A subsequent Kellermann-led study identified both fatal and nonfatal injuries occurring in homes in 3 cities – Seattle WA, Memphis TN, and Galveston TX. It noted that for every time a gun in the home was used in a self-defense or legally justifiable shooting, there were four accidental shootings, seven criminal assaults or homicides, and 11 attempted or completed suicides. (J of Trauma, August 1998. pp: 263-267). He then developed the now much criticized 43:1 ratio that states every time a gun is used in self-defense, it is 43 times more likely to be used in a homicide, suicide, or accidental shooting.