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Deaths related to hostage situations occur in many forms, as these situations can easily escalate as a result of many confounding variables. When approaching such cases, forensic pathologists and death investigators should be mindful of the many details that should be well-documented at the scene and during autopsy to ensure that the correct conclusions and death certification are determined. This case report highlights a death in a hostage situation and the importance of correlating scene information and autopsy findings. An elderly femal