A case report of complex suicide in physician: attempt drugs poisoning and adhesive tape asphyxia.
Adhesive tape
Asphyxia
Complex suicide
Drugs poisoning
Forensic pathology
Physicians
Journal
Forensic science, medicine, and pathology
ISSN: 1556-2891
Titre abrégé: Forensic Sci Med Pathol
Pays: United States
ID NLM: 101236111
Informations de publication
Date de publication:
05 Jun 2024
05 Jun 2024
Historique:
accepted:
16
05
2024
medline:
6
6
2024
pubmed:
6
6
2024
entrez:
5
6
2024
Statut:
aheadofprint
Résumé
Complex suicides are rare occurrences that can be categorized into planned (or primary) cases and unplanned (or secondary) cases. Additionally, individuals often select suicide methods based on their availability and accessibility. The body of a 58-year-old man was discovered deceased inside his medical office. He was found seated on the waiting room sofa, with his airways obstructed by several layers of adhesive tape wrapped around his head. An intravenous needle was observed in his left arm, and on the table in front of him, an empty 50 ml syringe, two empty vials of 10 ml potassium chloride, and an empty 10 mg vial of Valium (diazepam) were found. A roll of adhesive tape, similar to the one around his head, was also present. The autopsy, conducted 36 h after the body's discovery, revealed therapeutic concentrations of diazepam and its metabolite nordiazepam in the blood samples, while potassium chloride was not detected. Integrating forensic findings obtained from autopsy, histology, and other postmortem investigation, including toxicological analysis, can aid in defining suicidal behavior and preventing misinterpretation, particularly in differentiating diagnosis between homicide and suicide. It is crucial to consider circumstantial data and professional knowledge in such cases.
Identifiants
pubmed: 38839741
doi: 10.1007/s12024-024-00836-1
pii: 10.1007/s12024-024-00836-1
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.
Références
Kulkarni C, Mohite S, Meshram V. Unplanned complex suicide by self-stabbing and rail suicide: a case report and review of literature. Am J Forensic Med Pathol. 2020;41(1):78–80. https://doi.org/10.1097/PAF.0000000000000503 . PMID: 32022760.
doi: 10.1097/PAF.0000000000000503
pubmed: 32022760
Baldino G, Mondello C, Sapienza D, Stassi C, Bottari A, Gualniera P, Asmundo A, Ventura Spagnolo E. Suicide, depression, and thyroid dysregulation: an unusual case of unplanned complex suicide. Leg Med (Tokyo). 2023;61:102187. https://doi.org/10.1016/j.legalmed.2022.102187 . Epub 2022 Dec 23. PMID: 36580793.
doi: 10.1016/j.legalmed.2022.102187
pubmed: 36580793
Ateriya N, Kanchan T, Shekhawat RS, Setia P, Saraf A. Unplanned complex Suicide-A consideration of multiple methods. J Forensic Sci. 2018;63(3):945–6. https://doi.org/10.1111/1556-4029.13609 .
doi: 10.1111/1556-4029.13609
pubmed: 28766717
WHO. 2022.
Marcinkowski T, Pukacka-Sokolowska L, Wojciechowski T. Planned complex suicide. Forensic Sci. 1974;3(1):95–100. https://doi.org/10.1016/0300-9432(74)90013-2 . PMID: 4426552.
doi: 10.1016/0300-9432(74)90013-2
pubmed: 4426552
Simonit F, Bassan F, Scorretti C, Desinan L. Complex suicides: a review of the literature with considerations on a single case of abdominal self-stabbing and plastic bag suffocation. Forensic Sci Int. 2018;290:297–302. https://doi.org/10.1016/j.forsciint.2018.07.027 . PMID: 30103179.
doi: 10.1016/j.forsciint.2018.07.027
pubmed: 30103179
Gentile G, Galante N, Tambuzzi S, Zoja R. A forensic analysis on 53 cases of complex suicides and one complicated assessed at the Bureau of Legal Medicine of Milan (Italy). Forensic Sci Int. 2021;319:110662. https://doi.org/10.1016/j.forsciint.2020.110662 . PMID: 33401231.
doi: 10.1016/j.forsciint.2020.110662
pubmed: 33401231
Pélissier-Alicot AL, Gavaudan G, Bartoli C, Kintz P, Piercecchi-Marti MD, Desfeux J, Leonetti G. Planned complex suicide: an unusual case. J Forensic Sci. 2008;53(4):968–70. https://doi.org/10.1111/j.1556-4029.2008.00754.x . PMID: 18503524.
doi: 10.1111/j.1556-4029.2008.00754.x
pubmed: 18503524
Hösükler E, Hösükler B, Çoban İ, et al. Complex suicides: 21 cases and a review of the literature. Egypt J Forensic Sci. 2022;12:10. https://doi.org/10.1186/s41935-022-00269-3 .
doi: 10.1186/s41935-022-00269-3
Barranco R, Diana C, Ventura F. Forensic pathological study of complex and complicated suicides: A twelve-year case series in Genoa (Italy). J Forensic Leg Med. 2019;65:5–8. https://doi.org/10.1016/j.jflm.2019.04.007 . PMID: 31009839.
