Ateşli silah yaralanmalarına bağlı ölümlerde orijin tespiti parametrelerinin değerlendirilmesi

Öz

AMAÇ: Bu çalışmada, ateşli silah yaralanmalarının orijin tespitinde dikkate alınan parametreleri ayrıntılı şekilde incelemek amaçlanmıştır. YÖNTEM: Çalışmanın örneklem grubuna, 01/01/2008 – 31/12/2012 tarihleri arasında, mevcut yaralanmanın kişinin kendisi tarafından meydana getirilip getirilmediği sorusu ile merkezimize gönderilen ateşli silah yaralanmasına bağlı ölüm olguları dahil edilmiştir. Olgular kişinin fiziksel-kriminolojik-klinik özellikleri, otopsi bulguları ve diğer postmortem inceleme verileri açısından incelenerek tanımlayıcı istatistik karşılaştırmalar üzerinden tartışılmıştır. BULGULAR: Mevcut ateşli silah yalanmasının veya yaralanmalarının kişinin kendisi tarafından oluşturulup oluşturulamayacağı sorulan 128 olgu tespit edilmiştir. Bunların 111’inde yaralanmanın kişinin kendisi tarafından gerçekleştirilebileceği, 11’inin gerçekleştirilemeyeceği, altısında ise ayrım yapılamadığı belirlenmiştir. Yaralanmanın kişinin kendisi tarafından gerçekleştirilebileceği yönünde raporlanmış olgularda, yaş ortalamasının yüksek olması, olayın özellikle evde olmak üzere kapalı alanlarda olması, intihar notu veya tanık varlığı, olay yerinde silahın maktule temas eder veya yakın pozisyonda olması, kısa namlulu silah kullanılmış olması, ölümcül lezyonun en sık kafada olması, bitişik atış mesafesi parametreleri dikkat çekerken; yaralanmanın kişinin kendisi tarafından gerçekleştirilemeyeceği yönünde raporlanmış olgularda uzun namlulu silah kullanılmış olması, kanda alkol ve giyside atış artıklarının varlığı önemli bulunmuştur. SONUÇ: Kapalı alanda meydana gelmiş, olay yerinde intihar notu veya tanık olan, maktulün ileri yaşlarda olduğu ve kısa namlulu silah ile kafada bitişik atış meydana getirilmiş ateşli silah yaralanmasına bağlı ölüm olaylarında orijin yüksek ihtimalle intihar yönünde değerlendirilebilmektedir.

Anahtar Kelimeler

• Ateşli silah yaralanması
• atış mesafesi
• otopsi
• orijin

Evaluation of origin determination parameters in deaths related to firearm injury

Öz

OBJECTIVE: Detailed evaluation of parameters considered in the origin determination of firearm injuries is aimed in this study. METHODS: Death cases due to firearm injuries that were brought into our center between the dates of January 1, 2008 – December 31, 2012, with the question of whether the injury had been generated by the individual himself/herself or not, were included in the sample group of the study. The cases in this article were analyzed on the basis of statistical comparison taking into consideration physical-criminological-clinical specifications of the victims, findings of the autopsies and the data obtained in other postmortem investigations. RESULTS: One hundred twenty-eight cases dispatched with the question of whether the injury had been generated by the individual himself/herself or not were detected. In the 111 cases out of 128, it was found out that the injuries could have been generated by the individual himself/herself while the cause of injury could not be related to the individual in 11 cases and decision could not be made in six cases. Use of long-barreled weapon, presence of alcohol in blood and gunshot residue on clothes were found to be important in the cases reported in the direction of the fact that injury could not be generated by the individual himself/herself while the parameters of high average of age, occurrence of the incident indoors, especially at home, presence of a suicide note or a witness, close or contacting location of the weapon to the body of the victim on the incident scene, use of short-barreled weapon, presence of the lethal lesion on the head and contact shot were remarkable in the cases where self- injury was at stake. CONCLUSION: Origin most likely indicates a case of suicidewhen firearm injury related death incidents occur indoors, by a short-barreled weapon, causing a contact wound on the head, containing a suicide note, a witness or an old aged victim.

