectiles or their fragments as well as information about the kind of missile. In recent years, postmortem computed tomography (PMCT) has been gradually replacing x-ray examination for this purpose in forensic death investigations. This technology offers special opportunities for investigating gunshot trauma cases, especially through the simple detection of foreign bodies such as projectiles, a high sensitivity for detecting bone lesions, and the possibility of multiplanar reconstructions that allow visualization of trajectories and generation of three-dimensional (3D) images. To perform diagnosis concerning lesions of the vascular system, soft tissue, and parenchymatous organs, the sensitivity of PMCT can be greatly increased by postmortem angiography (PMCTA). Because firearm lesions can appear at multiple sites of the body and rarely concern only one organ, whole-body angiography methods are the tools of choice for investigating these lesions and their consequences. This chapter explains the possibilities offered by the technique of multiphase PMCT angiography (MPMCTA), which is regularly applied in cases of firearm injuries in our centers.
Article
The images of 66 gunshot entrance wounds with a defect on the back, a bullet in the body, hemorrhage along the wound track, and logical certainty that it was an entrance wound were collected from the files of a moderately busy medical examiner's office. Participants numbering 22 board-certified forensic pathologists viewed a single digital archival image of each of the 66 entrance wounds randomly mixed with 74 presumptive exit wounds to determine whether they were entrance or exit wounds. The concordance rate for correctly identifying the 66 logically known entrance wounds was 82.8% with a range from 58% to 97%. This pilot study was conducted to provide an evidence-based approach to the interpretation of the direction of gunshot wounds by reviewing pathologists with access only to archival photographs, and it is not a measure of the accuracy to distinguish entrance from exit wounds when given all of the circumstances.
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In the present paper, recent trends in the formulation and application of quality assurance (QA) parameters in forensic toxicology, as well as the selected validated applications published in the last five years, are reviewed. In the first part, QA aspects of the analysis of toxicologically relevant compounds in various materials are presented. In particular, QA aspects of analysis of various matrices, like seized street drugs, formalin fixed tissues, dried blood spots, oral fluid, hair, and nails are reviewed. The second part is devoted to identification as applied in general, untargeted and targeted screening; regulations and recommendations issued on international and national levels are presented in the third part, whereas existing QA programs applicable for forensic analysis are discussed in the fourth part.
Article
Objective: Study of firearm injuries of cases brought and treated at DHQ Teaching Hospital Haripur to know rate of morbidity, mortality and full recovery. Study Design: Original study. Place and Duration of Study: This study was conducted at the District Headquarter Teaching Hospital, Haripur from 1 st Jan, 2009 to 31 st Dec, 2010. Materials and Methods: All living victims of firearm injury brought and admitted in DHQ Hospital Haripur in during this period were included in this study, ward records, police investigation reports and discharge reports were made part of this study, Performa were made and filled directly from these reports. Results: A total 110 victims of firearm injuries were admitted and treated in DHQ Hospital Haripur from 1 st Jan, 2009 to 31 st Dec, 2010. Most affected age group was 10 to 30 years (70%), male to female ratio was 9:1. Victims from rural area were 65% while 35% were from urban areas. Most affected body region was Abdomen & Pelvis. Full recovery occurred in 74.54% cases, some degree of disability occurred in 13.63% and death occurred in 8.18% cases.
Article
Background: The objective of Medico-legal autopsy is not only to find out the cause of death but it also helps in establishing the manner of death. It also provides information about the criminal behavior of the society and usage of different weapons. This study was carried out to find out the predominance of firearms weapons in homicidal deaths. Study Design: Observational study Place and Duration of Study: This study was carried out on medico legal autopsies conducted at Forensic Medicine Department K.E.M.U. Lahore during the years 2006-2008. Material & Methods: Total number of autopsies during the period was 2979. Data was extracted from autopsy reports, police papers and hospital notes. Besides the causative weapon, the cases were examined for other factors too. Like age, sex, manner of death, cause of death, seasonal variations, kind of weapon and extent of damage on the body. Results: The results clearly showed that out of these cases 1285 deaths (43.13%) were due to fire-arm weapon. Men were showing higher frequency (83%) as compared to that of female which is (17%). Homicidal cases were 61.32%, suicidal 3.8% and accidental were 7.5%. Un-determined cases were 27.5%. Homicidal incidence was highest in 3 rd decade (38.58%), suicidal incidence was in 2nd decade (39.13%) and accidental incidence was high in 3rd decade of life. Homicidal/suicidal ratio was 17.1:1 and homicidal/accidental ratio was 8.1:1. Use of rifled fore-arms weapons was in 92% and smooth bored in 8.0%. In rifled fire-arms multiple entry wounds were in 52.9% cases and 47% were single entry wounds. Whereas in smooth bored single entry wounds were 66% and multiple wounds were 34%. In 56.8% homicidal deaths range of fire was distant, while it was close range in 30.4%. It was contact fire in 1.4%of suicidal cases. The blackening was seen in 16% case, tattooing in 10.58% and burning in 2.25% cases. Conclusions: There is marked predominance of homicidal deaths by fire-arms weapons and strict control over legislation will help in decreasing fire-arm fatalities.
