A 61-year-old man was found dead at night in the stairwell of the apartment building he lived in by a neighbor after the neighbor heard a “wolf-like growl” and went to investigate. The body showed extensive injuries on both wrists. From where the body was found in the stairwell, traces of blood ran through the open apartment door into the apartment’s bathroom. Large areas of blood, two bloody razor blades, and a denture with chunks of flesh were found there. A pack of “ibuprofen” (NSAID, 400 mg) was also detected in the apartment. Five tablets were missing. A suicide note was not found.

The man was an “artist,” smoked heavily, and abused illicit drugs for decades. According to the neighbors, he had recently exhibited schizophrenic traits and was apparently suffering from paranoia. Yet there were no hints for medical treatment.

Together with the pale body, two bloodied sharp razor blades and a bloodied lower jaw prosthesis with dried soft tissue–like adhesions were presented at post-mortem examination. Modifications on the prosthesis such as sharpening or filing were not noticeable (Fig. 1). The facial skin in the nose and mouth area was smeared with blood, as were the (own) front teeth (Fig. 2). Some metal pin teeth were implanted in the upper jaw.

Bloodied sharp razor blades and bloodied lower jaw prosthesis

Face and front teeth smeared with blood

On the inside of the right wrist, there was a deep injury that appeared to be mangled measuring approximately 5 × 4 cm, as well as a superficial, longitudinal skin incision approximately 15 cm long and further transverse, deeper skin incisions approximately 4 cm long with smooth edges of the wound with surrounding hesitation marks (Fig. 3). On the left wrist, there was another deep flesh wound, approximately 5 × 5 cm in size, which appeared to have been mangled, with hesitation marks surrounding it (Fig. 4).

On the left wrist, there was tearing of all flexor tendons and gross tears of the superficial skin veins. The left radial artery was roughly severed and torn. On the right wrist, the superficial flexor tendons were severed, and the large skin veins were extensively torn. In addition to the signs of severe blood loss (sparse livor mortis, pale internal organs), there was evidence of poisoning at the time of death with an enlarged urinary bladder (500 ml urine) as well as edema of the lungs and brain. The remaining organ findings were age-appropriate. There were no soft tissue particles in the stomach. Cause of death was hemorrhagic shock.

Toxicological analysis revealed that opiates and methadone had been ingested close before death, but not in toxic-lethal levels. NSAID was not detected, and there was no alcoholic influence at the time of death. Hair analysis showed that the man had frequently consumed methadone and heroin as well as occasional cocaine, amphetamine, buprenorphine, and benzodiazepines in the last few months prior to death.