Anahtar Kelimeler

• Firearm injury
• gunshot distance
• autopsy
• origin

Kaynakça

1. Soysal Z, Eke SM, Çağdır AS. [Forensic Autopsy] Volume III. Soysal Z, Eke S, Çağdır A, editors. Deaths due to suicide [in Turk- ish] Istanbul: Istanbul University Publishing Office; 1999. p.1147-9.
2. Maio VD. Gunshot Wounds Practical Aspects of Firearms, Ballistics and Forensic Techniques - Suicide by firearms. 2nd ed. VJM DM, editor. New York: CRC Press; 1999. p.355-67.
3. Poulos CK, Peterson BL. Two cases of firearm grip impres- sions on the hands of suicide victims. Am J Forensic Med Pathol 2012;33 1 :61-3.
4. Bennett AT, Collins KA. Elderly suicide: a 10-year retro- spective study. Am J Forensic Med Pathol 2001;22 2 :169-72.
5. Campanelli C, Gilson T. Murder-Suicide in New Hampshire, 2000. Am J Forensic Med Pathol 2002;23 3 :248-51.
6. Schmeling A, Strauch H, Rothschild M. Female sui- cides in Berlin with the use of firearms. Forensic Sci Int ;124 2 :178-81.
7. Hart Hansen J. Fatalities from firearms in Denmark. Foren- sic Sci 1974;4:239-45.
8. Druid H. Site of entrance wound and direction of bullet path in firearm fatalities as indicators of homicide versus suicide. Forensic Sci Int 1997;88 2 :147-62.

