Unusual suicides with band saws: Two case reports and a literature review
Article Outline
Abstract
Suicides or suicide attempts with power saws (band, circular or chain saws) are rather rare events and only a few case reports exist in the forensic literature. The use of a band saw, in particular, has been extremely rare in cases of suicide.
We report two cases of suicide that occurred in the same suburban area, three years apart. In each case, the victim was a carpenter and had a history of psychiatric disorder and/or of prior suicide attempts.
We summarize the findings of the death scene investigations, the pertinent autopsy findings, and also summarize the world literature pertaining to suicide committed with power saws.
Keywords: Forensic science, Suicide, Band saw, Power tools, Schizophrenia
1. Introduction
Suicides, or suicidal attempts committed with power saws, are uncommonly reported incidents. With fewer than 15 previously reported cases [1], [2], [3], [4], [5], [6], [7], [8], the use of a band saw in particular has been extremely rare in cases of suicide [1], [3], [4].
The pathologic features of wounds produced by such power tools are unusual and sometimes misleading and need therefore to be highlightened.
We report two cases of suicide by band saws committed by two schizophrenic male patients.
2. Case reports
2.1. Case 1
The deceased was a 41-year-old male schizophrenic patient. He had been ill for 19 years and had been hospitalized five times, the most recent time being 3 months prior to his suicide. He had been married between the ages of 34 and 37, but due to permanent conflicts with his wife, had divorced. He remained single and had disengaged socially since the divorce.
He had been a carpenter, but resigned from his job 2 years earlier.
He had a history of five suicidal attempts by gas inhalation and drowning in the past 1 year, the most recent attempt being 4 months prior to his death.
He was seen by a psychiatrist at a psychiatric outpatient department 6 days before he died and was reported to be still unemployed, socially disengaged with persistent depressive symptoms and auditory hallucinations commanding suicide, in spite of antidepressant and neuroleptic medications.
He was found dead in his carpentry workshop, lying down beside a band saw (Fig. 1).
Fig. 1.
Case 1: the deceased lying down beside the band saw with a large quantity of pooled blood around his head and neck. Note the saw blade running off its axis (black arrow).
At post-mortem examination, he was found to have sustained an incised, deep and gaping neck wound with ragged and lacerated edges, beginning at the anterior side of the neck, passing inferiorly and posteriorly along the left side to the posterior side of the neck with only a small cutaneo–muscular flap left on the right side of the neck joining the head to the thorax (Fig. 2). The wound extended through the deep structures of the neck, transecting the major blood vessels and nerves on both sides of the neck, the upper airways (thyroid cartilage), the 5th cervical vertebra and the spinal cord.
Fig. 2.
Case 1: an incised, deep and gaping neck wound with ragged and lacerated edges involving the anterior, left and posterior sides of the neck (white arrow).
The remainder of the autopsy showed a flooding of the trachea and bronchi with coagulated blood. There were no coexisting injuries suggestive of foul play and no hesitation injuries.
Investigations at the death scene showed a large quantity of pooled blood around the decedent's head and neck and a small amount of blood and tissue spray on the work surface and blade of the band saw (Fig. 3). There was also bone dust between the teeth of the saw blade.
Fig. 3.
Case 1: a small amount of blood and tissue spray on the work surface and blade of the band saw.
The investigating officers found no evidence of a struggle and, in view of the decedent's past history of suicidal ideation and previous suicidal attempts and the post-mortem findings, it was believed that the injuries could not have been produced accidentally and a verdict of suicide was returned.
2.2. Case 2
The decedent was a 47-year-old male schizophrenic patient. He had been ill for 15 years and had been hospitalized seven times, with a history of previous suicidal ideation 1 year earlier. He used to complain about depressive mood and command auditory hallucinations, but he had always been reluctant to take his medications once at home. He had been lost to psychiatric follow-up for 6 years prior to his death. He had been married for 25 years and had four children, but was not involved emotionally or financially with his family. He was a carpenter, but had quit his job several years earlier.
He was found dead in his carpentry workshop, lying down next to a band saw.
Post-mortem examination revealed a grossly linear, cleanly-cut wound of the head. It was located in the mid-line of the head and had a course following the sagittal plane, running from the base of the forehead through the convexity down to the occipital region (Fig. 4, Fig. 5). The cranial vault showed a sharp-edged sagittal section running from the external occipital protuberance along the sagittal suture, down to the nasal bone and extending to the two anterior thirds of the skull base. The superior sagittal sinus was incised and the cerebrum was divided into two symmetric portions along the falx cerebri with transection of the corpus callosum, the thalamus, the hypothalamus, the mid-brain and the upper part of the pons and cerebellum. There was a massive haemorrhage of the convexity extending into the ventricles (Fig. 6).
Fig. 4.
Case 2: an anterior view of the sagittal cranial wound inflicted by the band saw. .
Fig. 5.
Case 2: a posterior view of the deceased's head showing the course of the wound along the sagittal line down to the occipital region.
Fig. 6.
Case 2: sagittal section of the cerebrum and upper part of the brain stem and cerebellum into two symmetric parts.
The remainder of the autopsy was unremarkable, with no morphologic evidence of pre-existing disease, no coexisting injuries, and no hesitation injuries.
Investigations at the death scene showed a large pool of blood around the decedent's head and shoulders extending to the upper part of the thorax and a small amount of blood and tissue spray on the work surface and blade of the band saw.
