Death by asphyxia

Dr. G. Villaret-Matejka
College of Law
University of San Agustin
Types of asphyxial death:
• Anoxic death
• Anemic anoxic death
• Stagnant anoxic death
• Histotoxic anoxic death
Phases of asphyxial death:
• Dyspneic phase
• Convulsive phase
• Apneic phase
Classification of asphyxia:
• Hanging
• Strangulation
• Suffocation
• Asphyxia by submersion or drowning
• Asphyxia by pressure on the chest
• Asphyxia by irrespirable gases
Asphyxia by hanging:

• The constricting force is the weight

of the body.
Asphyxia by hanging:
• Mechanism of death
• Constriction of the larynx
• Compression of veins and arteries
• Compression of nerves
• The thinner and tougher the ligature, the
more pronounced the mark in the skin
• The presence of a noose
• Application of ligature
• Position of the knot
Asphyxia by hanging:
• As to the location of ligature:
• Typical
• Atypical
• As to the amount of constricting force:
• Complete
• Partial
• As to symmetry:
• Asymmetrical
• Symmetrical
Ligature in hanging:
• Materials used in ligature
• Noose
• Mode of application of the ligature
• Position of the knot
• Course of ligature around the neck.
Hanging: Investigation
• The rule is that hanging is suicidal unless
there are evidences to show that it is not.
• Determine whether hanging is ante-
mortem or post-mortem
• Presence of vital reaction
• Determine whether hanging is accidental,
homicidal or suicidal
• Presence of signs of struggle
• Presence of other injuries or defense wounds
Asphyxia by strangulation:
• Compression of the neck by means of a
ligature which is tightened by force
• Causes of death:
• Asphyxia due to occlusion of windpipe
• Coma due to arrest of cerebral circulation
• Shock or syncope
• Inhibition of the respiratory center due to
pressure ion the vagus and sympathetic nerves
Asphyxia by hanging:
• Time required in the process of death
depends on:
• Severity of constricting force
• Jugular veins – 2 kilos
• Carotid artery – 5 kilos
• Trachea – 15 kilos
• Vertebral artery – 30 kilos
• Point of application of the ligature of the knot
• Physical condition of the subject
Postmortem findings in hanging
versus strangulation:
• Hanging • Strangulation by
• Hyoid bone is frequently ligature
injured • Hyoid bone is frequently
• Direction of the ligature is spared
inverted V shape with • Ligature mark is usually
apex as the site of the
horizontal
knot
• Ligature is usually below
• Ligature is at the level of
hyoid bone the larynx.
• Ligature groove is deepest
• Ligature groove is
at the opposite side of the uniform in depth in its
knot whole course
• Vertebral injury is • Vertebral injury is not
frequently observed observed
Asphyxia by strangulation:
• Strangulation by ligature
• Ligature tightened by force
• Common in infanticide
• Manual strangulation or throttling
Manual strangulation or
throttling:
• Methods of throttling
• Manner of death:
• Blockage of air passage
• Compression of blood vessels
• Compression of the nerves
• Suicidal throttling is not possible
• Accidental throttling
• Common method in infanticide
Special forms of strangulation:
• Palmar strangulation
• Garroting
• Form of judicial execution
• Mugging (strangle hold)
• As seen in wrestling
• Compression of the neck with a stick
Asphyxia by suffocation:
• Occlusion of air from the lungs by closure of air
openings or obstruction of the air passageway
• Smothering maybe in the form of:
• Overlaying
• Accidental smothering of epileptic
• Gagging
• Plastic bag suffocation
• Choking:impaction of foreign body in the
airway: food, vomitus, dentures, blood
• Café`coronary
 Asphyxia by submersion or
drowning:
• Phases:
• Respiration de surprise
• Phase of resistance
• Dyspneic phase
• apneic phase
• Terminal respiration
• Causes:
• Typical drowning- asphyxia
• Atypical drowning-cardiac inhibition, laryngeal spasm,
unconscious
• Other condition – the body strikes a hard object in the
water, intoxicated, presence of cramps, cold exposure
Drowning:
• Average time for death to occur: 2-5 minutes;
the amount of froth in the respiratory tract is
proportional to the length of survival.
• Questions:
• Did death occurs prior to entry in the water?
• Did drowning cause death?
• Were there any ante-mortem injuries?
• Were there any post-mortem injuries?
• Was there a natural disease or any evidence of
poisoning?
• What was the manner of death?
Post-mortem findings:
• External findings
• Clothes are wet, face is pale
• Skin is puckered, pale, contracted (cutis anserina or
gooseflesh)
• Penis and scrotum are contracted and retracted.
• Washerwoman`s hand and feet
• Mouth half-opened with tongue protruding
• Post-mortem lividity is most marked in the head, neck
and chest.
• Presence of cadaveric spasm
• In suicidal drowning, pieces of stone in the pockets
Postmortem findings:
• Internal findings:
• “Emphysema aquosum”
• “edema aquosum”
• “champignon d`ocume”
• Heart: the blood chloride content is greater in the
left side of the heart if drowning took place in salty
water (Gettler`s test)
• Stomach: absence of water in the stomach shows
death is rapid or submersion is made after death.
• Brain: congested
• Blood: difference in the chloride content, it becomes
dark, decrease hemoglobin
Findings conclusive that the person
died of drowning:
• Presence of materials in the hands of the
victim. (clenching)
• Increase in volume and edema of the
lungs.
• Presence of water and fluid in the
stomach contents.
• Presence of froth, foam or foreign bodies
in the air passages.
• Presence of water in the middle ear.
Floating of body in drowning:
• Body floats within 24 hours of death