doi: 10.1016/j.jflm.2019.04.007
pubmed: 31009839
Racette S, Sauvageau A. Planned and unplanned complex suicides: a 5-year retrospective study. J Forensic Sci. 2007;52(2):449–52. https://doi.org/10.1111/j.1556-4029.2007.00387.x . PMID: 17316249.
doi: 10.1111/j.1556-4029.2007.00387.x
pubmed: 17316249
Bohnert M. Complex suicides. In: Tsokos M, editor. Forensic pathology reviews, vol. 2. Humana Press; 2005. https://doi.org/10.1385/1-59259-872-2:127 .
doi: 10.1385/1-59259-872-2:127
Demirci S, Dogan KH, Erkol Z, Deniz I. A series of complex suicide. Am J Forensic Med Pathol. 2009;30(2):152–4. https://doi.org/10.1097/PAF.0b013e318187deb7 . PMID: 19465805.
doi: 10.1097/PAF.0b013e318187deb7
pubmed: 19465805
Palazzo C, Fais P, Mazzotti MC, Gaudio RM, Pelletti G, Pelotti S. A homemade furnace. Influence of occupational skills in a fire-related planned complex suicide. Forensic Sci Med Pathol. 2018;14(1):109–13. https://doi.org/10.1007/s12024-018-9952-3 . Epub 2018 Feb 8. PMID: 29423778.
doi: 10.1007/s12024-018-9952-3
pubmed: 29423778
Töro K, Pollak S. Complex suicide versus complicated suicide. Forensic Sci Int. 2009;184(1–3):6–9. https://doi.org/10.1016/j.forsciint.2008.10.020 . Epub 2008 Dec 25. PMID: 19111411.
doi: 10.1016/j.forsciint.2008.10.020
pubmed: 19111411
Altun G. Planned complex suicide: report of three cases. Forensic Sci Int. 2006;157(2–3):83–6. https://doi.org/10.1016/j.forsciint.2005.04.039 . Epub 2005 Jun 23. PMID: 15979265.
doi: 10.1016/j.forsciint.2005.04.039
pubmed: 15979265
van den Hondel KE, Buster M, Reijnders UJ. Suicide by asphyxiation with or without Helium inhalation in the region of Amsterdam (2005–2014). J Forensic Leg Med. 2016;44:24–6. https://doi.org/10.1016/j.jflm.2016.08.012 . Epub 2016 Aug 26. PMID: 27591338.
doi: 10.1016/j.jflm.2016.08.012
pubmed: 27591338
Byard RW, Simpson E, Gilbert JD. Temporal trends over the past two decades in asphyxial deaths in South Australia involving plastic bags or wrapping. J Clin Forensic Med. 2006;13(1):9–14. https://doi.org/10.1016/j.jcfm.2005.05.005 . PMID: 16321561.
doi: 10.1016/j.jcfm.2005.05.005
pubmed: 16321561
Crudele GDL, Di Candia D, Gentile G, Marchesi M, Rancati A, Zoja R. One hundred and one cases of plastic bag suffocation in the Milan Area between 1993 and 2013-Correlations, circumstances, pathological and forensic evidence and literature review. J Forensic Sci. 2016;61(2):361–6. https://doi.org/10.1111/1556-4029.13003 . Epub 2015 Dec 31. PMID: 27404609.
doi: 10.1111/1556-4029.13003
pubmed: 27404609
Nadesan K, Beng OB. Two cases of death due to plastic bag suffocation. Med Sci Law. 2001;41(1):78–82. https://doi.org/10.1177/002580240104100115 . PMID: 11219130.
doi: 10.1177/002580240104100115
pubmed: 11219130
Dhaliwal JS, Rosani A, Saadabadi A. Diazepam. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023. PMID: 30725707.
Bertol E, Politi L, Mari F. Death by potassium chloride intravenous injection: evaluation of analytical detectability. J Forensic Sci. 2012;57(1):273–5. https://doi.org/10.1111/j.1556-4029.2011.01907.x . Epub 2011 Sep 16 PMID: 21923800.
doi: 10.1111/j.1556-4029.2011.01907.x
pubmed: 21923800
Palmiere C, Scarpelli MP, Varlet V, Baumann P, Michaud K, Augsburger M. Fatal intravenous injection of potassium: is postmortem biochemistry useful for the diagnosis? Forensic Sci Int. 2017;274:27–32. https://doi.org/10.1016/j.forsciint.2016.11.035 . Epub 2016 Nov 27. PMID: 27932048.
doi: 10.1016/j.forsciint.2016.11.035
pubmed: 27932048
Chaturvedi AK, Rao NG, Moon MD. Poisoning associated with potassium. Hum Toxicol. 1986;5(6):377–80. https://doi.org/10.1177/096032718600500608 . PMID: 3804354.
doi: 10.1177/096032718600500608
pubmed: 3804354
Zhang L, Zhao Q, Wang Q, Zhang P, Li H, Li J. Application of scanning electron microscopy in the auxiliary diagnosis of death caused by potassium chloride intravenous injection: a case report. Int J Legal Med. 2020;134(5):1719–25. https://doi.org/10.1007/s00414-020-02361-6 . Epub 2020 Jun 30. PMID: 32607752.
