@article{ref1,
title="A forensic analysis on 53 cases of complex suicides and one complicated assessed at the Bureau of Legal Medicine of Milan (Italy)",
journal="Forensic science international",
year="2020",
author="Zoja, Riccardo and Tambuzzi, Stefano and Galante, Nicola and Gentile, Guendalina",
volume="319",
number="",
pages="e110662-e110662",
abstract="Complex suicides are highly uncommon suicides in which multiple detrimental methods are used simultaneously or in chronological succession. We retrospectively analyzed  through our database the 25512 autopsy reports registered at the Bureau of Legal  Medicine of Milan in the last 27 years from 1993 until 2019, where 4498 suicides  were documented. We assessed 53 cases of complex suicides and only one case of  complicated suicide: for all of them we analyzed both data collected during the  on-site investigation and the autopsy. In our case series, we identified a total  number of 113 methods chosen and variably combined by the victims, which were  classified into 17 categories. On the whole the most frequent association of suicide  methods resulted in the combination of the plastic bag suffocation with inert gas  inhalation (13 out of 53 complex suicides; 24.5%). We also analyzed our cases of  simple suicides (1993-2019), to compare them with the complex suicides. In this  study, we present a complete analysis regarding our cases of complex suicides,  discussing the challenges and the interpretative issues which a forensic pathologist  might deal with. A thorough on-site judicial inspection and a careful autopsy  examination are crucial in such cases. Moreover, the clinical history of the victims  and laboratory findings are supplemental elements to be necessarily considered to  establish the actual manner of death and avoid any misinterpretations.<p /> <p>Language: en</p>",
language="en",
issn="0379-0738",
doi="10.1016/j.forsciint.2020.110662",
url="http://dx.doi.org/10.1016/j.forsciint.2020.110662"
}