A rare case of planned complex suicide involving multiple methods: forensic reconstruction and interpretive challenges

Abstract

Planned complex suicides that combine multiple mechanisms pose substantial challenges for medicolegal reconstruction. We report a rare case of a 27-year-old man who simultaneously employed four methods: plastic-bag asphyxia with a continuous natural-gas supply (stove hose taped to bag tubing), environmental sealing of door seams with adhesive tape, rodenticide ingestion, and superficial incised injuries to the neck and wrist. Scene reconstruction, full autopsy, and comprehensive toxicology established asphyxia from natural-gas inhalation via the plastic-bag apparatus as the cause of death; anticoagulant rodenticides and superficial sharp-force injuries were contributory but not independently lethal. The high level of technical preparation supported classification as a planned complex suicide and underscores the need for integrated, multidisciplinary assessment to avoid misclassification as homicide and to weigh contributory mechanisms appropriately.