Article
Aim: To study the pattern, age, gender, number and location of firearm injuries in Firearm victims brought to the medicolegal department of Sandeman Hospital Quetta during the year 2001. Design: Observational descriptive study Duration of study: One year Methods: The study was conducted in Rahber Medical College, Lahore based on the data of firearm cases of the year 2001, collected from the Medicolegal Department Sandeman Hospital Quetta. Results: Out of 466 cases of firearm cases, Firearm victims were composed of 380(81.5%) males and 86(18.5%) females. Ages of victims ranged from 0 to more than 60 years and most frequent cases of firearm found at the age of 31-40yrs, 160(34.3%) and most common region found in fire arm victims was Thorax 200(42.9%). Conclusion: The victims of firearm injuries were young people aged between 20-40 years and most common region involved was Thorax. It must be targeted for made aware of lifestyle adjustments such as training to refrain from anger or disputes.
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On a regular basis, news stories appear in the media about public shootings where shooters use their guns to open fire and kill people in shopping malls or on school campuses. Mostly these stories deal with incidents in the United States. Over the last years, however, a number of European countries have experienced similar public shooting incidents. Notable cases were the shootings at Tuusula and Kauhajoki in Finland (2007 and 2008), the killings in Cumbria in the UK (2010), the Utøya attacks by Anders Breivik in Norway (2011), and the shootings at Alphen aan den Rijn in the Netherlands and Liège in Belgium in 2011. Public shootings draw a high level of media attention. Less striking in the public eye, but not less significant – not least in quantitative terms –, are the numbers of people in Europe killed by firearms in the context of gun-related crime or in domestic shootings. It is estimated that between 2000 and 2010, over 10,000 victims of murder or manslaughter were killed by firearms in the 28 Member States of the European Union (EU). Every year, over 4000 suicides by firearm are registered in the EU. This means that, on average, there are 0.24 homicides and 0.9 suicides by firearm per 100,000 population in Europe every year. Compared with the US or other countries around the globe, the rates of gun-related violent death in Europe are rather low, certainly where the homicide rates are concerned. This does not mean, however, that the problem of gun violence has not appeared on the European policy radar in recent years. On the contrary, the attention devoted to the problem by law enforcement agencies and policy-makers has been growing. Reacting not only to shooting incidents such as those mentioned above, but also to warnings by police and law enforcement agencies that criminals are increasingly willing to use (heavy) firearms and that illegal trafficking in firearms is on the rise, a number of European countries have announced policy interventions targeted at reducing levels of gun-related violence and crime. The European Commission has also become an active actor in firearms policy. In October 2013 it announced a plan to reduce gun violence in Europe, in which it defined the misuse of firearms, whether legally-owned or illicitly manufactured or acquired, as “a serious threat to the EU’s security from both an internal and an external perspective”. One of the major problems the Commission identified in its initial policy papers was the problem of a lack of sound and adequate knowledge about firearms in Europe. The commission noted that “a lack of solid EU-wide statistics and intelligence hampers effective policy and operational responses”. One of the ambitions of the EU’s firearms policy is, therefore, to address the gaps in knowledge concerning gun violence. An additional problem is that the lack of reliable and comprehensive information on firearms in Europe is not limited to the sphere of law enforcement and policy-making. European scholarly research focusing specifically on firearms availability, gun control and gun-related violence is scarce. There is a research community in Europe focusing on small arms and light weapons (SALW), but it is predominantly concerned with the export of firearms and the connections between these arms flows and violence in developing, transitional or fragile states outside Europe. Scientific research on firearms and gun-related violence in the domestic European context is much less advanced. The scanty research efforts made in this field by epidemiologists, criminologists and legal scholars remain fragmented, and suffer from the fact that there is no integrated scholarly community dealing with gun-related issues. Language barriers, moreover, often prevent the wider dissemination of research results. Given this relative lack of European firearms research, American studies are still clearly dominant at present in research on the links between the availability of firearms and gun-related violence. Greene and Marsh have calculated that out of the 665 studies on firearms and violence that they reviewed, 64% were about the USA. Of the remaining studies not on the USA, 13% concerned cross-national comparisons or articles in which the geographical focus was unspecified (such as reviews), while 8% were about developing countries. Only 15% concerned other