When a gunshot victim arrived at a trauma center in British Columbia two years ago, doctors initially assumed that the case would be fairly straightforward.
The patient, a 39-year-old woman, was responsive at first, even talking, despite having been shot at close range with a shotgun. Bullet fragments had lodged in her chest and her abdomen, but none appeared life-threatening. X-rays also showed a variety of metal around the patient’s body — keys, a cellphone and the like — but doctors figured they were items inside the pockets of a jacket she was still wearing.
Soon, however, the woman’s breathing deteriorated rapidly. She was immediately intubated and rushed to an operating room, where doctors made an alarming discovery after they cut into her body.
“When the surgeon opened her, this thing just literally sprang up at 90 degrees,” Laura Duggan, an anesthesiologist at the University of British Columbia, told The Washington Post in a phone interview.
It appeared to be a metal wire — sharply curved, measuring a half-chest in length — but no one could positively identify it at first.
The surgeon thought it might be “some kind of detonation device” and summoned a nearby police officer, Duggan said. “We’re always thinking in medicine of worst-case scenarios,” she added.
The police officer examined the wire and told doctors that it didn’t look like any sort of explosive he was familiar with. Still, they decided to begin evacuating the operating room out of an abundance of caution.
“We were starting to get people to leave,” Duggan said. “That’s when this nurse came in and said, ‘Hey, that’s an underwire!’ "
Duggan remembers taking a closer look at the patient’s clothing, which had been hastily removed only after she became unstable and was rushed to the operating room. Sure enough, the wire from her bra was missing.
Doctors later speculated that the force of the shotgun pellets had propelled the underwire into her body — where it did incredible damage.
“I couldn’t believe the sharpness on those edges, man, on the underwire,” Duggan said. “It was like a scythe, truly.”
Specifically, the bra wire horizontally transected the patient’s stomach in half, took off the left lobe of her liver, lacerated her diaphragm and nicked her aorta, Duggan and anesthesiology resident Martha DiGiuseppe detailed in an article titled “Underwire bra complicating a gunshot injury” in the March 2019 issue of the Canadian Journal of Anesthesia.
“Partial liver resection and near-total gastrectomy were required to control the bleeding,” the report stated.
Though the patient did make a complete recovery, she spent nearly two weeks in the intensive care unit. And the injuries that threatened her life were caused by the bra wire, not the bullet fragments.
“There’s no question in anybody’s minds … that [wearing an underwire bra] was what just exponentially increased her injury pattern,” Duggan said.
Duggan and DiGiuseppe looked in medical literature for similar cases. They could find only one, an incident from about 50 years ago in France, where a woman’s underwire bra cut into her right ventricle after she was shot. (They also came across a handful of cases where people claimed their underwire bras had deflected bullets, but Duggan is skeptical that those weren’t simply bullets that had merely grazed the victims.)
Duggan said it’s much more likely an underwire bra could be overlooked as a reason for complicating injuries in gunshot cases like the one in British Columbia.
“I’ve been doing this job for 20 years. … Anything I’ve seen has probably been seen before,” Duggan said. “But I would have never considered an underwire leading to a life-threatening cluster of upper-abdominal injuries, and that’s why we decided to write it up.”