The Iron Maiden, dubbed by fans as Derek, is an NPC who lurks in the Silent Hill area. When approached in its usual dead end, its cloak opens, revealing a set of ribs or sideways teeth resembling a horseshoe crab. Hitting it with the Nail Bat does nothing. Usotsuki can walk away from it, but must leave Silent Hill to avoid being caught.
At random points while walking the streets, it will rush towards you, sending you to an inescapable area. This can be considered the game's only jump scare. It can catch you in an instant, even with the Rabbit effect equipped.
- It is likely that the Maiden is the culprit behind the slaughter on the streets.