9. Karger B, Billeb E, Koops E, Brinkmann B. Autopsy features relevant for discrimination between suicidal and homicidal gunshot injuries. Int J Legal Med 2002;116 5 :273-8.
10. Selway R. Gunshot suicides in Victoria, Australia, 1988. Med Sci Law 1991;31 1 :76-80.
11. Selway R. Firearm fatalities in Victoria, Australia 1988. Med Sci Law 1991;31 2 :167-74.
12. Gill JR, Lenz KA, Amolat MJ. Gunshot fatalities in chil- dren and adolescents in New York City. J Forensic Sci ;48 4 :832-5.
13. Shkrum M, Ramsay D. Forensic Pathology of Trauma Common Problems for the Pathologist - Pentrating trauma close - range firearm wounds. Shkrum M, Ramsay D, editors. Totowa, New Jersey: Humana Press; 2007. p.295-356.
14. Bennett AT, Collins KA. Suicide: a ten-year retrospective study. J Forensic Sci 2000;45 6 :1256-8.
15. Karlsson T. Multivariate analysis ‘Forensiometrics’ – a new tool in forensic medicine. Differentiation between firearm-related homicides and suicides. Forensic Sci Int ;101 2 :131-40.
16. Altındağ A, Özdemir B, Yanık M. Firearm suicides in Şanlıurfa. Anadolu Psikiyatri Derg 2005;6:240-4.
17. Aşırdizer M, Cantürk G, Cantürk N, Yavuz MS, Sari H. Anal- yses of suicidal deaths with shotguns in Istanbul, 1998-2007. Ulus Travma Acil Cerrahi Derg 2010;16 1 :47-53.
18. Cina SJ, Ward ME, Hopkins MA, Nichols CA. Multi- factorial analysis of firearm wounds to the head with at- tention to anatomic location. Am J Forensic Med Pathol ;20 2 :109-15.
19. Kohlmeier R, McMahan C, DiMaio V. Suicide by fire- arms: a 15-year experience. Am J Forensic Med Pathol ;22 4 :337-40.
20. Nowers M. Gunshot suicide in the County of Avon, England. Med Sci Law 1994;34 2 :95-8.
21. Demirci S, Doğan KH, Deniz I, Erkol Z. Evaluation of shot- gun suicides in Konya, Turkey between 2000 and 2007. Am J Forensic Med Pathol 2014;35 1 :45-9.
22. Garavaglia JC, Talkington B. Weapon location follow- ing suicidal gunshot wounds. Am J Forensic Med Pathol ;20 1 :1-5.
23. Felthous AR, Hempel A. Combined homicide-suicides: A review. J Forensic Sci 1995;40 5 :846-57.
24. Lee CJ, Collins KA, Burgess SE. Suicide under the age of eighteen: a 10-year retrospective study. Am J Forensic Med Pathol 1999;20 1 :27-30.
25. Weinberger LE, Sreenivasan S, Gross EA, Markowitz E, Gross BH. Psychological factors in the determination of sui- cide in self-inflicted gunshot head wounds. J Forensic Sci ;45 4 :815-9.
26. Özaslan A, Koç S, Üner B. [Shotgun and Legal Regulations Turkish]. Acta Turcica 2009;1 1 :181-200.
27. Yücel Beyaztaş F. The Determination of discharge distance with shotgun. Cumhuriyet Üniv Tıp Fak Derg 2003;25 1 :43-6.
28. Thomsen JL, Albrektsen S. An investigation of the pattern of firearms fatalities before and after the introduction of new legislation in Denmark. Med Sci Law 1991;31 2 :162-6.
29. Thoresen S. Fatal head injuries from firearms. Z Rechtsmed 1984;93 2 :65-9.
30. Avis SP. Suicidal gunshot wounds. Forensic Sci Int ;67 1 :41-7.
31. Nikolić S, Zivković V, Babić D, Juković F. Suicidal single gunshot injury to the head: differences in site of entrance wound and direction of the bullet path between right-and left-handed--an autopsy study. Am J Forensic Med Pathol ;33 1 :43-6.
32. Miller M, Azrael D, Hemenway D. Firearm availability and unintentional firearm deaths, suicide, and homicide among 14 year olds. J Trauma Acute Care Surg 2002;52 2 :267-75.
33. Gören S, Gürkan F, Tıraşçı Y, Özen Ş. Suicide in children and adolescents at a province in Turkey. Am J Forensic Med Pathol 2003;24 2 :214-7.
34. Eisele J, Reay D, Cook A. Sites of suicidal gunshot wounds. J Forensic Sci 1981;26 3 :480-5.
35. Knight B. Forensic Pathology - Gunshot and explosion deaths. 2nd ed. Knight B, editor. New York: Oxford University Press; 1996. p.243-74.
36. Kury G, Weiner J, Duval JV. Multiple self-inflicted gunshot wounds to the head: report of a case and review of the litera- ture. Am J Forensic Med Pathol 2000;21 1 :32-5.
37. Sekula-Perlman A, Tobin JG, Pretzler E, Ingle J, Callery RT. Three unusual cases of multiple suicidal gunshot wounds to the head. Am J Forensic Med Pathol 1998;19 1 :23-9.
38. Hudson P. Multishot firearm suicide: examination of 58 cases. Am J Forensic Med Pathol 1981;2 3 :239-42.
39. Karger B, Brinkmann B. Multiple gunshot suicides: poten- tial for physical activity and medico-legal aspects. Int J Legal Med 1997;110 4 :188-92.
40. Stone IC. Characteristics of firearms and gunshot wounds as markers of suicide. Am J Forensic Med Pathol ;13 4 :275-80.
41. Kunz S, Brandtner H, Meyer H. Unusual blood spatter pat- terns on the firearm and hand: A backspatter analysis to re- construct the position and orientation of a firearm. Forensic Sci Int 2013;228 1-3 :54-7.
42. Karger B, Nüsse R, Brinkmann B, Schroeder G, Wüsten- becker S. Backspatter from experimental close-range shots to the head. Int J Legal Med 1996;109 2 :66-74.
43. Azmak D, Altun G, Koç S, Yorulmaz C, Özaslan A. Intra-and perioral shooting fatalities. Forensic Sci Int 1999;101 3 :217-27.
44. Karger B, Billeb E, Koops E. Accidental firearm fatalities. Int J Legal Med 2002;116 6 :350-3.
45. Ditrich H. Distribution of gunshot residues–The influence of weapon type. Forensic Sci Int 2012;220 1 :85-90.