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Asfiksia Hanging Monticelli2015
Asfiksia Hanging Monticelli2015
Case report
a r t i c l e i n f o a b s t r a c t
Article history: We report a rare case of homicide by hanging. The postmortem examination resulted in a verdict of death
Received 2 February 2015 by suicidal hanging and the Public Prosecutor's Office released the body for burial. After intervention by
Received in revised form the relatives police investigations were resumed. Based on evidence impossible to reconcile with the
15 April 2015
results of the postmortem examination and requiring further clarification, an autopsy was ordered. The
Accepted 17 April 2015
Available online 30 April 2015
results of the postmortem could not be brought in line with a suicidal hanging and were further sub-
stantiated by DNA analysis. The scenario put forward by the defense claiming a secondary transfer of
trace evidence onto the ligature and the victim's clothes was excluded because of the distribution pattern
Keywords:
Homicide
and the trace evidence ratio. The defendant was sentenced to 20 years of prison for homicide. The verdict
Hanging was confirmed by the Supreme Court and commuted to 18 years.
Electric cable © 2015 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.
Burking
Postmortem
Trace evidence
http://dx.doi.org/10.1016/j.jflm.2015.04.006
1752-928X/© 2015 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.
72 F.C. Monticelli et al. / Journal of Forensic and Legal Medicine 33 (2015) 71e75
Table 1
Ratio of autopsies (by court order) in the validation group of hanging cases (“Statistik Austria”).17
should be carried out in “all obvious or suspected unnatural showed “basically no indication of further acts of violence or
deaths”, also including suicide or suspected suicide cases. Even defensive wounds”, however “a few [ … ] spots of dry skin (small
though from the medico-legal perspective this would be ideal, for hematoma?) [ … ] next to the ligature mark require clarification”.
the prosecutor in Austria it is still mandatory to have at least hints Based on this new evidence, an official autopsy was finally ordered.
of a third party involvement in the case to decide on autopsy. For
this reason Austria does not follow the European recommenda- 2.1. Autopsy findings
tions, which have been established by the Council of Europe in
1999. Four days after discovery of the body, an autopsy was performed
The following case report demonstrates that deaths by hanging on a young woman in good general and nutritional condition. No
may be difficult to assess. We will call particular attention to po- significant internal diseases could be discovered, which corre-
tential deficits observed in postmortem examination as well as to sponded with the previous anamnestic information. After the
the significance and especially the scope of further examinations.
2. Case
ligature had been removed at the time of discovery, an asymmetric interposition of the victim's hair in the ligature knot (Fig. 3) as well
ligature groove was found almost completely encircling the throat as a trace of saliva above the left mandibular ramus. Police docu-
and neck with the apex projected at the right external auditory mentation further stated that the zip of the victim's biker jacket
canal (Fig. 2). In addition to the protruding tongue, numerous was fastened, with the turned-up jacket collar covering the neck
petechial hemorrhages in the facial skin, the areas behind both ears, and the encircling ligature almost completely, leaving the impres-
the conjunctiva, the eyelids and oral mucosa were present. Other sion that the jacket had been closed only after the ligature had been
findings included circumscribed hemorrhages in the skin and soft put in place.
tissues in the left mandibular ramus (Fig. 2) as well as extensive
blue-grey discoloration of the skin on the right front of the chest, 2.3. Instrumentality
immediately below the clavicle, with an approximate diameter of
5 cm. After appropriate preparation, these became apparent as The configuration of the ligature, especially the double wrap
recent subcutaneous hematoma, which could be confirmed by around the door handle without evidence of a knot e although also
histopathological examination. only discernible from photographs (Fig. 4) e appeared as if the
In addition, there were small hemorrhages no larger than a cable had been fastened in haste and without prior planning. At
fingertip in the skin and subcutaneous fatty tissue across the front least, there was no indication of any course of action consistent
of the left shoulder joint and across the extensor side of the met- with a planned suicide.
