A fatal case of suicidal stabbing and cutting.

A 36-year old male was found dead inside a pub bath lying in a pool of blood. A small single-edged knife was discovered on the top of the water cistern. Multiple sharp weapon wounds at the usual sites of self-inflicted injuries were reported. It was possible to hypothesize a carotid artery injury as a bloodstain pattern compatible with high pressure blood exiting from a severed artery. At autopsy 39 stab and incised wounds were found: the left forearm showed 13 incised wounds, one of which deep enough to sever the radial artery, while 14 ones were found on the right forearm. Neck observation revealed three deep cut injuries but none reached the internal jugular vein or the carotid artery. On the chest there were nine stab wounds, one of which injured the heart apex leading to a 80ml haemopericardium. Toxicological screening resulted as negative. Death was attributed to haemorrhagic shock following left radial artery injury. On the basis of circumstantial evidences and autopsy findings, there was no doubt that this was a suicide. The authors suggest that a complete forensic approach by means of scene investigation, autopsy as well as toxicological analysis is fundamental in discriminating between homicide and suicide.