Strong dude made his wife stranlge him but it all went horribly wrong when he passed out and fell from the table he was lying on naked causing broken nose and head trauma.
Still cause of death was listed as asphyxia during sexual game.
I guess this game wasn't such a good idea. What is wrong with these people that a wife would put zip ties so tightly around her husband's neck for fun? For crying out loud, just fuck.