Legal Medicine 15 (2013) 35–37

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Legal Medicine
journal homepage: www.elsevier.com/locate/legalmed

Case Report

Air gun injury with deadly aftermath – Case report

Aleksandar Stankov a,⇑, Zlatko Jakovski a, Goran Pavlovski a, Nedzat Muric d, Andrew J. Dwork a,b,c,
Zdravko Cakar a
a
Institute of Forensic Medicine, Criminalistic and Medical Deontology, Ss. Cyril and Methodius University, School of Medicine, Skopje, Republic of Macedonia
b
Department of Pathology and Cell Biology, College of Physicians and Surgeons of Columbia University, United States
c
Department of Psychiatry, College of Physicians and Surgeons of Columbia University, Division of Molecular Imaging and Neuropathology, New York State Psychiatric Institute,
United States
d
Ministry of Internal Affairs, Forensic Department Ballistic and Mechanoscopy Unit, Republic of Macedonia

a r t i c l e i n f o a b s t r a c t

Article history: In Republic of Macedonia the use of air guns is quite widespread. They are used mainly for target practice.
Received 21 March 2012 They are regulated by the Law of Arms, where they are defined as pneumatic weapons. There is no legal
Received in revised form 8 August 2012 limit on type or quantity of ammunition that one may possess. Our Institute performs at least 90% of the
Accepted 8 August 2012
forensic autopsies in Macedonia. In this report we describe the only fatality by pneumatic weapon to
Available online 25 September 2012
come to our attention over the past 10 years. A 6-year-old girl was accidentally wounded by her brother
when he and his father were trying a new air gun, a 4.5 mm single shot, break barrel, spring piston air
Keywords:
rifle manufactured in China under the brand ‘‘Westlake’’. She died within minutes. Autopsy showed car-
Air gun injury
Deadly aftermath
diac tamponade due to penetration of the aorta. A 0.5 g metal projectile, 4.5 mm in diameter, with a
Law control pointed, conical shape, was recovered from the pericardial sac.
Ó 2012 Elsevier Ireland Ltd. All rights reserved.

1. Introduction
In Republic of Macedonia, the use of air guns is quite wide-
spread. They are used mainly for target practice. At the time of
the incident reported in this paper, they were regulated by the
law of arms [1] (Official Gazette No. 7/05 of 1 February 2005),
where they were defined as pneumatic weapons. These include
all types of long guns, pistols, and other devices that, under the
pressure of compressed air or other gas, discharge a bead, ball or
other projectile. All pneumatic weapons with projectile energy
up to 7.5 J and caliber up to 4.5 mm fall into class C. All that is
required to possess them is a license that is easy to obtain. Any
pneumatic weapon with greater energy or caliber fell into class
B, for which special approval was necessary. There is no legal limit
on type or quantity of ammunition that one may possess. Our Insti-
tute performs at least 90% of the forensic autopsies in Macedonia.
In this report we describe the only fatality by pneumatic weapon to
come to our attention over the past 10 years.
2. Case history
A 6-year-old girl was accidentally wounded by her brother when
he and his father were trying a new air gun. She was running in the
⇑ Corresponding author. Tel.: +389 75490545; fax: +389 23178831.
E-mail address: astankov@medf.ukim.edu.mk (A. Stankov).
back yard of the house, very close to her brother and her father.
The gun was folded for insertion of the projectile and misfired as
soon as the barrel and stock were rejoined. According to the father,
the girl started crying immediately and fell, but she remained
conscious and crying while carried to bed. A doctor living in the
neighborhood arrived within 5 min but could do nothing, and the
girl expired within 10 min of the shot. By order of the investigating
judge, we investigated the scene and performed an autopsy. After
our report, we were not asked for further testimony; the case was
apparently treated as an accident, without prosecution.
3. Results
3.1. Autopsy findings
The entrance wound was on the right side of the chest (Fig. 1),
7 cm to the left and above the right nipple and 90 cm above the
heel. The wound was circular with a diameter of 3 mm. There
was an eccentric abrasion collar, 2 mm wide, in the upper right
margin around the hole. The projectile passed downwards and left
through the right second intercostal muscle in the parasternal line,
through the superior lobe of the right lung to the pericardial sac at
the base of the heart, where it left two stellate perforations in the
wall of the aorta. The projectile was found in the bottom of the
pericardial sac, which was completely filled with blood. Cause of
death was cardiac tamponade.

