Homicidal and dyadic falls from a height: rarities in Singapore.
A review of homicidal falls from a height, over a ten-year-period (1991-2000), demonstrated the rarity of such deaths in Singapore, despite the high frequency of fatal falls from a height that prevails in the city-state. During that time, there were four cases (involving five individuals) of pure homicide and nine episodes (involving 19 individuals) of dyadic death involving vertical deceleration from a considerable height in the approximate range of 17-31 m (6-11 floors) and 17-50 m (6-18 floors), respectively. The index cases were gleaned from a total of 533 homicides and 3,963 fatal falls from a height. Hence, the corresponding ten-year prevalence rates of homicidal falls were 0.9% in terms of all homicidal deaths and 0.1% in relation to all fatal falls, and 3.6% and 0.5% for dyadic falls, respectively. The majority of victims were children, with almost equal numbers of males and females, aged between two months and six years for pure homicides and between 20 months and 13 years for homicide-suicides. Over a third (9/24) of these subjects attained the maximum Injury Severity Score (ISS) of 75. With respect to the dyadic deaths, the majority of the perpetrators (6/9) were females, comprising four mothers and two live-in maids. It would appear that strained or broken relationships, probable or actual mental illness, or a combination of both factors, had largely predisposed them to these tragic events which may, potentially, carry diplomatic implications when foreign nationals are involved.