Baldino Gennaro, Vanin Stefano, Burrascano Giorgia, Forzese Elena, Asmundo Alessio, Ventura Spagnolo Elvira
Section of Legal Medicine, Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Via Consolare Valeria, 98125, Messina, Italy.
Department of Earth, Environmental and Life Sciences (DISTAV), University of Genoa, Genoa, 16132, Italy.
Forensic Sci Med Pathol. 2025 Mar;21(1):302-306. doi: 10.1007/s12024-024-00836-1. Epub 2024 Jun 5.
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.
复杂自杀事件较为罕见，可分为有计划（或原发性）案例和无计划（或继发性）案例。此外，个体通常会根据可得性和易获取性来选择自杀方式。一名58岁男性的尸体在其医务室被发现死亡。他被发现坐在候诊室沙发上，头部被几层胶带缠住，气道受阻。在他的左臂发现了一根静脉注射针，在他面前的桌子上，发现了一个空的50毫升注射器、两个空的10毫升氯化钾小瓶和一个空的10毫克安定（地西泮）小瓶。还发现了一卷与缠在他头上的胶带类似的胶带。在尸体被发现36小时后进行的尸检显示，血液样本中地西泮及其代谢产物去甲地西泮的浓度处于治疗水平，而未检测到氯化钾。综合尸检、组织学检查以及包括毒理学分析在内的其他死后调查所获得的法医鉴定结果，有助于界定自杀行为并防止误解，尤其是在区分他杀和自杀的诊断方面。在此类案件中，考虑间接证据和专业知识至关重要。
