Nail Gun Suicide: An Atypical Case Report and Review of the Literature

Suicide by a construction nail fired from a pistol

Penetrating head injury to accomplish suicide by a non-ammunition-related projectile discharged from a nail-gun is a very rare entity. The authors describe even much rarer, and the first reported case of a suicide penetrating head injury by a construction nail discharged from a blank cartridge of a pistol. The absence of beveling and muzzle impression, the non-ejection of the discharged cartridge, and the exit of just the tip of the nail from the other side of wound were the atypical features in this firearm fatality sustained at a contact-range. The entry wound prototypes like abrasion and grease collar, and blackening were absent. An improvisation to insert a construction nail into the chamber of firearm, for utilization as a projectile was another unique highlight here. The deceased was a construction builder. Being debt-ridden, he probably could not manage to purchase even one live cartridge for his licensee pistol to bring suicidal ideation to culmination.

Delayed Surgical Intervention for a Self-Inflicted Left Chest Injury From a Nail Gun: Addressing 28 Nails Six Months Post-incident

In 2021, there were 1.7 million suicide attempts in the US, with firearms being the most common method used, comprising more than 50% of attempts. We present a case report of delayed operative intervention for foreign body removal after a suicide attempt using a nail gun fired into the left hemi thorax. Initial conservative management was complicated by the delayed presentation of hemoptysis requiring surgical intervention. We hypothesize that the delay was secondary to foreign body migration. Initial management was attempted robotically, but dense adhesions were encountered, requiring conversion to an open thoracotomy. Twenty-eight nails were removed. The post-operative course was uncomplicated.