title: [Unusual circumstances in a fourfold complex suicide].
abstract: Complex suicides are defined as suicides using more than one method, which may sometimes suggest homicide. We present the case of a 27-year-old man who killed himself by using four different methods. The man was known as a loner and sufferd from bipolar psychosis. An eyewitness saw him afire and falling out of a window on the 4th floor of a hotel. He was wearing a judo dress with the belt wound twice around his neck. He died in a hospital about two hours later. The autopsy showed signs of neck compression typical of (self)-strangulation, several stab and cut wounds in the thoracic and abdominal region from sharp force, extensive first- to third-degree burns caused by the effect of heat, contusions of internal organs, serial rib fractures and several bone fractures of the extremities as signs of blunt force. The CO-Hb value in the blood amounted to 7%; the other toxicological tests were negative. Death was found to be due to exsanguination from a deep stab wound in the abdomen and multiple trauma caused by the fall from a great height in the course of a suicide. Homicide could be excluded due to the circumstances of the case, which demonstrated again that both the medical findings and the investigation results of the police are indispensable for the differentiation between suicide and homicide.
authors.affiliation: Institut für Rechtsmedizin der Christian-Albrechts-Universität zu Kiel.
authors.forename: Regina
authors.initials: R
authors.lastname: Schlenger
authors.forename: Hans-Jürgen
authors.initials: HJ
authors.lastname: Kaatsch
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Grellner
mesh_terms: D000007:Abdominal Injuries / Q000473:pathology*; D000328:Adult; D001237:Asphyxia / Q000473:pathology*; D001344:Autopsy / Q000331:legislation & jurisprudence; D001714:Bipolar Disorder / Q000473:pathology; D002056:Burns / Q000473:pathology*; D006801:Humans; D008297:Male; D009104:Multiple Trauma / Q000473:pathology*; D019838:Neck Injuries / Q000473:pathology*; D013405:Suicide / Q000331:legislation & jurisprudence*; D013898:Thoracic Injuries / Q000473:pathology*; D014949:Wounds, Nonpenetrating / Q000473:pathology*; D014951:Wounds, Stab / Q000473:pathology*