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Case Reports in Emergency Medicine
Volume 2012 (2012), Article ID 795648, 2 pages
Case Report

Novel Suicide by Division of a Chronically Infected, Externalised Axillofemoral Graft Presenting Challenges in Prehospital Assessment of Mental Capacity

1Department of Trauma and Orthopaedics, University College Hospital, London, NW1 2BU, UK
2The Liver Unit, University Hospitals Birmingham, Birmingham B15 2WB, UK

Received 24 October 2011; Accepted 25 December 2011

Academic Editor: W. D. Grant

Copyright © 2012 Lewis G. Stevens and Keith J. Roberts. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Assessing a patient's competence to give informed consent in pre-hospital care is difficult. In the presented case an elderly patient attempted suicide by division of a chronically infected and externalised prosthetic arterial graft. He was able to comprehend his situation and understand the consequences of declining treatment. Without prior knowledge of his medical care and psychological state, however, we did not believe we could fully assess the patient's ability to act in his own best interest. After sedation and resuscitation he was transferred to hospital. This case report discusses a unique method of suicide and the challenge of obtaining valid consent in prehospital care.