title: Three rounds as "tandem bullets": unusual findings in a case of a suicidal gunshot to the head.
abstract: We report an unusual case of suicide in which three 7.65 caliber projectiles were found in the single gunshot wound to the head of a 53-year-old man. Based on data collected at the death scene, CT scan, autopsy findings, and ballistics analysis, the events were reconstructed as follows: two 7.65 mm rounds had already been fired from the 9 mm Makarov pistol the subject was using but, being a smaller caliber, the cartridges had slipped forward and lodged within the barrel. When a third 7.65 mm cartridge was chambered and the gun fired for the third time, the nose of the last bullet hit the lodged bullets and all three rounds were propelled out of the muzzle in tandem as a single shot. Ballistic investigations confirmed that the kinetic energy of the three tandem bullets would have been sufficient to perforate the skull. In cases of gunshot wounds where the manner of death is unclear, a number of well-described circumstantial parameters, such as an atypical anatomical location of the gunshot, unusual firearm, or ammunition, as well as ambiguous autopsy findings, can raise doubts about the manner of death. In very rare cases, despite a single entrance wound, two or more bullets are recovered from the body, fired by the same weapon at the same time (the so-called "tandem bullet" phenomenon). Injuries by "tandem bullets" have crucial implications in gunshot deaths because of the mismatch between the number of entrance and exit wounds and the number of bullets found in or near the body.
authors.affiliation: Institute of Legal Medicine, University of Bari, P.zza G. Cesare, 11, 70124, Bari, Italy, luciatattoli@libero.it.
authors.forename: Lucia
authors.initials: L
authors.lastname: Tattoli
authors.forename: Simone
authors.initials: S
authors.lastname: Schmid
authors.forename: Michael
authors.initials: M
authors.lastname: Tsokos
mesh_terms: D001344:Autopsy; D002423:Cause of Death; D017809:Fatal Outcome; D044709:Forensic Ballistics / Q000379:methods*; D020197:Head Injuries, Penetrating / Q000000981:diagnostic imaging / Q000473:pathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012886:Skull / Q000000981:diagnostic imaging / Q000293:injuries*; D013405:Suicide; D014057:Tomography, X-Ray Computed; D014948:Wounds, Gunshot / Q000000981:diagnostic imaging / Q000473:pathology*
references.citation: Am J Forensic Med Pathol. 1997 Jun;18(2):168-71
references.pmid: 9185935
references.citation: Forensic Sci Med Pathol. 2014 Jun;10(2):262-5
references.pmid: 24235025
references.citation: Am J Forensic Med Pathol. 2007 Sep;28(3):220-2
references.pmid: 17721170
references.citation: J Forensic Leg Med. 2008 Jul;15(5):343-5
references.pmid: 18511013
references.citation: J Forensic Sci. 1997 Jul;42(4):678-81
references.pmid: 9243831
references.citation: Int J Legal Med. 1998;112(1):58-61
references.pmid: 9932745
references.citation: J Forensic Sci. 1997 Nov;42(6):1214
references.pmid: 9397570
references.citation: J Forensic Sci. 1995 Sep;40(5):893-5
references.pmid: 7595334
references.citation: Forensic Sci Med Pathol. 2013 Mar;9(1):68-72
references.pmid: 22956431
references.citation: Forensic Sci Med Pathol. 2013 Jun;9(2):265-9
references.pmid: 22753009
references.citation: J Forensic Leg Med. 2013 Aug;20(6):601-4
references.pmid: 23910842
references.citation: Forensic Sci Med Pathol. 2012 Dec;8(4):460-2
references.pmid: 22622785
references.citation: Med Sci Law. 1975 Oct;15(4):280-3
references.pmid: 1181504
references.citation: J Forensic Sci. 2012 Jul;57(4):1129-33
references.pmid: 22390348
references.citation: Forensic Sci Med Pathol. 2014 Mar;10(1):3-8
references.pmid: 23564061
references.citation: Am J Forensic Med Pathol. 1997 Mar;18(1):56-9
references.pmid: 9095302
references.citation: Med Sci Law. 1989 Jul;29(3):249-50
references.pmid: 2770476