Lethal head injury due to tear-gas cartridge gunshots

Two case reports of fatal injuries sustained from tear gas guns loaded with pebbles as missiles

These two case reports are of fatal injuries from less-lethal weapons (tear gas guns) using pebbles as an unconventional ammunition. Reported here are the fatal outcomes of two 19-year-old males, one with head trauma and the other with abdominal trauma. They were admitted to the ED and subjected to immediate exploratory operations, but they passed away. On autopsy, the first case demonstrated a right frontal bone fracture with subdural hemorrhage and a 3 × 2.5 cm pebble retained in the skull. The second case showed severe liver laceration in close vicinity to a cubical pebble (3.2 × 3 cm). The mechanical forces involved in skull fracture and autopsy are discussed. In the current cases, the relatively larger weight and size together with the surface configuration of the pebble projectile were the main influential factors that contributed to the severity of damage and fatality.These case reports are a working example of the effect of the mass of projectiles in increasing the power of penetration. The direct shooting to the head and the abdomen together with the misuse of these weapons are capable of inflicting fatal injuries.

Investigation of the variability in the tool marks produced by modified blank firing pistols on fired 7.65 mm projectiles

Firearms identification has an important place in forensic ballistic investigations since the weapons are widely used in criminal offences. Firearm examiners resolve many case files, through the use of automatic systems or comparison microscopes. Advanced forensic technologies like BALİSTİKA helps to record and analyze non standard ballistic evidence. In today's world, with the ease of access to materials and production technique information, pistols modified from blank firers are frequently encountered as crime tools. In this study, the characteristics of 7.65 mm fired cartridge cases obtained by controlled shots from blank firing modified pistols were examined, and their detection performances were compared by means of the Balistika system. Although distinctive differences are not expected after successive test shootings, balistically important changes were seen after the use of blank firing modified pistols and the 3D imaging system proved to be useful in observing such differences. The analyses showed that the modifications in weapons lead to variation in the ballistic characteristics and reduce the accuracy of the detection performance, which may result in flawed forensic decisions. It was also found that the deviations in ballistic impressions of modified blank firing pistols were greater than that of standard fabricated and hand-made pistols. This unique study contributed to the forensic sciences literature by focusing on the impact of modified weapons on ballistic characteristics.

Fatal Penetrating Head Injuries Caused by Projectile Tear Gas Canisters

BACKGROUND

Since their advent in the 1920s, tear gas canisters (TGCs) have been frequently used in crowd control. Few reports have documented nonpenetrating injuries attributed directly to TGCs. In this study, we report a case series of fatal penetrating head injuries caused by TGCs.

METHODS

We conducted a retrospective chart review of all the patients who were admitted to the Neurosurgery Teaching Hospital in Baghdad, Iraq, since the start of the antigovernment protests (October 2019). All patients who suffered penetrating head trauma caused by TGCs were included in our study. We collected patient demographics, wound location, neurologic examination, computed tomography (CT) scan findings, surgical management, and clinical outcomes.

RESULTS

We found 10 cases of penetrating head trauma caused by TGCs. All victims were men, with a mean age of 16 years (range, 14-19 years). The mean Glasgow Coma Scale score was 7 (range, 3-10). The neurologic examination revealed unilateral hemiplegia/hemiparesis and pupillary abnormality in 40% (n = 4) and 50% (n = 5) of the patients, respectively. CT scans revealed an extensive pattern of brain damage. Surgical intervention was done in 80% of cases (n = 8), which included removal of the TGC, wound debridement, and hemostasis. The in-hospital mortality rate was 100% (N = 10), with all fatalities occurring within 1-3 days of admission.

CONCLUSIONS

TGCs have the potential to cause lethal penetrating head injuries, calling for a reevaluation of their safety and methods of use in terms of human health.

Direct head injury caused by a tear gas cartridge. Questions on safety: A case report from Iraq and review of the literature

INTRODUCTION AND BACKGROUND

Primary injuries from tear gas weapons include injuries to the visual and respiratory systems and skin. However, few studies have reported direct mechanical brain injuries from tear gas weapons.

CASE REPORT

A 27-year-old male presented to the emergency department of a neurosurgery teaching hospital in Baghdad, Iraq, with a penetrating head injury of unknown source.

DISCUSSION

Tear gas weapons are considered safe, but tear gas exposure causes severe complications. Traumatic brain injuries as a direct effect of tear gas bombs are rarely reported in the literature. Tear gas cartridge injuries should be managed in the same manner as any penetrating brain injury, with appropriate neuromonitoring. This monitoring is crucial for the detection and prevention of secondary brain insults.

CONCLUSION

Emergency medicine specialists and neurosurgeons should be aware that tear gas weapons are not always safe, and they should anticipate chemical, thermal and mechanical side effects of tear gas weapons. The literature and our results suggest that these weapons should not be considered civil and harmless.