doi: 10.1007/s00414-020-02361-6
pubmed: 32607752
Milner A, Witt K, Maheen H, LaMontagne AD. Access to means of suicide, occupation and the risk of suicide: a national study over 12 years of coronial data. BMC Psychiatry. 2017;17(1):125. https://doi.org/10.1186/s12888-017-1288-0 . PMID: 28376757; PMCID: PMC5379531.
doi: 10.1186/s12888-017-1288-0
pubmed: 28376757
pmcid: 5379531
Palazzo C, Pascali JP, Pelletti G, Mazzotti MC, Fersini F, Pelotti S, Fais P. Integrated multidisciplinary approach in a case of occupation related planned complex suicide-peticide. Leg Med (Tokyo). 2021;48:101791. https://doi.org/10.1016/j.legalmed.2020.101791 .
doi: 10.1016/j.legalmed.2020.101791
pubmed: 33054997
Schmidt PH, Padosch SA, Madea B. Occupation-related suicides. In: Tsokos M, editor. Forensic pathology reviews, vol. 2. Humana Press; 2005. https://doi.org/10.1385/1-59259-872-2:145 .
doi: 10.1385/1-59259-872-2:145
Dutheil F, Aubert C, Pereira B, Dambrun M, Moustafa F, Mermillod M, Baker JS, Trousselard M, Lesage FX, Navel V. Suicide among physicians and health-care workers: a systematic review and meta-analysis. PLoS ONE. 2019;14(12):e0226361. https://doi.org/10.1371/journal.pone.0226361 . PMID: 31830138; PMCID: PMC6907772.
doi: 10.1371/journal.pone.0226361
pubmed: 31830138
pmcid: 6907772
Agerbo E, Gunnell D, Bonde JP, Mortensen PB, Nordentoft M. Suicide and occupation: the impact of socio-economic, demographic and psychiatric differences. Psychol Med. 2007;37(8):1131–40. https://doi.org/10.1017/S0033291707000487 . Epub 2007 Apr 20. PMID: 17445281.
doi: 10.1017/S0033291707000487
pubmed: 17445281
Torre DM, Wang NY, Meoni LA, Young JH, Klag MJ, Ford DE. Suicide compared to other causes of mortality in physicians. Suicide Life Threat Behav. 2005;35(2):146–53. https://doi.org/10.1521/suli.35.2.146.62878 . PMID: 15843332.
doi: 10.1521/suli.35.2.146.62878
pubmed: 15843332
Hawton K, Clements A, Sakarovitch C, Simkin S, Deeks JJ. Suicide in doctors: a study of risk according to gender, seniority and specialty in medical practitioners in England and Wales, 1979–1995. J Epidemiol Community Health. 2001;55(5):296–300. https://doi.org/10.1136/jech.55.5.296 . PMID: 11297646; PMCID: PMC1731901.
doi: 10.1136/jech.55.5.296
pubmed: 11297646
pmcid: 1731901
Hawton K, Clements A, Simkin S, Malmberg A. Doctors who kill themselves: a study of the methods used for suicide. QJM. 2000;93(6):351–7. https://doi.org/10.1093/qjmed/93.6.351 . PMID: 10873184.
doi: 10.1093/qjmed/93.6.351
pubmed: 10873184
Labecka M, Lorkiewicz-Muszynska D, Sobol J, Przystanska A. Use of occupational knowledge to commit suicide. J Forensic Res. 2016;7:348. https://doi.org/10.4172/2157-7145.1000348 .
doi: 10.4172/2157-7145.1000348
Austin AE, van den Heuvel C, Byard RW. Physician suicide. J Forensic Sci. 2013;58:S91–3. https://doi.org/10.1111/j.1556-4029.2012.02260.x .
doi: 10.1111/j.1556-4029.2012.02260.x
pubmed: 22900898
Gold KJ, Sen A, Schwenk TL. Details on suicide among US physicians: data from the National Violent Death Reporting System. Gen Hosp Psychiatry. 2013;35(1):45–9. https://doi.org/10.1016/j.genhosppsych.2012.08.005 . Epub 2012 2. PMID: 23123101; PMCID: PMC3549025.
doi: 10.1016/j.genhosppsych.2012.08.005
pubmed: 23123101
Alongi A, Stassi C, Mondello C, Baldino G, Argo A, Ventura Spagnolo E. Hanging disguised as bondage: accidental or suicidal death? Forensic Sci Med Pathol. 2020;16(4):724–7. https://doi.org/10.1007/s12024-020-00261-0 .
doi: 10.1007/s12024-020-00261-0
pubmed: 32495262
Baldino G, Mondello C, Sapienza D, Stassi C, Asmundo A, Gualniera P, Vanin S, Ventura Spagnolo E. Multidisciplinary forensic approach in “complex” bodies: systematic review and procedural proposal. Diagnostics (Basel). 2023;13(2):310. https://doi.org/10.3390/diagnostics13020310 .
doi: 10.3390/diagnostics13020310
pubmed: 36673120