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:

As to the amount of constricting force:

Typical
Atypical
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 antemortem 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

Hyoid bone is frequently

injured
Direction of the ligature is
inverted V shape with
apex as the site of the
knot
Ligature is at the level of
hyoid bone
Ligature groove is
deepest at the opposite
side of the knot
Vertebral injury is
frequently observed

Strangulation by
ligature

Hyoid bone is frequently

spared
Ligature mark is usually
horizontal
Ligature is usually below
the larynx.
Ligature groove is
uniform in depth in its
whole course
Vertebral injury is not
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

Mugging (strangle hold)

Form of judicial execution

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
Caf`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

Perceptive defect

Defective vision and hearing

Delayed or sluggish reaction time

Disease

Reckless driving, inattention, fatigue, inexperience

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

Front seat passenger

Driver may strike the steering wheel, windshield, side

window and the dashboard; accordioned car injuries
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

Rear impact crash

Common in street intersections

Injuries more severe because sides of the car less
rigid; ribs fractures, contusions and lacerations of
the lungs
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.