Wound morphology in contact shots from blank cartridge handguns: a study on composite models

It is a well-known fact that blank cartridge guns can cause penetrating and even fatal injuries when discharged in contact or at very close ranges. In these cases, the gas jet perforates the skin leaving an entrance wound similar to that from a conventional gun. In order to investigate the wound morphology in contact shots from blank firearms, test shots were fired at composite models of pig skin and gelatin blocks using three different calibre 9-mm blank cartridge handguns (two pistols and one revolver) and two types of ammunition. It turned out that the penetrating gas jet produced roundish skin defects resembling bullet entrance holes. Small skin particles from the perforation site were dispersed in the underlying simulant where radiating cracks containing greyish gunshot residues indicated the original expansion of the inrushing combustion gases. Apart from the size of the permanent entrance hole in the skin and the final position of the displaced tissue particles, the penetration depth of the gas jet was determined. Under the specified conditions of the test shots, the zone of mechanical destruction within the simulant was 2.2 to 6.1 cm in length, which illustrates the injuring potential of contact shots inflicted with blank cartridge handguns.

Tear gas: an epidemiological and mechanistic reassessment

Deployments of tear gas and pepper spray have rapidly increased worldwide. Large amounts of tear gas have been used in densely populated cities, including Cairo, Istanbul, Rio de Janeiro, Manama (Bahrain), and Hong Kong. In the United States, tear gas was used extensively during recent riots in Ferguson, Missouri. Whereas tear gas deployment systems have rapidly improved-with aerial drone systems tested and requested by law enforcement-epidemiological and mechanistic research have lagged behind and have received little attention. Case studies and recent epidemiological studies revealed that tear gas agents can cause lung, cutaneous, and ocular injuries, with individuals affected by chronic morbidities at high risk for complications. Mechanistic studies identified the ion channels TRPV1 and TRPA1 as targets of capsaicin in pepper spray, and of the tear gas agents chloroacetophenone, CS, and CR. TRPV1 and TRPA1 localize to pain-sensing peripheral sensory neurons and have been linked to acute and chronic pain, cough, asthma, lung injury, dermatitis, itch, and neurodegeneration. In animal models, transient receptor potential inhibitors show promising effects as potential countermeasures against tear gas injuries. On the basis of the available data, a reassessment of the health risks of tear gas exposures in the civilian population is advised, and development of new countermeasures is proposed.

Demonstration control agents: evaluation of 64 cases after massive use in Istanbul

An uncontrolled use of "demonstration control agents" commonly known as "teargas agents" has recently been a common practice in Turkey. One of the first massive uses of these agents had been during a meeting of the North Atlantic Council and NATO in 2004, in Istanbul. After the demonstrations, 64 patients were evaluated and treated by the Human Rights Foundation of Turkey. Their files have been reviewed retrospectively and were classified regarding age, sex, physical findings related of chemical agents, and other injuries.The patients were received 1 to 9 days after the chemical gas exposure. The maximum referral was 35 patients on the day of the gas exposure. The last application was 9 days after the exposure. Complaints and physical findings/symptoms were highest during the first 3 days.This study has been carried out to reveal the short- and long-term aftereffects of "demonstration control agents." The safety and effects of these agents are discussed in this article, based on our findings and existing references.

Upon a failure to equal entry and exit wounds: a possible case of tandem bullets in view of the literature

Forensic medicine specialists take account of the projectiles remaining in the body when determining whether there are an equal number of entry and exit wounds. The absence of projectiles should suggest blank cartridges, a single exit wound despite several firings and bullet embolization, whereas the presence of more projectiles than expected may indicate tandem projectiles and multiple projectiles entering through the same hole. Radiological examination of the whole body, follow-up of the bullet trajectories, examination of the clothes, and examination of the gun and projectiles play a key role in solving difficult cases. We review such situations based on a case of tandem bullets. Two 7.65-mm bullets created lethal wounds entering through a 32-year-old victim's neck followed the same trajectory to a certain point and diverted. We discussed the possibilities in cases that show inequalities between entry and exit wounds, in light of relevant literature.

Three cases of death caused by shots from blank cartridge

The authors describe 3 cases of lethal injuries caused by 7.62 mm blank cartridge shots from military automatic rifle of domestic origin (AK 47, 7.62 mm). In 1 case, the cartridge was fired from a weapon that had been leaned on the head, with subsequent destruction of brain, and in other 2 cases, the weapon had been leaned on the chests, which led to destruction of heart parts. The injuries were caused by the action of striking wave of gunpowder explosion, the air blast type. The cases demonstrate that the gas pressure from the exploding propellant of blank cartridge is powerful enough to penetrate the thoracic wall and the skull.

Fatalities caused by spherical bullets fired from blank cartridge guns in Istanbul, Turkey

Blank cartridge guns are generally regarded as being harmless and are not considered to be firearms in the legal sense in most countries. To show the danger of these guns upon simple modifications, we report 59 fatalities resulting from these simply modified blank cartridge guns in Istanbul, Turkey. The great majority of the victims were males and the age of those ranged from 11 to 61 years. In 55.9% of these cases, homicide was the origin followed by suicide (39%). The right temporal region was detected to be the preferred region in suicidal shots by blank cartridge guns with a frequency of 56.5%. In trial shots, all these guns were detected to discharge steel or lead spherical objects, generally 4 or 5 mm in diameter, successfully. Our findings strongly suggest that these guns should also be considered as handguns in the legal sense.