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Tissue damage is a function of velocity and diameter of projectile (and many other factors). A high-velocity but smaller caliber rifle bullet can easily damage more tissue and cause more blood loss than a larger, slower-moving bullet. Additionally, blood doesn't need to drain out of the hole to cause death; many people have died of internal bleeding.
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If you have a 50-50 chance of being right, you'll be wrong 90% of the time.
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