Forensic Pathology Case Studies


CASE 5: Suicide, gunshot wound


Clinical History:

Police respond to a residence after receiving a report of "shots fired". Inside the unlocked house they find the body of an elderly man lying on the floor. Near the body is a large caliber pistol. There are gunshot wounds of the head and chest. No notes are found at the scene, but the decedent's important papers are laid out on a desk in the study. Further investigation with interview of family members reveals that the man had recently been diagnosed with prostate cancer. He had also recently argued with his son over financial matters and had threatened that he was going to change his will to make sure that his son got nothing.

Image 5.1:

This is the wound on the forehead. Describe the features that indicate the range of fire.
There is evidence of contact, with an abrasion ring, grey-black discoloration, and stellate lacerations from the release of gases into the subcutaneous tissues.

Image 5.2:

This is the soot on the skull beneath the forehead wound. How does this help you to determine the range of fire?
The soot would come from the muzzle of the gun being very close and gunshot residue being deposited.

Image 5.3:

The wound on the chest is shown in relation to the weapon. Describe the features.
Note that the imprint on the skin matches the muzzle of the weapon. There is also dark discoloration.

Image 5.4:

This is a microscopic section from the chest wound. What is the black material?
This is soot and gunpowder.

Image 5.5:

This is the wound on the back. Note the lack of any dark discoloration or abrasion ring or stellate laceration. This is an exit wound.

Image 5.6:

This is the victim's hand. What is present?
Blood and soot. These help to support a theory of self-infliction.

Questions:

  1. Based upon the investigative and pathologic findings, what do you determine is the manner of death (accident, suicide, homicide)?

    2. Suicide.

  2. How do you interpret the wound on the back in relation to the wound on the chest. What is the direction of fire?

    3. The wound on the back is the exit wound. Thus, the direction of fire is front to back, which can be consistent with a suicide.

  3. What is the range of fire of the two wounds?

    4. The entrance wounds are typical of a close contact gunshot wounds, which is consistent with a suicide. The presence of multiple gunshot wounds does not exclude suicide (about 3% of suicides by firearms are multiple).