Experts have issued a stark warning regarding the long-term consequences of pellet gun injuries, stating that they can lead to irreversible damage and permanent disability, even with optimal medical treatment. The concerns come amid ongoing parliamentary discussions about the use of excessive force and pellet guns, particularly against student protesters.
Information was available with The Chenab Times that highlighted the severe nature of these injuries, especially when they involve significant soft-tissue loss, bone defects, or disruption to nerves and blood vessels. Such trauma affecting structures with limited regenerative capacity, including major nerves, blood vessels, bones, joints, the spinal cord, and vital organs, can result in chronic pain, long-term disability, or a permanent loss of function.
The issue gained prominence following protests in the national capital on July 20, where students demonstrating against alleged irregularities in the NEET examination reportedly faced police action. Visuals circulating online depicted protesters with pellet injuries, with allegations that the Rapid Action Force (RAF) had deployed metal pellets, causing widespread harm.
Pellet guns function by firing cartridges containing hundreds of small pellets, which disperse over a wide area at high speeds. Unlike a single bullet from a conventional firearm, the impact of multiple pellets from a shotgun or pellet cartridge poses distinct challenges.
Shalini Solanki, a faculty member at the school of studies in forensic science, Samrat Vikramaditya Vishwavidyalaya in Ujjain, Madhya Pradesh, explained that the severity of pellet injuries is influenced by several factors. These include the number of pellets hitting the body, the distance from which the gun was fired, the size of the pellets, their velocity upon impact, the angle of impact, and crucially, the specific anatomical structures that are affected.
One young protester, Sahil Lochab, faces the potential loss of vision in his right eye due to injuries sustained. His family reported that doctors confirmed the pellets were metallic. The RAF, in a statement issued on July 28, stated that anti-riot gear was used and that non-lethal munitions, including two rounds of plastic pellets, were fired.
Standard operating procedures mandate that pellet guns should be fired from a minimum distance of 500 feet and aimed below the waist. However, deviations from these protocols can exacerbate the severity of injuries.
Dr Nikhil Valsangkar, senior consultant and unit head, department of orthopaedics and robotic joint replacement, Sarvodaya Hospital in Greater Noida West, elaborated on the nature of pellet wounds. He noted that pellets fired from a distance typically cause multiple superficial wounds with minimal tissue damage. However, at close range, the pellets can cluster and strike as a cohesive mass, leading to extensive and complex tissue destruction, significant soft-tissue loss, and severe bleeding.
He further stated that while superficial pellet wounds and injuries to highly elastic skeletal muscle might heal well or result in reversible stretching injuries, the damage is frequently irreversible in cases of substantial soft-tissue loss, bone defects, or compromised continuity of nerves and blood vessels. Stretching, in this context, refers to a mechanism where a pellet creates a temporary cavity that expands, displacing surrounding tissue.
Dr Sakshi Singhal, consultant, surgical oncology, Yatharth Hospital in New Delhi, outlined the potential permanent disabilities resulting from pellet injuries. These can include blindness, hearing loss, chronic pain, joint stiffness, and psychological trauma, such as Post Traumatic Stress Disorder (PTSD). PTSD is characterized by the involuntary reliving of traumatic experiences through flashbacks, accompanied by severe anxiety, constant tension, or hypervigilance.
Dr Vandana Prakash, a clinical psychologist and senior consultant at Max Superspeciality Hospital Vaishali, observed that individuals with a prior history of trauma, those with less developed emotional regulation skills, younger individuals, and women may experience more severe impacts. Flashbacks and nightmares associated with such events can persist for extended periods, sometimes indefinitely.
The ultimate consequences of a pellet injury are more dependent on the location of the impact rather than the number of pellets involved. Wounds confined to the skin, subcutaneous layer, or superficial muscles often heal effectively with medical intervention.
Solanki, with her expertise in forensic ballistics, highlighted the particular vulnerability of the face due to the concentration of delicate anatomical features within a small area. Facial nerve injuries can lead to muscle weakness or paralysis, while eye injuries may result in partial or complete vision loss, depending on the structures affected.
Injuries to the shoulder region are considered particularly concerning due to the proximity of critical neurovascular structures. Singhal noted that severe haemorrhage, loss of limb function, or chronic neuropathic pain are possible outcomes. While fractures are less common, they can occur at close range with high-velocity impacts.
The prognosis for visual recovery varies. Cases of corneal abrasion, timely repaired retinal tears, mild anterior chamber bleeding, or mild vitreous haemorrhage offer a better chance of recovery. Conversely, globe rupture, macular destruction, or optic nerve damage present a poorer outlook.
Valsangkar pointed out the high vulnerability of internal organs such as the liver, kidneys, and spleen. These organs absorb kinetic energy poorly, leading to extensive disruption and tearing throughout the impact cavity. Although the lungs, due to their low density and high elasticity, offer some protection, a close-range blast to the chest can still be devastating, causing severe tears to lung tissue, the heart, and major blood vessels, resulting in significant internal bleeding.
It is not always necessary to remove every embedded pellet. Solanki advised that attempting to remove deeply lodged pellets can sometimes cause more harm than leaving them in place, emphasizing the need for individualized treatment approaches. Long-term management, especially for wounds with retained pellets, requires continuous monitoring and strict adherence to infection prevention measures by the victims.
Valsangkar stressed the importance of prophylactic antibiotics, tetanus immunisation, and vigilance for delayed bone healing or infections among victims. For those with multiple retained pellets or pellets in high-risk areas, periodic evaluations may be recommended. If lead fragments are suspected to be a source of prolonged exposure, blood lead level testing might be advised, although significant lead poisoning is uncommon.
Solanki added that recovery from eye injuries can be a prolonged process, with potential delayed complications such as retinal detachment or glaucoma emerging years after the initial incident.
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