Suffocation by massive blood aspiration due to intraoral gun-shot injury –the oldest museum specimen in the Institute of Forensic Medicine in Belgrade

The forensic museum specimen presented in this paper is the oldest specimen in the collection of the Institute of Forensic Medicine in Belgrade. It comprises a jar containing six cervical vertebras connected to a small amount of dry connective tissue. During the autopsy, the cervical part of the spine was completely opened posteriorly: the base of the odontoid process of the axis was crushed, but the transverse and posterior longitudinal ligaments and the spinal cord were intact. Attached to the specimen, there is a partly cored piece of lead which looks like a severely deformed handgun projectile, approximately 12 mm in diameter. The deceased was a 23-year-old man who committed suicide with a gun in a public park. The gun used was most probably a Nagant M1893 revolver, popular in the region until the end of the Second World War. The pathologist, Dr. Eduard Michel, concluded that the immediate cause of death was asphyxiation due to massive blood aspiration caused by an intraoral gunshot wound. Although the revolver model used is a low-velocity firearm, in such cases the shock wave secondary to the impact of the projectile on the second vertebral bone is likely to have been the cause of widespread neuro-axonal damage at the level of the spinal cord, however, Dr. Michel assumed that death was not instantaneous due to massive hemoaspiration. Nevertheless, without examination of all internal organs and the cervical spine, this case could have remained unexplained.