I've actually seen several injuries like this. You work long enough in an ER which serves a high proportion of "troubled youths," and you will eventually see this type of injury. And the stories they tell about how such a thing could happen are hilarious. One kid told me that he was just laying there on his back in a park, minding his own business, when "Essé walks up to me and bends over like this [mimics standing person stooping over, holding roscoe parallel to the ground] and shot me, man!" Never mind that there was no entrance hole in his pants, and the front of his boxers were nearly incinerated from powder burns. Essé would have had to shoot him through the top of his head to get the trajectory the bullet took through the top and left angles of his family triangle.
I have absolutely no pity for someone, licensed to carry or not, who shoots himself that way. I hope it hurts. Stupidity should be painful.