developed countries such as Canada, Australia, the UK and Germany. Given the particularities of the American context, and more specifically the fact that the US has one of the highest rates of gun-related deaths and crime among industrialized democracies, simply transposing the results of American research to the European context is problematic. What are the levels of firearms availability in Europe? Are there links between the levels of gun ownership in European countries and these countries’ rates of violence and violent death? And what is the impact of European gun laws on public safety and health? The absence of evidence specifically for the European context makes it difficult for policy-makers and researchers to find impartial and unbiased answers to these questions. Hence the pressing need for research that specifically focuses on gun-related violence in the European context: and with the present report, we would like to make a contribution to that effort. As we are moving into largely uncharted territory, our analysis of the European situation will necessarily be exploratory. Our primary ambition is to collect and take stock of the fragmented evidence that is available on gun-related violence in Europe. Our geographical coverage will be broader than the EU and encompasses a group of approximately 40 European countries, although in some instances we will limit our analyses to the EU28. In the report’s first chapter, we briefly dwell on one of the most crucial variables in research on gun control and violence: the level of gun ownership in society. Although the prevalence or availability of firearms is a key variable, collecting adequate data on levels of gun ownership can be troublesome. In chapter 1 we therefore devote some space to a critical assessment of the available statistics for Europe. Next, in chapter 2, we look at gun-related violence in Europe. Given the absence of good data on gun-related violence in general, including information not only on mortality but also on injuries and other forms of firearms-related victimization, we will focus exclusively on violent deaths – which seems a legitimate methodological choice for exploratory purposes. We urge the reader, however, to keep in mind that gun-related violence is a much more complex phenomenon than this focus might suggest. As is normal in research dealing with gun control not only from a public safety but also a public health perspective , we shall look both at gun-related homicides and at suicides. Taking the analysis further, we then ask in chapters 3 and 4 whether rates of gun possession and violent death in Europe are correlated: do high levels of gun possession in European countries correlate with high levels of homicide and suicide? The results of probing that question lead us to suggest that research into gun possession and violent death should also factor in the effects of firearms legislation. Specific European research into this question is scarce, which makes it difficult at the moment to arrive at conclusions for the whole of Europe. In chapter 5 we therefore focus on the results of three recent studies on the effects of stricter gun legislation on violent death rates in Austria, Belgium and Switzerland.
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Violent death represents a significant health problem for people. Are violent deaths described in the Bible? Who were the characters affected? Are violent deaths prevalent in the modern times? What is their epidemiology? All biblical texts we examined and verses dealing with violent death were studied closely
Article
A retrospective review of 1704 cases of suicide involving firearms investigated by the Bexar County Medical Examiner’s office between 1984 and 1998 was performed. The age distribution was similar in male and female victims, and the type of weapon was not associated with age. Approximately 78% of the victims used a handgun (87% of female and 76% of male victims). In 4.0% of head wound cases, the site of the entrance wound was the back of the head. Thus, this report refutes the common belief that all gunshot wounds to the back of the head represent homicides. In 1.9% of the cases, the wounds were inflicted at intermediate range. With handguns, the right temple was the most common site, but with rifles and shotguns, the most common site was the mouth.
Article
To the Editor.— The recent SPECIAL COMMUNICATION by Richard B. Drooz, MD (238:43-45, 1977), contains a serious factual error that we wish to correct. In referring to our paper on accidental firearm fatalities,1 he writes, "... the number of accidents due to keeping a handgun for selfdefense is obscured and swelled in several ways. Their description is unclear, but apparently they counted suicides among accidental deaths" [italics added]. The "Method" section of our publication states clearly that firearm fatalities are classified as accident, suicide, homicide, or violence of undetermined origin, and the medical and legal methods of classification, which were consistent over the 15 years reported, are described in some detail. We fail to see how anybody could come away with the impression that our accident data include firearm suicides. The paper in question reports 148 fatal firearm accidents (83% of which resulted from mishaps with handguns) in Cuyahoga County
Article
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.