due to decomposition (gas
formation).
• Floating is with flexed extremities,
head submerged
• “tete de nigre” – dark bloated face
as seen in decomposing body in
water.
Compression asphyxia(Traumatic
or crush asphyxia)
• Exchange of air is prevented by the
immobility of the chest and abdomen due
to external pressure or crush injury:
• Assailant may kneel on the chest of the victim
or between arms and legs as in wrestling.
• Sudden fall of earth or masonry
• Pinned under the rubble of a collapsed building.
• Crushed in a highway accident.
• Crushed in crowd.
Traumatic asphyxia:
• Burking:
• Burke and Hare
• Traumatic asphyxial death
• Sitting or kneeling on the chest of the
victim with hands closed on the nostrils
and mouth.
• No external marks
• Crucifixion
Carbon monoxide:
• Incomplete combustion of carbon fuel.
• Also called the “silent killer”
• Its main action is oxygen deprivation since
carboxyhemoglobin is 250X more stable than
oxyhemoglobin.
• Symptoms include: mild headache, lethargy,
fatigue, convulsions and coma.
• Painless deaths
• Use in judicial death by gas chamber.
Carbon dioxide:
• Product of complete combustion of carbon
containing compounds.
• Found in drainage pipes, deep wells,
sewage tanks
• Symptoms include hypotension,
anesthesia, muscular weakness,coma,
convulsions and death.
• Post-mortem findings: cyanotic face,
swollen, frothy mouth, pupils are dilated
Death of Physical Injuries due to
Automotive Crash or Accident
• Factors responsible for automotive
crash:
• Human factor
• Environmental factor
• Mechanical factor
• Social factor
• Pedestrian
Human Factor:
• Mental attitude
• Reckless driving, inattention, fatigue, inexperience
• Perceptive defect
• Defective vision and hearing
• Delayed or sluggish reaction time
• Disease
• Driver suffer from epileptic fit or heart attack while
driving
• Chemical factor
• Alcohol, drugs, marijuana, CO
Environmental factor:
• Poorly maintained road, poor
visibility, rain, blind intersection,
parked vehicle, trees, absence of
road signs
• Stiff and slippery road prolonged
sked time
Mechanical factor:
• Defect in the steering wheel, poor
brake, transmission failure,worn out
tires
Social factor:
• Speed is an added dimension of our
life.
• Car insurances develop “devil may
care” attitude
Collisions:
• First collision
• Impact of a moving vehicle with another
vehicle or a fixed object.
• Second collision
• The impact of the unrestrained occupant
with the interior of the vehicle.
Front impact crash:
• Driver
• Driver may strike the steering wheel, windshield, side
window and the dashboard; “accordioned” car injuries
• Front seat passenger
• Like the driver; injuries include- abrasions and
lacerations in face and scalp, fracture of the skull,
crashing of the neck, laceration or rupture of the
heart, lacerations and contusions of the heart, fracture
of ribs and sternum, laceration of liver and spleen.
• Rear seat occupants
• Strike the back of the front seat
Impact:
• Side impact crash
• Common in street intersections
• Injuries more severe because sides of the car less
rigid; ribs fractures, contusions and lacerations of
the lungs
• Rear impact crash
• Causes ‘whiplash” injury
• Roll over crash
• Injuries from striking the interior of the vehicle
• Because of process of rolling, severe injuries are
rarely seen.
Homicide by motor vehicle:
• Simulation of a crash to conceal a
prior homicide.
• Driver maybe shot while driving
Pedestrian-vehicle collision:
• Primary impact:
• First contact between the pedestrian and the
vehicle
• If the impact is below the center of gravity,
pedestrian moves toward the vehicle; above
the center of gravity, the body is moving away
from the vehicle.
• Average height of bumper: 40-60 cms
• Bumper fracture: fracture of leg bones
• If brake is applied, injuries to the legs are
lower.
Secondary impact:
• Impact of the pedestrian to the
ground after the first impact.
• This accounts for the multiple
contusions and abrasions on the
body.
Run over injuries:
• Usually occurs in children
• May occur after the initial impact or
thereafter
• Crash fracture, skid or tire marks,
rupture of internal organs maybe
seen
Hit and run injuries:
• Injuries sustained from vehicular accident
with the vehicle getting away from the
scene without regard to the unfortunate
victim.
• Thread marks, abrasion prints of parts of
the vehicle and paints detached from the
vehicle found in the body or crime scene
may be compared with the suspect car.
• The suspect car maybe examined for
blood stain, hair and clothings.
Evidences in vehicular crash:
• From the scene of the crime
• Photographs of the scene; skid and tire marks
on the road; condition and position of the
victim;condition of the vehicle involved; blood,
paint stain; narration of the witnesses
• From the driver
• Fitness to drive;alcoholic drunkeness;injuries
due to second collision
• Alcohol blood level: 0.15% and more
considered drunk
Evidences in vehicular crash:
• From the victim
• Crush injury
• Tire thread marks
• Abrasion marks
• Paint marks
• Blood, hair or clothings of the victim
• Physical defects of the victim
• Inebriation of the victim
Purposes of the autopsy:
• The examiner can give his opinion as to the
deceased position in the vehicle or the pattern of
the injuries correlated to the point of contact with
the vehicle.
• Examination will determine the true nature of the
cause of death.
• The examiner can form an opinion as to who from
among them survived the longest. (survivorship)
• The size of the monetary reward in a civil suit
may depend on the nature and extent of the
injuries.