Atypical gunshot entrance wound and extensive backspatter

This case report describes a suicidal gunshot to the head using a solid hollow-point bullet (Quick Defense). There was an irregular skin defect measuring 16 x 6 cm on the right side of the head and a bone defect of 9 x 6 cm while a 1.2 x 0.7 cm skin defect was located at the left temple. This atypical wound morphology caused confusion at the scene but during autopsy, a muzzle imprint and an abrasion ring were found in the frontal aspect of the large skin defect in the right temporoparietal region, which therefore had to be the entrance wound. In addition, extensive backspatter consisting of brain tissue, bone fragments and blood had been expelled from the huge entrance wound and had travelled up to a distance of 4.6 m. The extraordinary entrance wound cannot be fully explained by special anatomical or ballistic features such as a muzzle velocity of 420 m/s or the solid hollow-point design of the bullet.