Article
One hundred and twenty eight cases of shooting fatalities were investigated during an 11-year period. Of these 57% were homicidal shootings with 34% suicidal in nature. Only two suicidal fatalities were female. Analysis of the sites of entrance wounds confirmed the 'sites of election' in suicidal shootings, whilst homicidal wounds showed a much wider distribution. Multiple entrance wounds were seen in 42% of homicidal shootings. Injuries to hands were seen in 7 homicidal fatalities.
Article
Firearm fatalities occurring in Yorkshire and Humberside between 1975-1991 were examined; 130 cases were found, 64 were homicides, 55 suicides and 11 were accidental or unclassifiable. All but two of the suicides were men. Shotguns were the most frequent weapon used in both suicides and homicides. Of the 55 suicides, 17 were by men who had murdered before committing suicide. In 15 of these cases the assailants knew their victims. The other two cases involved murder of police officers. These cases were mostly with shotguns. In both homicide and suicide, rifled weapons and handguns were infrequently used. Most suicides and homicides occurred at home. Alcohol was again shown to be a significant factor in suicides. Overall firearms account for less than 10% of homicides in England and Wales and less than 5% of suicides in men and is most unusual in women.
Article
A study of all the firearm fatalities in the state of Victoria, Australia is presented for the year 1988. The overall incidence was 138 (3.24 per 100,000) of which 71% were suicides, 24% homicides, 2% accidental and 2% undetermined. Twice as many males were homicide victims as females. The female homicide victims being mainly shot by their husbands. 47% of homicides were of a domestic nature, while 15% were criminals shot by police. Only 3 women shot themselves compared with 11 who were victims of homicide. The relative frequency of accidental shooting deaths is the lowest recorded, a surprising finding in a state where hunting is such a common pastime.
Article
All firearms fatalities in East Denmark during the period 1984–1987 were examined. There were 276 cases or 3.0 per 100,000 living inhabitants. The majority were suicides (80%) and by far the majority of these were men. There were only four accidents, two of which were the results of ‘Russian roulette’. There were no hunting accidents. No specific decrease could be demonstrated in the number of fatal cases with shot guns, but possibly a general preventive effect. When compared with previous Danish investigations an increase in the total number of suicides with firearms was found in the period examined, whereas an increase was found in the total as well as the relative number of homicides. More information and further endeavours to limit the number of firearms in the population is recommended.
Article
In this article, we describe an unusual case of suicide involving nine gunshot wounds to the anterior chest. This illustrates that individuals may function for a short time with fatal wounds and stresses the importance of a complete investigation.
Article
We report two cases of suicide by multiple gunshots to the head. The first victim (of two shots) fired the first shot, which was observed, into his mouth, leading to damage to the left optic nerve and frontal lobe. The man still was able to drive his car home, where he shot himself in his right temple. He died 2 days later. The second victim (of three shots) was a 58-year-old man who was found dead on his bed. Reconstruction of the case disclosed that the first shot had passed through his tongue and slightly damaged the second cervical vertebral body. He then shot himself in his right temple, leading to damage of the temporal lobe. Finally, he shot himself in his left temple, resulting in destruction of the pons. In the first case, an amateurishly modified 8-mm blank revolver firing 6.35-mm- (.25)-caliber ammunition was used; in the second case, a rifle firing 5.6-mm (.22)-caliber ammunition with a reduced charge was used. In both cases, low-energy transfer to brain tissue by the initial bullets was due to low bullet energy or due to the bullets' missing the brain or vital centers.
Article
Nine cases of multiple-shot suicides (suicides involving more than two gunshot wounds) examined in the last 6 years at the Office of the Chief Medical Examiner. State of Maryland, are reported. All victims, with the exception of one, were white: three were women and six were men, with ages ranging from 22 to 81 years. For each case, the results of the scene investigation, the ammunition used, and the autopsy and toxicological findings are described. Each victim suffered 3-5 gunshot wounds. The most common site for the gunshot wounds of entrance was the precordial region, followed by the left chest, the head, and the abdomen. Gunshot wounds were rarely localized exclusively to the head, whereas gunshot wounds scattered on different classic suicide body sites or all confined to the precordial region and the left chest were common. A distinction between instantaneously lethal targets, rapidly lethal targets, and targets of secondary importance is provided, and the guidelines for the proper determination of a multiple-shot suicide are presented.
Article
Accidental deaths by firearm injury were studied over 11 years, 1972-1982, in Metro-Dade County. A total of 54 cases were studied. After noting the percentage of the cases that occurred by year, the age, race, sex, of the victim were tabulated. Type of weapon, body part involved, whether self-inflicted or not, blood alcohol of victim were also studied along with scene circumstances. A final admonition to the reader on how to handle such cases is discussed.
