Patricide (killing the father) is uncommon form of homicide. Usually the assaults occur at home in the
absence of witnesses and adult sons are frequently involved. Homicides in a domestic context usually do
not tend to recurrence, because the motivation for the crime ends with the death of the parent. However,
this is not what was observed in the present case study dealing with the death of a 70 years old white
man originally misclassified as accident and discovered three years later only after an additional
homicide in a family context of a 60 years old white lady. Multiple stab wounds to the neck and thorax
were misinterpreted at the external male body examination as blunt trauma falling down stairs. No
forensic autopsy was requested and no comparison of medical findings with the results from the death
scene, such as a bloodstain analysis was performed by the police officers nor required by the judicial
authority. This was quite surprising because an additional but preliminary post-mortem external examination
performed by a general practitioner on the male body already raised the suspicion that the
external lesions were stab wounds thus requiring a forensic autopsy. Only the exhumation of the elderly
body, performed years later, confirmed the diagnostic hypothesis raised by the first physician. The
present case is quite representative of a death investigation not run professionally and performed by
individuals with no specific training where most of the medico-legal investigations (especially for
traumatic and violent deaths) are restricted to an external body examination without subsequent autopsy.
Although misinterpretation of external lesions is inevitable and significant discrepancies between
external body examination and forensic autopsy are not rare, in the case of contradictory results of postmortem
external examination or unclear/suspicious cause and manner of death, investigation should
proceed necessarily with a forensic autopsy