Death by asphyxia

Dr. G. Villaret
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
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
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
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
Asphyxia by breathing irrespirable
gases:
Carbon monoxide
Carbon dioxide
Hydrogen sulfide
Hydrogen cyanide
Sulfur dioxide
War gases

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
Hydrogen sulfide: (H
2
S)

Decomposition of substances containing
sulphur.
Found in septic tank, sewers, deep wells
or byproducts in some industries
Colorless transparent gas with odor
similar to a rotten egg.
Produce irritation to the eyes, air
passages followed by headache, vomiting,
cyanosis and labored breathing.
Post-mortem findings: putrefaction is
early, offensive odor on opening the body
Hydrogen cyanide:
One of the most toxic and rapid acting
gases.
Naturally found in bitter almond, kernels
of berry, plums, peaches, bamboo shoots,
oil seeds and beans.
As tablet: 60-90 mg is fatal
As vapors: symptoms within seconds and
death within minutes
Post-mortem findings:Body is livid or
violet in color. Lividity is bright red or
pink
Sulfur dioxide:
Colorless gas with pungent odor
Found in eruption of volcanoes
Use as disinfectant, bleaching agent
Causes irritation of respiratory
system and eyes.
War gases:
Characteristics:
The substance must be heavier than air.
It must be capable of spreading rapidly on the area
where the chemical effects is desired.
It must be capable of producing effect even in low
concentration.
It may be a true gas, smoke, volatilized liquid or finely
divided solid.
It can be manufactured in big quantity.
It must be stable substance or not easily made non-
toxic by rapid chemical reaction.
It is capable of storage for an ample length of time.

Classification:
Lacrimator or tear gas
Causes irritation and copious flow of tears.
Chloracetophenone (CAP)
Bromobenzyl cyanide (BBC)
Ethyl iodoacetate (KSK)
Vesicant or blistering gas
Contact with skin causes bleb or blister
formation.
Mustard gas sulfide (yellow cross,
yperite):dichlordiethyl sulfide; mustard like odor
Lewisite (chlorovinyl-dichlorarsine):odor of geranium
Classification:
Lung irritants (asphyxiant or choking gas)
When inhaled causes dyspnea, coughing,
vomiting, coma and death
Chlorine: yellowish green gas; pungent
iritating odor; death is due to laryngeal
spasm.
Phosgene (COCl
2
): 10X more toxic than
chlorine but has poor solubility
Chloropicrin: 4X more toxic than chlorine
Diphosgene: intense lacrimator
Classification:
Sternutator (nasal irritants or
vomiting gases)
Causes coryza, nausea, headache,
vomiting, salivation and chest pain
Paralysants (nerve gas)
Blood poisons



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.