New fragmenting bullet leads to unexpected injury pattern: A case report involving the Radically Invasive Projectile

Abstract

New developments in bullet technology are challenging what is commonly known about penetrating injuries from gunshot wounds. The so-called 'bullet-rule' posits the number of wounds and projectiles associated with a patient should add to an even number. This trauma paradigm is being shattered by the advent of new fragmenting projectiles. These frangible rounds break into several pieces after soft tissue penetration changing the expected trajectory, injury location, and extent of tissue damage. In this case report, the authors describe the case of a 15-year-old boy injured by a G2 Radically Invasive Projectile (RIP). The patient's resultant pattern of injuries and the diagnostic utility of imaging were imperative for guiding his clinical management. The case serves as a useful example of the challenges and recommended strategies in managing a patient injured by a new fragmenting bullet.

G2 Research Radically Invasive Projectile

“…The bullet that entered the abdomen resulted in massive liver damage, diaphragmatic, duodenum, and stomach injuries. 6 Similar to our case, the fragments of the RIP bullet caused extensive tissue damage in the patients. Both reports and a recently published article by Ditkofsky et al 7 discussed the application of radiographic imaging in evaluating the extent of injury, locating the projectile, and making surgery plans.…”

“…So far, only a few cases of G2RIP-related wounds have been reported in the reviewed literature, and these reports focused on the surgical and clinical significance. [5][6][7] To the best of our knowledge, our case is the first reported G2RIP-related autopsy. In this case report, we also discuss the radiographic and wound findings, the characteristics of the bullets, and their significance in forensic practices.…”

Lodged bullets on computed tomography: Three classification procedures for the virtual investigation of bullets or their fragments that cannot be recovered from the living patient

“…14 The shape of individual fragments may indicate special types of bullets that are designed to fragment in a predictable manner, such as the Radical Invasive Projectile (RIP), which has been frequently encountered in recent years. [15][16][17][18] This frangible bullet consists of a solid base ('base slug') and six or eight trocar-shaped petals ('trocars'), depending on its calibre. [15][16][17][18] The 'trocars' expand radially after entering tissue, while the 'base slug' further penetrates the tissue along its trajectory.…”

“…[15][16][17][18] This frangible bullet consists of a solid base ('base slug') and six or eight trocar-shaped petals ('trocars'), depending on its calibre. [15][16][17][18] The 'trocars' expand radially after entering tissue, while the 'base slug' further penetrates the tissue along its trajectory. [15][16][17][18] The detection of these 'trocars' of the same shape enables the identification of these special bullets.…”

“…[15][16][17][18] The 'trocars' expand radially after entering tissue, while the 'base slug' further penetrates the tissue along its trajectory. [15][16][17][18] The detection of these 'trocars' of the same shape enables the identification of these special bullets. The 'base slug' may be used for calibre measurements in addition to the number of detected 'trocars'.…”