Fatal ingestion of firecracker in borderline personality disorder: suicide or not?

Borderline Personality Disorder (BPD) is a mental health condition marked by intense emotions, unstable relationships, and a distorted self-image, which often leads to impulsive and self-destructive behaviors. Individuals with BPD frequently engage in deliberate foreign body ingestion (DFBI), a behavior that can result in severe outcomes if dangerous objects are ingested. Herein, we present a case of 45-year-old man with a history of BPD that was found in his apartment with fatal head injuries caused by the explosion of a firecracker in his mouth. Besides extensive head injuries that undoubtedly led to lethal outcome, autopsy revealed a sewing needle deeply embedded in a cardiac muscle, with fibrinous deposits suggesting that its ingestion occurred prior to the fatal incident. Such cases are crucial because they highlight the forensic significance of autopsy findings. By integrating autopsy findings with clinical data and other relevant case circumstances, valuable information can be obtained regarding the cause and manner of death. This case underscores the importance of thorough forensic investigation in cases of unusual self-harm to accurately determine intent and underlying factors.