Article
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.
Article
Two hundred twenty-six suicides by firearms were analyzed to determine the entrance wound site. Overall, the head was the most favored site, accounting for 75% of the wounds; specifically, the right temple accounted for 39% of the wounds. The data were further examined in terms of specific weapon types. In the case of handguns, the preference for the temple was even more prominent, with this site accounting for nearly two thirds of the wounds. With long guns the predominance of head wounds was less pronounced but still present. Correlations with sex and age showed no significant difference in choice of site but did show differences in selection of gunshot as the means of suicide. Correlations of site with handedness showed that most individuals held true to form but that a significant proportion (8%) inflicted their wounds on the other side. Finally, three cases of suicide by multiple gunshots are presented.
Article
Suicide by firearm is a frequent mode of death and the most common mode of suicide in the United States. So typically is there but one bullet entrance would in the suicide victim, and so often are there multiple wounds with homicide that some investigators and the public are unaware or forget that the person intending suicide may discharge his gun into himself more than once. The frequency, incidence, and other characteristics of the phenomenon deserve more recognition. The data presented are from medical examiner reports and related material from 7,895 gunshot deaths, including 3,522 suicides by firearm, that occurred in North Carolina in the 7-year period 1972-1978. The 58 multishot firearm suicides represent 0.7% of all firearm deaths (one in 136) and 1.6% of forearm suicides (one in 61). Characteristics of the individual entrance wounds such as body regions involved and muzzle distance were the same as those of single shot cases. Long gun use was not rare, but 0.22 caliber handguns predominated. Other characteristics of weapon, victim, wounds, and situations are presented. Each of the cases was assessed by forensic pathologists as it was reported and was reviewed again for the study. The type of data presented is one advantage of a structured, centrally guided, statewide medical examiner system.
Article
During the years 1980–1992 the Swedish legislation regarding possession and use of firearms has remained fairly unchanged. Simultaneously the reported incidence of both stolen firearms and confiscation of illegally possessed handguns has increased significantly. In order to determine the impact of this trend on gunshot mortality, all victims of firearm fatalities subjected to medicolegal autopsy in the Stockholm area 1980–81 and 1990–91 were studied. The overall two-year rate increased from 50 to 65, homicides and suicides contributing seven new cases each; accidents and “not determined” comprising only 0 to 2 cases in each period. Suicides were four times as common as homicides in the former period; ca. three times as common in the latter. Thus, a 70% increase in homicidal shooting has occurred (from 10 to 17), and the fatal use of illegal firearms increased from 50% to 93%. As expected, there was a definite male dominance (96%) among perpetrators as well as among victims (85%). Concerning suicides, the rate in the latter period was 18% above that in the former; illegal guns were used in 30% in 1990–91 as compared to 20% 1980–81. The pattern of wounding in suicides was similar to that reported in earlier studies; confirming that entrance wounds in the back, extremities and lower abdomen are indicative of homicide. Thus, common sense knowledge of firearm fatalities are confirmed: • More widespread access to illegal weapons conveys a higher rate of gunshot fatalities. • The perpetrator is likely to be male. • Suicidal shots are usually aimed at the head (mouth, temple, forehead) or precordium. • Most gunshot suicides are committed by means of legally possessed firearms.
Article
Although much information about firearm fatalities has been published, few articles have characterized all types of gunshot victims, the weapons used, and the injuries sustained in a well-defined geopolitical unit. This study of 597 persons sustaining gunshot injuries serious enough to cause death or hospitalization in Mobile County Alabama during 1985-1987, addresses that deficit. The overall rate of these 597 seriously gunshot-injured victims was 53/100,000 population per annum. Of the 597 victims, 215 died, resulting in a rate of 18.9 per 100,000 population per annum. Demographic characteristics of the homicide victims, predominantly young black men, and the suicide victims, predominantly middle-aged and elderly white men, are similar to those reported from other parts of the country. Assault victims accounted for the largest (316) number of victims: again, young black men also constituted the largest demographic group among assault victims. Handguns accounted for 71% of the weapons used. No assault type weapons were employed. Head, neck, and chest wounds led with the greatest fatality rates. Information about nonfatally wounded victims, particularly data about the weapons, proved difficult to obtain. This was one of the many problems encountered in this type of project and, consequently, is discussed at some length. Additional population-based studies using prospective methods and a variety of investigators, including persons knowledgeable of firearms, are needed.
