Suicidal tandem bullets to the heart with subsequent embolization – a case report

A tandem bullet phenomenon is a rare situation in which two bullets travel nose-to-base towards the target. In terminal ballistics, a classic feature of the tandem bullet phenomenon is the presence of a single entrance wound with two or more bullets inside the body. During the autopsy, the phenomenon may result in confusion, especially related to the dynamics of the shooting. The present study reports a case of suicide by tandem bullets to the heart with subsequent bullet embolization into the aorta. A 40-year-old Caucasian woman, with a previous history of suicide, shot herself in the chest with a 0.32 revolver. During the autopsy, a single entrance wound (one centimeter in diameter) was observed in the sternal region. The injury was a close-range shot. Internally, a single wound was detected in the right atrium of the heart. Two 0.32 S&WL lead bullets were found inside the descending abdominal aorta. The bullets fitted each other perfectly in a nose-to-base position. Both bullets were tracked back to a single firearm that belonged to the victim’s father using forensic ballistics. The forensic report suggested a suicide. A multidisciplinary approach involving crime scene investigation, forensic pathology and forensic ballistics is necessary to investigate tandem bullet cases. Forensic experts must be aware of this phenomenon and, more importantly, they must be aware of its unusual manifestations, such as embolization, in order to come to optimal conclusions.