title: Multiple injuries in suicide simulating homicide: report of three cases.
abstract: Multiple inflicted injuries in traumatic deaths usually indicate homicide. Three cases are reported where homicide was initially suspected due to findings at the death scene and the apparent nature of the injuries however, after investigation, involvement of any other individuals in the deaths could be excluded. Case 1: A 52-year-old male was found with multiple stab wounds. At autopsy, 36 stab wounds were identified, the majority of which were superficial. Only two stab wounds had penetrated deeply. Case 2: A 19-year-old female was found with three gunshot entry wounds to the right temple and a .22 calibre automatic rifle resting across her lap. Case 3: A 47-year-old female was found with numerous haematomas and three deep head wounds in keeping with trauma from impact with a blunt object. A high level of clozapine was detected on toxicological analysis of blood and a history of schizophrenia was reported. Although multiple self-inflicted wounds are most often caused by sharp objects such as knives, on occasion multiple gunshot wounds and rarely, blunt trauma may also be encountered. Careful integration of scene and autopsy findings may be required to avoid misinterpretation of the circumstances and manner of death.
authors.affiliation: Discipline of Anatomy and Pathology, The University of Adelaide, Frome Road, Adelaide, SA 5005, Australia.
authors.forename: Amy E
authors.initials: AE
authors.lastname: Austin
authors.forename: Saskia S
authors.initials: SS
authors.lastname: Guddat
authors.forename: Michael
authors.initials: M
authors.lastname: Tsokos
authors.forename: John D
authors.initials: JD
authors.lastname: Gilbert
authors.forename: Roger W
authors.initials: RW
authors.lastname: Byard
mesh_terms: D014150:Antipsychotic Agents / Q000097:blood; D003024:Clozapine / Q000097:blood; D005260:Female; D049429:Forensic Pathology; D016489:Head Injuries, Closed / Q000473:pathology; D020197:Head Injuries, Penetrating / Q000473:pathology; D006406:Hematoma / Q000473:pathology; D006470:Hemorrhage / Q000209:etiology / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009104:Multiple Trauma / Q000473:pathology*; D013405:Suicide; D014948:Wounds, Gunshot / Q000473:pathology; D014951:Wounds, Stab / Q000473:pathology; D055815:Young Adult
chemical_list: D014150:Antipsychotic Agents; D003024:Clozapine
keywords: Blunt force trauma; Homicide; Multiple injuries; Overkill; Penetrating injury; Self-mutilation; Suicide; Tentative injury