Article
In a retrospective study, 288 firearm deaths were analysed to identify factors indicating homicide. The cases were classified as suicides (213), homicides (54), accidents (14) and undetermined cases (7). A number of factors, related to the circumstances and the autopsy findings, were studied. Whereas 41% of the homicide victims were females, women only constituted 1.4% of the suicide victims. The mean age was 37 and 50 years among homicide and suicide victims, respectively. Most suicides were committed at or in the vicinity of the residence, whereas a majority of the homicides occurred elsewhere. The majority of the suicide victims had either left a suicide note or had medical records of previous psychiatric illness. In all groups, shotguns were the most frequent weapon used. Fifty-seven percent of the homicide victims, but only three percent of the suicide victims had sustained more than one gunshot wound. One-third of the homicide victims were shot at close range. Alcohol was present in one-third of both homicide and suicide victims. Whereas 38% of the homicidal gunshot wounds had their entrances at anatomical regions typical of suicide, the direction of the bullet path often differed from the directions recorded in suicides. Hence, in this material, an entrance wound in the right temple indicated suicide, but in combination with a direction back-to-front, the wound was more likely to be homicidal. This study suggests that an estimation of the direction of the internal bullet path should be conducted in firearm fatalities, and that this factor may assist in the determination of the manner of death.
Article
During the 14-year period from 1984 to 1997 there were 85 firearm fatalities investigated by the Department of Forensic Medicine and the Department of Pathology in Edirne, Turkey. We determined the characteristics of these 85 firearm deaths which comprised 17.03% of all medicolegal autopsies. The overall incidence was 1.58 per 100,000 population. The median age was 35.5 years. Fifty-four percent of the victims were aged between 20 and 40 years. Males constituted 82% of the victims. The most frequent manner of death was homicide (68.3%). Handguns accounted for 62.4% of the weapons used. The most common sites for the firearm entrance wounds were both head-neck-nape (32.8%) and chest (32%). In conclusion, our study shows that, in spite of legal restrictions, illegal access to firearms is easy and deaths by firearms are still increasing.
Article
Firearm wounds to the head are often fatal and are routinely encountered in the practice of forensic pathology in the United States. Often, the anatomic site of the entrance wound is used to support or refute the manner of death indicated by the scene investigation and/or circumstances of the case. The present retrospective study of 120 fatalities resulting from 140 firearm wounds to the head correlates the anatomic region of the entrance wound and range of fire with the manner of death. Other demographic data analyzed include age, race, and gender of the decedents, as well as evidence of drug and/or ethanol use. It is hoped that this study will provide concrete data to support the largely anecdotal associations between the specific site of entry of firearm injuries to the head and the manner of death.
Article
A retrospective review of 1704 cases of suicide involving firearms investigated by the Bexar County Medical Examiner's office between 1984 and 1998 was performed. The age distribution was similar in male and female victims, and the type of weapon was not associated with age. Approximately 78% of the victims used a handgun (87% of female and 76% of male victims). In 4.0% of head wound cases, the site of the entrance wound was the back of the head. Thus, this report refutes the common belief that all gunshot wounds to the back of the head represent homicides. In 1.9% of the cases, the wounds were inflicted at intermediate range. With handguns, the right temple was the most common site, but with rifles and shotguns, the most common site was the mouth.
Article
The Statistical Office of Berlin recorded a total of 5488 suicides within the 10-year period 1990-1999 (3550 males, 1938 females). Firearms were used in 238 cases (218 males, 20 females). An autopsy was performed in 19 of the 20 female cases. The women's ages ranged from 21 to 88 years. Their marital status was single (n=6), married (n=5), divorced (n=5) and widowed (n=3). Eight of the women had one or more children. A suicide note was found in eight cases; six women had a history of psychiatric illness, and six had previously attempted suicide. Predominant among the suicide motives were mental (n=5) and organic (n=4) disorders as well as relationship problems (n=3) and financial difficulties (n=2). Most of the women (n=16) committed suicide in their own apartment, mainly in the bedroom. The weapons used were pistol (n=10), revolver (n=6), rifle (n=2) and a blank cartridge gun (n=1). In 16 cases we found a contact discharge at point blank range. Six of the dead women were found with the weapon still in their hands. The site of bullet-entry was the right temple (n=11), high-parietal (n=2), mouth (n=3), neck (n=1), and chest (n=2). A comparison of our results with the data of other authors for male or predominantly male collectives did not indicate any sex-specific differences regarding the type of weapon, location of the entry wound or the scene. However, alcohol was detected at a lower frequency compared with male gunshot suicides.