1344-6223/$ - see front matter Ó 2012 Elsevier Ireland Ltd. All rights reserved.
http://dx.doi.org/10.1016/j.legalmed.2012.08.004
36 A. Stankov et al. / Legal Medicine 15 (2013) 35–37
Fig. 1. Circular entrance wound with a diameter of 3 mm and eccentric abrasion
collar, 2 mm wide, in the upper right margin around the hole.
Fig. 2. Lead pellet found in the bottom of the pericardial sac.
3.2. Ballistic examination
The caliber of the lead pellet was 4.5 mm. It had a pointed, con-
ical shape and weighed 0.5 g (Fig. 2). It was not deformed, and it
was identical to test shots of unfired ammunition recovered with
the weapon (Fig. 3). The weapon was a 4.5 mm single shot, break
barrel, spring piston air gun with the brand name ‘‘Westlake’’.
The police did not perform ballistic tests to determine the projec-
tile energy, but based on the classification of the weapon as ‘‘C’’,
the energy is presumably 7.5 J or less.
4. Discussion
Fatalities from pneumatic weapons are very rare. Most of them
are accidents, but there are occasional homicides and suicides
[2,3]. Di Mayo noted only four lethal cases throughout his career
[4].
The potential for lethal injuries depends on the ability of the
discharged projectile to penetrate, which depends in turn on its
muzzle energy (1/2 mass of projectile  velocity2), shape of
projectile, distance from which the shooting is done, and of course,
the anatomical region hit by the projectile. There are three basic
systems for discharging the projectile from an air gun. Pneumatic
air guns have an air chamber into which air is pumped. The projec-
tiles achieve a maximum speed of 235 m/s. The spring air compres-
sion system derives its energy from the cocking of the gun. The
maximum speed of a 4.5 mm caliber projectile is 305 m/s. Gas
Fig. 3. Unfired ammunition recovered with the weapon.
compression systems, which use carbon dioxide from a disposable
cartridge, achieve the muzzle velocities comparable to those of
spring guns of the same caliber [4]. Experiments made on human
lower extremities show that a 0.59 g projectile with a calibre
4.5 mm needs a velocity of at least 100 m/s (energy = 2.95 J; energy
density = 0.19 J/mm2) to perforate skin. A 1-gram projectile with a
calibre of 5.5 mm, can perforate skin at velocity of 74 m/s [5]
(energy = 2.74 J; energy density = 0.12 J/mm2). These experiments
suggest, not surprisingly, that the energy of the projectile is closely
related to its potential for injury. Furthermore, the energy required
to perforate skin is well below that achieved by many Class C air
guns (up to 0.44 J/mm2) and by all class B air guns. The shape of
the projectile and the distance at which it was shot are also impor-
tant. In one study, projectiles with various shapes were fired into
ballistic gel. Pointed projectiles caused 11–53% more penetration
than projectiles with rounded tips.
Investigating the behavior of air gun pellets in ballistic gel and
their interaction with bone [6], Hallikeri et al. [7] performed
experimental shots with 4.5 mm caliber pellets, weighing 0.5 g,
from three different distances (contact, 15 cm, 30 cm). Dimensions
of the entrance perforation and depth of penetration depended
on the distance from which shots were fired. At close range, the
entrance perforation measured 4.5 mm in diameter, and the pene-
tration was 13 cm deep. The entrance perforation made by a pellet
shot from 15 cm was 4.2 mm in diameter with penetration of 8 cm,
and from 30 cm, the entrance perforation measured 4.0 mm in
diameter and penetration was 6 cm.
An entrance wound inflicted by an air gun pellet appears as a
round hole with an abrasion collar. There will be no evidence of a
powder explosion, such as tattooing, burns or soot. Because of the
low kinetic energy, tissue damage is less extensive than with a con-
ventional gunshot wound, and there is no evidence of injury remote
from the bullet’s path. Long-range air gun wounds are difficult to
distinguish from long-range gunshot wounds, differing mainly by
the extent of tissue damage. Lethal wounds are localized in the head,
especially in children, whose thin skulls can be perforated by
pellets. In adults, wounds are localized in the orbits or other exten-
sively perforated weak spots, such as the cribriform plate.
Although restrictions on air guns were more rigorous in Mace-
donia than in many other countries, this unfortunate case shows
how lax restrictions on pneumatic weapons can lead to lethal con-
sequences. We are especially concerned about the lack of control
over the type and amount of ammunition that any holder of such
weapons may have. The law in Macedonia was changed in 2010,
removing distinctions among pneumatic weapons of different
energies, but restricting their use to controlled spaces, such as
target ranges. This report of a tragic fatality with a weapon of
relatively low energy confirms the need for such control.
 A. Stankov et al. / Legal Medicine 15 (2013) 35–37 37

References [5] DiMaio VJM, Copeland AR, Besant-Matthews PE, et al. Minimal velocities
necessary for perforation of skin by airgun pellets and bullets. J Forensic Sci
1982;27:894–8.
[1] Law of Weapons of Republic of Macedonia, Official Gazette No. 7/05 of 1
[6] Wightman G, Beard J, Allison R. An investigation into the behaviour of air gun
February 2005.
pellets in ballistic gel and their interaction with bone. Forensic Sci Int
[2] Milroy CM, Clark JC, Carter N, Rutty G, Rooney N. Air weapon fatalities. J Clin
2010;200:41–9.
Pathol 1998;51:525–9.
[7] Hallikeri VR, Gouda HS, Kadagoudar SA. Country made scare gun vs. air gun–a
[3] Green GS, Good R. Homicide by use a pellet gun. Am J Forensic Med Pathol
comparative study of terminal ballistics using gelatine blocks. Forensic Sci Int
1982;3:361–5.
2012;214:148–51 [Epub 2011 Aug 11].
[4] DiMaio VJM. Gunshot wounds practical aspects of firearms, ballistics, and
forensic techniques. 2nd ed. New York: CRC Press LLC.; 1999.