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In examining deaths resulting from gunshot wounds, it is important to describe the wound pathway created by the projectile. Forensic pathologists must identify all entrance and exit wounds and account for all projectiles. Occasionally, confusion arises as to whether a skin defect represents an entrance wound or not, an exit wound, or some other type of wound. Herein, we propose the descriptor "bullet track skin defect" as a formal description for a superficial skin defect created along the pathway of a projectile within the body. Specifically, we define the "bullet track skin defect" as a partial‐ or full‐thickness skin defect produced by a projectile traveling beneath the skin in a relatively tangential fashion as part of a wound pathway within the body. It is somewhat analogous to a traditional graze or superficial tangential wound, wherein the projectile traveling outside the body strikes the skin tangentially from above, without entering the body. However, the projectile is already traveling within the body with the bullet track skin defect, disrupting the skin tangentially from below rather than from above, without exiting the body. Although these defects are not a common presentation of gunshot wounds, they are certainly not rare. With this case series, we suggest that such defects may be referred to as "bullet track skin defects." Alternative language that can substitute for "bullet track skin defects" includes "bullet track skin wounds" or "bullet track cutaneous defects." [ABSTRACT FROM AUTHOR]

The Tucson Police Department, Tucson, AZ, has begun using the Polyshok Impact Reactive Projectile (IRP), a new type of shotgun ammunition that includes a lead bead core that travels within single, plastic-encased projectile. On impact, the core is released to distribute over a small area, thereby disintegrating on impact to reduce the likelihood of exit or collateral damage on missed shots. After a brief review of shotgun slug ballistics and wound characteristics and a discussion of the mechanism of the Polyshok IRP, we report the first death in the United States from this ammunition. Findings included a single entrance wound with plastic ammunition components and small lead particles recovered from the body, the combination of which normally would suggest a close-range shooting with birdshot. However, the characteristics of this ammunition create different patterns than are found with slugs or shot, so that a medical examiner unfamiliar with the Polyshok IRP could draw inaccurate conclusions about ammunition and range of fire. Because the single projectile fired from this ammunition is composed of both plastic and lead, plastic components are likely to be found within the wound at any range of fire, unlike traditional shot or slug ammunition. Also, the small size of lead particles found spread through the wound cavity would ordinarily suggest a small-size shot, whereas the external appearance of the wound (a single entrance with no dispersion of shot) and the pattern of tissue destruction are more consistent with the patterns of injury associated with shotgun slugs. [ABSTRACT FROM AUTHOR]