Article
A total of 624 consecutive gunshot autopsies from the Institutes of Legal Medicine in Münster and Hamburg was investigated retrospectively. In a subsample of 284 suicides and 293 homicides (n=577), a large variety of features such as firearm, ammunition, number and site of entrance wounds, shooting distance and direction of the internal bullet path were recorded and binary logistic regression analysis performed in the case of bullet paths. Females constituted 26.3% of the homicide victims and 10.6% of the suicides. Short-barrelled firearms outnumbered long arms in homicides by 6:1 and in suicides by 2:1. More than 1 gunshot injury was found in 5.6% of the suicides (maximum 5 gunshots) and in 53.9% of the homicides (maximum 23 gunshots). The suicidal gunshots were fired from contact or near contact range in 89% while this was the case in only 7.5% of the homicides. The typical entrance wound sites in suicides were the temple (36%), mouth (20%), forehead (11%) and left chest (15%) but uncommon entrance wound sites such as the eye, ear, and back of the neck and head were also encountered. In suicidal gunshots to the right temple (n=107), only 6% of the bullet paths were directed downwards and only 4% were directed from back-to-front. In gunshots to the left chest (n=130), bullet paths running right-to-left or parallel occurred frequently in suicides (75%) and infrequently in homicide victims (19%). From 61 suicides who fired the gun inside their mouth, only 1 pointed the gun downwards. Consequently, some bullet path directions cannot be considered indicative of suicide: downwards and back-to-front in gunshots to the temple, left-to-right in gunshots to the left chest and downwards in mouth shots. The isolated autopsy findings can only be indicative of suicide or homicide but the combined analysis of several findings can be associated with a high probability.
Article
Out of a total of 624 consecutive gunshot autopsies from Münster and Hamburg, Germany, 32 cases (5.1%) were accidental. The accidents were self-inflicted in 3 cases while another person fired the gun in the remaining 29 cases. More than half of the victims were younger than 25 years and 75% were male. A single gunshot injury was present in all cases and the head was struck in 47% but a detailed analysis of the entrance wound sites did not show any preferential anatomical sites. A surprising finding was the presence of five contact or near contact gunshots (16%). The reasons for these and most other accidents were extreme carelessness when handling a firearm, the involvement of children or adolescents or a foolish behaviour with a gun intended to impress others. Gun-cleaning accidents occurred rarely and there were no major technical defects of the weapons. Preventive measures should concentrate on strict inaccessibility of guns to children and on increased educational efforts to subgroups at risk such as hunters and members of the armed forces. A single non-contact gunshot injury from a long-barrelled firearm can be considered typical for an accident but the great variety and the possible presence of "disguised" suicides and homicides requires a careful forensic investigation including inspection of the scene and reconstruction of the events. It is recommended that a case should always be considered to be non-accidental in the beginning of an investigation.
Article
Cases at study comprise 48 gunshot fatalities (33 suicides--29 males and 4 females; 12 homicides--8 males and 4 females; 3 uncertain cases--3 males), examined from 1992 to 2002. The age range of suicides is 22-96 years, mean 58.8 years. In 16 cases the age was upper 65. Scene of death was at home in 27 cases (of which 6 on bed), in a car in 2 cases and in an open place in 4 cases. Uncertain cases happened during hunting. The implements used in suicides were shotgun in 14 cases, rifles in 7, handguns in 11 and a humane veterinary killer in 1. In suicides single entrance wounds were found, apart 1 case with two entrance wounds. A script manifesting suicidal intent was present in 6 cases. Homicides showed both single and multiple entrance wounds: in the cases of multiple entrance wounds, no sign of contact/near contact injuries were seen. In 4 cases, bodies were hidden.
Article
We present the as yet unresolved case of the death by gunshot wound of a 21-year-old student from a recent local inspection. It was reported that the daughter of the house had been shot through the window while she was washing the dishes. Slight discrepancies were noted in the statements of the family, who are very religious. The firearm, projectile and cartridge have not been found despite an intensive search. The daughter and the mother tested positive for traces of gunpowder on their hands, while in the case of the son traces were found on his hands and on his vest. That the trajectory of the projectile was from the kitchen outwards was established on the basis of a small hole in the inner pane of the kitchen window and a larger hole in the outer pane. The shot passed through the victim's cheek and the neck. The entrance wound (aditus) on the right cheek had complementary features characteristic of a gunshot from a short-barrelled firearm at relative proximity. The shot passed through the left jugular vein and the left internal carotid artery. The exit wound (exitus) was slightly larger and of irregular shape. The family chose a traditional burial. The mother and son did not present themselves for polygraph testing. A charge was filed against the mother of the deceased. Emphasis was placed on the scene investigation. A covered-up suicide? An accident (a scuffle when trying to prevent suicide)?
