Sathish Ayyappan Senior Resident, Department of Forensic Medicine and Toxicology, All India Institute of Medical Sciences, Jodhpur, Rajasthan,, India
Nirmal Kumar E.S. Assistant Professor, Department of Forensic Medicine and Toxicology, Madha Medical College, Chennai, Tamil Nadu,, India
Mohammed Akbar N.J. Senior Resident, Department of Forensic Medicine and Toxicology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
Address for correspondence: Sathish Ayyappan, Senior Resident, Department of Forensic Medicine and Toxicology, All India Institute of Medical Sciences, Jodhpur, Rajasthan,, India E-mail: jipmersathish@gmail.com
This license enables reusers to distribute, remix, adapt, and build upon the material in any medium or format for noncommercial purposes only, and only so long as attribution is given to the creator.
Ayyappan S, Kumar E.S. N, Akbar N.J. M. Planned Complex Suicide involving Phenyl ingestion and Hanging: A Medico-Legal Autopsy Report. J Forensic Chem Toxicol. 2025;11(2):115-20.
Timeline
Received : July 30, 2025
Accepted : September 27, 2025
Published : December 30, 2025
Abstract
Complex suicide is the use of more than one suicidal method to commit suicide. They are primary and secondary complex suicides depending on the utilization of multiple suicidal methods in a simultaneous or one-after-another manner. We are reporting a case of a planned complex suicide of a 47-year-old male who ingested
a floor cleansing agent (phenyl) and simultaneously hanged himself. There was no suicide note at the scene of the incident. History of previous suicidal attempts and depression present. During the autopsy, a pressure abrasion was seen running obliquely above the thyroid prominence, sparing the nape of the neck. The neck
structures underneath the ligature mark were intact. All the visceral organs were congested. Petechial hemorrhages were present over both lungs and the heart. The stomach contains 700 ml of pink-colored fluid with a pungent odor, and the mucosa is congested. The toxicology screening of the blood and stomach contents
was positive for phenyl. This case report discusses the forensic implications associated with complex suicides by differentiating them from homicide.
References
1. Cingolani M., Tsakri D. Planned complex suicide: report of three cases. Am J Forensic Med Pathol. 2000; 21(3): 255-60. http://dx.doi. org/10.1097/00000433-200009000-00015
2. Kaliszan M., Karnecki K., Tomczak E., Gos T., Jankowski Z. Complex suicide by self-stabbing with subsequent drowning in the sea. J Forensic Sci [Internet]. 2013; 58(5): 1370–3. Available from: http://dx.doi.org/10.1111/1556- 4029.12229
3. Demirci S., Dogan K.H., Erkol Z., Deniz I. A series of complex suicide. Am J Forensic Med Pathol. 2009; 30(2): 152–4. http://dx.doi. org/10.1097/PAF.0b013e318187deb7
4. Töro K., Pollak S. Complex suicide versus complicated suicide. Forensic Sci Int. 2009; 184(1-3): 6-9. http://dx.doi.org/10.1016/j.forsciint.2008.10.020
5. Bohnert M., Rothschild M.A. Complex suicides by self-incineration. Forensic Sci Int. 2003; 131: 197–201. http://dx.doi.org/10.1016/s0379- 0738(02)00449-8
6. Bohnert M., Pollak S. Complex suicides – a review of the literature. Arch Kriminol. 2004; 213(5–6): 138–53
7. Racette S., Sauvageau A. Suicide by drowning after two gunshots to the head: a case report. Med Sci Law. 2008; 48: 170–2. http://dx.doi. org/10.1258/rsmmsl.48.2.170
8. Bohnert M. Complex suicide. In: Tsokos M., editor. Forensic pathology reviews. vol. 2. Totowa, NJ: Humana Press, 2005; 127–43.
9. Racette S., Sauvageau A. Planned and unplanned complex suicides: A 5-year retrospective study. J Forensic Sci. 2007; 52(2): 449–52. http://dx.doi.org/10.1111/j.1556- 4029.2007.00387.x
10. Lignitz E., Strauch H. Kombinierter Suizid durch Verbrennen und Sturz aus der Höhe [Combined suicide caused by burns and falling from a high place]. Arch Kriminol. 1986; 178(1- 2): 51-3.
11. Grimm U., Sigrist T. Verbrennen im Freien. Tod durch eigene oder fremde Hand? [Death by burning in open spaces. Death caused by suicide or homicide?]. Arch Kriminol. 1998; 201(5-6): 137-45.
12. Taff M.L., Boglioli L.R., Danto B.L. Planned complex suicide. Am J Forensic Med Pathol. 1998; 19(2): 194. http://dx.doi. org/10.1097/00000433-199806000-00020
13. Turk E.E., Anders S., Tsokos M. Planned complex suicide. Report of two autopsy cases of suicidal shot injury and subsequent self-immolation. Forensic Sci Int 2004; 139(1): 35–8. http://dx.doi.org/10.1016/j. forsciint.2003.09.013
14. Altun G. Planned complex suicide: report of three cases. Forensic Sci Int. 2006; 157(2- 3): 83-6. http://dx.doi.org/10.1016/j. forsciint.2005.04.039
16. Pélissier-Alicot A.L., Deveaux M., Sastre C., Baillif-Couniou V., Christia M.A., ChampeauxFesquet C., et al. Planned complex suicide involving combined drug intoxication and femoral catheterization. J Forensic Sci. 2021; 66(6): 2527-2531. http://dx.doi. org/10.1111/1556-4029.14809
17. Kanchan T., Menon A., Menezes R.G. Methods of choice in completed suicides: gender differences and review of literature. J Forensic Sci. 2009; 54(4): 938-42. http://dx.doi. org/10.1111/j.1556-4029.2009.01054.x
Data Sharing Statement
There are no additional data available. All raw data and code are available upon request.
Funding
This research received no funding.
Author Contributions
All authors contributed significantly to the work and approve its publication.
Ethics Declaration
This article does not involve any human or animal subjects, and therefore does not require ethics approval.
Acknowledgements
We would like to express our gratitude to the patients, their families, and all those who have contributed to this study.
Conflicts of Interest
No conflicts of interest
About this article
Cite this article
Ayyappan S, Kumar E.S. N, Akbar N.J. M. Planned Complex Suicide involving Phenyl ingestion and Hanging: A Medico-Legal Autopsy Report. J Forensic Chem Toxicol. 2025;11(2):115-20.
This license enables reusers to distribute, remix, adapt, and build upon the material in any medium or format for noncommercial purposes only, and only so long as attribution is given to the creator.
This license enables reusers to distribute, remix, adapt, and build upon the material in any medium or format for noncommercial purposes only, and only so long as attribution is given to the creator.
Scene of the incident showing the ligature material (Green arrow) tied to the ceiling beam with a chair placed beneath it (Yellow arrow showing the height of the ceiling beam from the floor- 8.5 feet)
Description: No description available.
Pink-coloured floor cleaners that are frequently used in India
Description: No description available.
Pressure abrasion runs above the thyroid prominence from below upwards from the right to the left side of the neck
Description: No description available.
Pressure abrasion runs above the thyroid prominence from below upwards from the right to the left side of the neck
Description: No description available.
No significant findings noted in the neck structures after removing platysma and sternocleidomastoid muscles
Description: No description available.
No significant findings noted in the neck structures after removing strap muscles
Description: No description available.
Pink-coloured stomach content with a pungent odor
Description: No description available.
Stomach shows congested mucosa
Description: No description available.
Comparing the possibilities of complex suicide and homicide
Description: No description available.
Comparing the possibilities of complex suicide and homicide