Complex suicide-A novel case report and a brief review of literature

Background:Suicides are usually known to be either simple or complex, the latter which is defined as a combination of more than one method. Additionally, complex suicide can be practiced in an unplanned manner where several methods are used, consecutively, when the first method has not achieved the desired outcome. The procedure usually gets changed after the first method chosen failed, was working slowly, or proven to be overly painful. The rotation between failed suicidal acts causes difficulties in determining the manner and the mode of death. Method: In the present study, we will discuss some of the relevant previous studies regarding complex suicide and a systematic approach to managing such cases from a medicolegal perspective. Besides, an unusual case of complex suicide, which was handled in 2018 in the Kuwaiti Forensic Medicine Department, will be presented. She is a middle-aged female, domestic worker, who was found dead in the bathroom, with secured inlets and outlets from inside. She was incompletely hanged with multiple neck, chest, and abdominal cut wounds, apart from bilateral wrist cut. Furthermore, bloody knife, razor and razor-blade were found inside the basin. Result and conclusion: After a complete autopsy, forensic pathology and toxicology examination were done, the forensic and crime scene reports together with the criminal investigations were declared. Consequently, the case was reported as a complex suicide case and the cause of death was haemorrhagic shock after lung stabbing. The case represents a novel complex suicide with self-stabbing, wrist cutting and hanging