The arrowhead had not come out cleanly. The arrow shaft had either broken off or been removed — possibly by the attacker, to leave less evidence — but the stone tip remained embedded in the shoulder. The wound had damaged major blood vessels and nerves. If Ötzi had not died immediately, he would have bled out within minutes. Even with modern surgical capability, a wound of this type to this location would be life-threatening.
Further examination in subsequent years built out the picture. Blood traces from at least four individuals other than Ötzi were identified on his equipment: one source on the knife, two different sources on a single arrowhead, and one source on the coat. These findings — if the DNA analysis is reliable, as the researchers who conducted it argued — suggest that Ötzi had been in a violent encounter in the days before his death. One interpretation is that the same arrows he carried had been used against two different opponents; another is that his coat had come into contact with a wounded companion. Neither interpretation requires a specific scenario and neither can be confirmed from the available evidence.
A deep cut on his right hand, found healed and in the process of further healing at the time of death, was interpreted as a defensive wound from a hand-to-hand struggle — the kind of injury sustained when a hand grabs a blade. The wound was days old when he died, suggesting the violent encounter predated his final ascent into the mountains.
The forensic consensus — acknowledged as a consensus rather than a certainty, given the limitations of evidence five thousand years old — is that Ötzi was ambushed and shot from behind. The shooter fired from a distance. The arrowhead hit the left shoulder and severed the left subclavian artery, one of the main vessels supplying the arm. Ötzi fell and died within minutes. His body was then covered by the snow and ice that would preserve it.