The cause of death was attributed to a massive haemorrhage resulting from injury to the superior sagittal sinus and the manner of death was ruled as suicide.
3. Discussion
With a few cases of suicide reported in the literature involving the use of power saws (band saws, circular saws or chain saws) [1], [2], [3], [4], [5], [6], [7], [8], and only five of those involving band saws [1], [3], [4], these two additional cases of the use of band saws contribute to the description of the features of this uncommon manner of death.
In suicide committed with power saws, the injuries are typically severe and most often inflicted to the head [1], [4], [5], [6], [7] or the neck [1], [2], [3], [4], [7] leading to central dysregulation, exsanguination, air embolism or blood aspiration as a cause of death, although two transections of the same arm [1] and a shallow mid-chest wound [8] have also been reported. The decedents generally have only one large wound similar to our two cases. Hesitation marks, nevertheless, have been reported [1], [6], [8]. In those cases, the marks were caused by other edged instruments, knives for example [1], [8], or by the saw itself [1], [6]. They may not always be superficial, but can even involve the skull [1], [6]. According to some authors, the occurrence of those hesitation injuries could considerably contribute to the diagnosis of suicide [1].
As with almost all of the reported cases [1], [2], [3], [5], [6], [8], the decedents had prior psychiatric disorders; both of them were schizophrenic, with depressive mood and hallucinations being the most prominent symptoms. One of them had attempted suicide five times using gas inhalation and drowning and the other had a previous history of suicidal ideation. In the literature, the two major psychiatric disorders associated with suicide by power saws are major depression and schizophrenia. Two of the reported victims with psychiatric disorders also had a prior history of suicide attempts [2], [5].
Härtel et al. [4] reported two cases of suicide with band saws by workers in carpenter's workshops. The choice of this method for suicide was based on the fact that they knew how dangerous such machines were. Both cases were observed by witnesses who were unable to intervene due to the speed of events.
Data from previous research suggests that the mode of suicide reflects the underlying condition and in particular, that more violent modes of suicide are associated with psychotic illness [5]. Schizophrenia, in particular, is associated with a higher risk of suicide than in the general population [9], with men being at higher risk than women [10], [11], [12], [13], [14], [15]. Furthermore, it seems that, in schizophrenic patients, active illness, depressive symptoms, alcoholism and a history of previous suicide attempts and/or suicidal ideation are highly prevalent immediately before suicide [10], [14], [15], [16]. Social and vocational impairment are often present at the time of suicide [14], [15], [16]. Younger male subjects most often use violent suicide methods [14]. However, even in suicidal schizophrenic patients using highly lethal methods, the use of power saws is extremely rare, the most classic means being hanging, jumping from a high place or shooting with a firearm [10], [11], [13], [14].
Both of our cases were male. In the literature, there is a large predominance of male victims with only three reported cases where the decedents were female [1].
Both of them were carpenters, lived in the same suburban area, and used the band saw at their workshops. In the literature, six of the ten victims are reported to have had occupational experience with power saws [2], [3], [4], [6]. Although Betz [1] reported three cases in which the victims showed no particular or apparent relation to power tools, either in connection with their hobbies or jobs.
The autopsy findings often reveal unusual patterns of injury due to the high lethality of the tools used and the determination of the victims. Indeed, the location, the extent and depth of the wounds, and most often the absence of any hesitation injuries, might bring up the suspicion of homicide at the beginning of the death investigation [2], [7].
The autopsy findings in our two cases revealed some interesting aspects. In case 1, there was a sub-total decapitation. In previously reported cases of suicide by power saws, involving wounds to the neck, the wounds were not deep enough to result in such a pattern of injury as in our case [1], [2], [3], [4], [7]. The ragged edges of the wound, however, are not typical of wounds produced by band saws, although these are not well typified, but rather of wounds inflicted by chain saws. This could be interpreted as a result of a spontaneous movement of the head (perhaps mediated by the vibrations of the blade of the band saw and/or by a change in the position of the body after loss of consciousness). It is, also likely that the victim must had applied some degree of force, pushing his neck into the blade to produce such a deep wound, as suggested by the fact that the blade of the band saw ran off its axis (Fig. 1).
In case 2, there was a craniocerebral wound following the sagittal plane, extending to the skull base, and resulting in a median sagittal section of the cerebrum and upper part of the brain stem and cerebellum. To our knowledge, such a self-inflicted pattern of injury has not been previously described in the forensic literature. The two cases reported describing craniocerebral wounds were also produced by band saws but had a horizontal direction resulting in an amputation of the upper skull including almost the total brain [1], [4].
4. Conclusion
These two cases add to the literature on suicides occurring with the use of power tools by further illustrating that the power saw is most often applied to the head or neck region, that the decedents usually have a history of psychiatric illness, and that they are more likely male and have occupational experience with the saw.
However, the atypical and sometimes misleading post-mortem findings are noteworthy and need to be investigated carefully. Jointly, all background factors must be considered in order to determine the manner of death.
Acknowledgements
The authors wish to thank Mr. Mark Whitlock for the manuscript editing, Mr. Jamel Ben Slama for putting the photographs 1, 2 and 5 at their disposal and Mr. Néji Ayadi for his expertise in preparing the photographs for publication.
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PII: S0379-0738(08)00373-3
doi:10.1016/j.forsciint.2008.09.017
© 2008 Elsevier Ireland Ltd. All rights reserved.