acarpophalangeal joint of the left thumb, some scattered fresh
hemorrhages about the size of a thumb on the extensor side of the
2.4. Additional forensic and molecular biological examination
left thigh and tibia, the outside of the right proximal tibia and
groups of punctiform extravasations on the extensor side of the left
DNA of the suspect could be detected in a total of 18 items
thigh. During the preparation of the rear parts of the body, skin and
containing biological evidence. All of them consisted of mixed
tissue hemorrhages in projection on the lower lumbar region,
traces from both suspect and victim. In detail, DNA material of the
extensive muscle hemorrhages on the right of the mid-back region
suspect was found on the adhesive lifted off both the palm and the
as well as in projection on the left scapula were found. The prep-
back of each hand as well as on both sides of the neck, on the biker
aration of the clavicles showed subperiostal bleeding on the right,
jacket worn by the victim (collar and cuff area of both sleeves, in
at the base of the sternocleidomastoid muscle. The laryngeal skel-
projection on the outside of neck and throat, respectively), on each
eton and the hyoid bone were resilient and intact. The neck muscles
finger of the right hand (abrasions), fingers I to III of the left hand
showed no relevant hemorrhage when prepared in situ. An internal
(abrasions) and the ligature itself (hair straightener, knot area).
ligature mark could not be detected. Toxicological analysis of the
In order to be able to anticipate a statement of the suspect
body fluids saved during the autopsy showed negative results.
regarding possible secondary transfer of trace evidence, the DNA
mixture ratios of suspect/victim were determined by peak-area
2.2. Evaluation calculation via electropherogram. They amounted to 1:5 for the
abrasions on the hair straightener (knot area) and 1,2:1 for the
Based on the autopsy results, it was determined that the victim abrasions on the victim's thumb.
had died of non-natural cause as a result of asphyxiation by violent
ligature strangulation. However, numerous findings were not
2.5. Trial
compatible with a suicidal hanging, such as the hemorrhages in the
skin and subcutaneous fatty tissue on front of the chest, across the
The defendant did not confess. From the forensic point of view
left mandibular ramus, the front of the left shoulder joint and
and based on the autopsy findings, it was concluded that the
across the extensor side of the metacarpophalangeal joint of the left
deceased had been the victim of violent asphyxiation by strangu-
thumb, the extensor side of the left thigh and tibia and the outside
lation and had died of a non-natural cause. Apart from the inter-
of right proximal tibia, the hemorrhages to back muscles and the
position of hair in the ligature knot, the numerous findings on the
groups of punctiform extravasation on the extensor side of the left
body were inconsistent with a suicidal event. The DNA results in
thigh.
particular pointed to a homicidal event. As a possible explanation of
Other conclusive findings e reconstructed from photographic
the multiple blunt force injuries on the victim's body, in particular
material and the relevant police documentation e include the
Fig. 2. Neck and conjunctival petechiae. Fig. 3. Interposition of hair in the ligature knot.
74 F.C. Monticelli et al. / Journal of Forensic and Legal Medicine 33 (2015) 71e75
possible scenario that breathing was inhibited to the point of un- In general, it would be our opinion that the autopsy itself should
consciousness by the pressure of knees to the chest, in combination be seen as a part of the death investigation. Therefore we recom-
with a violent obstruction of the mouth and nose, consistent with mend to perform an autopsy in all obvious or suspected unnatural
so-called Burking (named after the serial murderers William Burke deaths, for example according to the European guidelines (coe R99-
[1792e1829] and William Hare [1792e1859]). Burking is a special 3, 2 Feb. 1999).18
form of mechanical asphyxia, usually leaving little evidence and
therefore easily missed.19 Although such a scenario could not be Conflict of interest
substantiated in the present case, it at least offered a set-up that fit
the body of evidence. The authors declare that they have no conflict of interest.
Another indication that a third party had been involved was the
interposition of the victim's hair in the knot area of the ligature, a Acknowledgments
phenomenon found in the majority of homicidal hangings.2
Additional investigations subsequent to the autopsy resulted in No funding from any organization has been received.
important evidence further substantiating the defendant's
involvement in the crime. The defendant's statements could be
References
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