Article
Gunshot injuries are a major problem worldwide from the human, medical, and economic perspectives. The number and characteristics of gunshot fatalities have been observed to vary significantly between countries. This study analyzes fatal gunshot wounds in the region of Uusimaa, Southern Finland, between 1995 and 2001. Gunshot wounds were typically found in suicides committed by men aged between 20 and 60 years. In most cases, a handgun was used. Mental disorders were present in the history of almost one quarter of the victims. Alcohol was identified in postmortem toxicology in half of the cases, but drugs of abuse were relatively uncommon. The autopsy rate in Finland is among the highest of the European Union countries, and a medicolegal investigation is performed in virtually all fatal gunshot incidents. This study is therefore representative of forensic investigations of gunshot fatalities in Finland overall.
Article
Central Forensic Science Laboratory (CFSL), Chandigarh undertakes the examination of the crime cases of some northern states of India. The shooting cases of last two decades (1980-1999) involving shotguns were analysed in this laboratory. This paper consists of the study of 360 actual cases of shotguns for evaluation of various parameters, such as type of firearm, number of firearm and firing, location of wound, age, occupation, sex and caste of accused and victim, etc. Out of 360 cases, 253 (70%) were classified as homicidal, 68 (19%) accidental, 11 (3%) suicidal, 9 (2.5%) hunting and 19 (5.5%) cases of insufficient information including the cases of illegal possession of firearm. Single Barrel Breech Loading (SBBL) gun 144 (40%) was preferred over Single Barrel Muzzle Loading (SBML) 109 (30.3%), Double Barrel Breech Loading (DBBL) 72 (20%) and Double Barrel Muzzle Loading (DBML) gun 35 (9.7%). All the breechloader guns were of 12 bore. Muzzleloader gun were recovered only from the remote rural areas. Three hundred and thirty-one (92%) cases involved single, 22 (6%) double and 7 (2%) more than two shotgun. Majority of cases were found of single firing 288 (80%), followed by double 29 (8%) and multi-firing 18 (5%). Eleven (3%) cases were of misfiring and in 14 (4%) cases information was not available. Accidental and suicidal cases had only one firing. The mean age for male and female victim was 31 and 24 years, respectively. Occupationally, agriculture is predominating over business, service and security guards for accused and for victim agriculture followed by service, business, student and security guards are in the descending order. Caste wise the most aggressive community of Kshatriyas is predominating as accused and victim over lower cast people. Head (64%) being a vital part was chosen most frequently for committing suicide followed by body (36%). Service personnel committed maximum number of suicide.
Article
Suicide, a manner of death, ranked as the eleventh leading cause of death in the United States and accounted for approximately 30,000 deaths in 2001. A host of biological and psychosocial components interplay in a suicide investigation. Precipitating factors may include domestic quarrels, loss of employment, financial difficulties, substance abuse, chronic disease, or mental illness. The authors conducted a ten-year (1993--2002) retrospective review of suicide from all Medical Examiners' Offices in Kentucky. There were 2,864 suicides ranging between 11 and 96 years (average age 42.0 years). The majority of victims were males (81.7%) and Caucasian (94.8%). African-American females comprised the smallest group, consisting of only 0.59%. The preferred mode of death was by firearm (67.5%), followed by hanging (13.7%), overdose (9.9%), and carbon monoxide poisoning (4.4%). This comprehensive study discusses the trends of suicide in the United States during the twentieth century and underscores the importance of a multidisciplinary approach to the investigation and prevention of suicide.
Article
We estimate a crime equation using a panel dataset of Italian regions for the period 1980 to 1989. Four different crimes are considered: murder, theft, robbery, and fraud. To take account of the presence of criminal organizations—a salient feature of the Italian context and a relevant factor usually disregarded by the empirical literature—we exploit the panel structure with unobservable individual components. Our results suggest that: (i) the probability of punishment is relatively more effective than both the severity of punishment and the efficiency of police authority in deterring crime; (ii) among the variables representing the opportunity costs of participating in illegal activities, the rate of unemployment, the value of public works started by government, and the proportion of people employed in the service sector have a significant effect; (iii) for three types of crime the regional unobservable component is correlated with the regressors; (iv) spillovers from drug consumption to theft are substantial; and (v) with the exception of fraud, the results are in contrast with the predictions of the standard economic model of crime.
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