Death from positional asphyxia is often an accidental event occurring when the victim's body assumes a position which can compromise an effective respiration. Its diagnosis is usually not simple, because it needs to know the exact circumstance in which the body was found and the original positioning of all the body segments. In this case, a 41-year-old man with a history of opioid drugs abuse was found dead in a knee-chest position; the head was down on the floor with the face resting on a plastic bag. Pictures of the scene of death was taken while the body was still in its original position. At first, the main suspicion was that of a fatal overdose. Following the autopsy examination, completed by histological and toxicological examinations, the cause of death was determined as postural asphyxia secondary to intoxication by methadone, in the presence of ischemic heart disease. Some features, moreover, were typical of the death in head down position, and the prolonged knee-chest position was also associated with the obstruction of mouth and nose by the plastic bag, which may have contributed to the asphyxiation. These cases of "combined" asphyxia represent a challenge for the current classifications of asphyxia, which are very variable and not standardized, as we observe from a brief review of the literature. The elaboration of new systems of classification for asphyxias, which must be clear, simple and shareable, is necessary to avoid confusion in categorizing cases that present overlapping between several types of asphyxiation modalities.
Suicide of 47-year-old male butcher lying on a sofa in prone position. The bolt of the slaughterer’s gun (Schermer type) had got stuck within the cranium. Entrance site was located after pre-autopsy removal of the head hair with a roundish skin hole surrounded by irregular soot deposits.
The body of a 60-year-old man was discovered in his apartment after concerned neighbors, unable to reach him for nearly a day, alerted law enforcement. A forensic pathologist conducted an on-site inspection. The apartment, located on the third floor, comprised a main corridor, a bedroom, a restroom, a small living room with a couch, and a kitchen.
The living space was in disarray, with overturned chairs and numerous broken objects strewn across the floor. Doors and windows were secured from the inside, showing no signs of forced entry. A substantial pool of vomit was present at the transition between the living room and the kitchen. Various traces of dried blood were mainly located on the floor, pieces of furniture, the refrigerator, and the walls between the corridor and the living room showing at blood stain analysis a transfer and wipe patterns without evidence of impact or projection spatter.
The body, partially unclothed and surrounded by a mixture of blood and vomit, was discovered in the corridor near the main door. Dried blood covered the entire body, revealing multiple head lacerations. The apartment contained various medications, including antihypertensives, pump inhibitors, and anxiolytics, as well as scattered bottles of wine. In the living room, a container of “Bromazepam” 2.5 mg/ml without a cap was also found. Analysis of circumstantial data revealed that the deceased had been experiencing depression, leading to a period of isolation in the final stages of his life. His medical history included hypertension, carotid stenosis, hyperlipidemia, chronic hepatitis C, and HIV infection. Previous treatments consisted of aspirin, atorvastatin, amlodipine, ramipril, venlafaxine, tamsulosin, perfenazine, bromazepam, lansoprazole, and bictegravir/emtricitabine/tenofovir alafenamide.
The autopsy findings alone could not exclude the involvement of a perpetrator in the causation of these injuries and two different hypotheses were formulated: accidental multiple falls or repeated struck in the face and head with blunt objects as brass knuckles, small clubs, or kicks and punches.
The occipital injury, ultimately leading to death, could result from a backward fall of the subject with a consequent impact on the floor.
Suicide by shot to the head in a sitting slightly leaning position.
The trigger was pulled with the foot. The body was slightly tilted to the side and rigor mortis had fully set in in this position. Before the autopsy corpse was tested on morgue table and showed strongly developed rigor mortis.
Super Rare Case of Suicide by Ligature Strangulation while Lying on Dining Table in Turkey
Case details: A 37-year old male was found dead in his home where he lived alone with no signs of forced entry to the house. The body was lying supine on the dining table with the feet hanging free and the head completely resting on the table.
A thick, orange-coloured rope was wrapped three times around the neck and below the table where the head was resting was a 20kg demijohn full of water, with a broken rope with the same features wrapped around the neck of the bottle.
In addition, a telephone charger was found with one end attached to the leg of a coffee table next to the dining table and the other end on the inside of the left arm of the body. A suicide note written by the victim was found in the same room in clear view on a bed.
The cause of death in strangulation by ligature with pressure created on the airways and the nerve and vascular bundle in the neck.