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The American Journal of Forensic... Sep 2020The majority of hanging deaths are relatively straightforward when opining the manner of death, typically determined to be suicide. However, there are rare hanging...
An Illustrative Case of Suicidal Hanging Versus Accidental Hanging Associated With Autoerotic Activity: Necessary Medicolegal Death Investigation and Role of Cognitive Bias.
The majority of hanging deaths are relatively straightforward when opining the manner of death, typically determined to be suicide. However, there are rare hanging deaths that require the forensic pathologist to seek additional information. Forensic pathologists commonly consider an accidental manner of death when the hanging death scene includes evidence of solitary sexual activity consistent with autoerotic asphyxia. Here, the authors present a case of an initially apparent suicidal hanging where important death scene details photographed by the medical examiner investigator and history provided by family members during subsequent conversations ultimately helped the forensic pathologist conclude an opinion that the hanging was accidental, likely due to autoerotic activity. The decedent, who hanged himself in the closet of his bedroom, was wearing shorts that were initially believed to be inadvertently torn; however, further investigation revealed his shorts were intentionally modified to expose his genitalia. Additional evidence documented from the death scene photographs and conversations with his mother revealed items and activities consistent with autoerotic behavior. Before opining a manner of death in hanging deaths, forensic pathologists are encouraged to consider details beyond that obtained from the initial death scene investigation and postmortem examination. A thorough medicolegal death investigation should not be viewed as introducing cognitive bias, but rather as necessary information needed to determine the most accurate cause and manner of death.
Topics: Accidents; Adult; Asphyxia; Bias; Forensic Medicine; Humans; Male; Masturbation; Neck Injuries
PubMed: 32568885
DOI: 10.1097/PAF.0000000000000576 -
Medicine, Science, and the Law Jan 2013Accidental autoerotic asphyxia occurring during autoerotic activity is usually considered the unanticipated failure of a sexual stimulation device to induce hypoxia...
Accidental autoerotic asphyxia occurring during autoerotic activity is usually considered the unanticipated failure of a sexual stimulation device to induce hypoxia during solitary sexual arousal. Here, we provide the first reported case of autoerotic death in Korea. In the present case, a young man died from asphyxiation as a result of being suspended with his head in a plastic bag. The death was considered accidental and not suicidal. The diagnosis of autoerotic death may be difficult when typical features are absent.
Topics: Accidents, Home; Adult; Asphyxia; Forensic Pathology; Humans; Male; Masturbation; Neck Injuries; Paraphilic Disorders; Purpura
PubMed: 22941517
DOI: 10.1258/msl.2012.012033 -
La Clinica Terapeutica May 2021In the large series of forensic injury, death from accidental me-chanical asphyxiation in adults is rare and is usually secondary to suffocation, aspiration,...
In the large series of forensic injury, death from accidental me-chanical asphyxiation in adults is rare and is usually secondary to suffocation, aspiration, strangulation caused by entrapment of clothing in machinery (deaths at work) or asphyxiation in the course of erotic maneuvers. Compression asphyxia is a form of violent mechanical asphyxia in which the asphyxiated insult is produced by means of a compression and constriction mechanism of the thoracic cage. The authors report an unusual case of asphyxiated death from chest com-pression resulting from the action of a compacting machine, which occurred in a person who had fallen asleep in a waste bin.
Topics: Accidents; Adult; Asphyxia; Forensic Medicine; Humans; Male
PubMed: 33956033
DOI: 10.7417/CT.2021.2310 -
Medicine, Science, and the Law Oct 1999While hanging is a common method of committing suicide in India, accidental hanging is uncommon. However, it does occur when people are engaged in auto-erotic practices....
While hanging is a common method of committing suicide in India, accidental hanging is uncommon. However, it does occur when people are engaged in auto-erotic practices. An adult male who was helping passengers trapped in the lift of an outpatient department at a teaching hospital was accidentally hanged. He survived for 39 days. This case highlights a rare but serious hazard in the use of lifts.
Topics: Accidents, Occupational; Adult; Asphyxia; Brain; Elevators and Escalators; Humans; Hypoxia, Brain; Male; Neck Injuries; Sepsis; Wound Infection
PubMed: 10581915
DOI: 10.1177/002580249903900412 -
International Maritime Health 2022Venturing onto the water for business or pleasure is not a risk-free activity. Despite the dangers facing crew and passengers there is little data on the characteristics... (Review)
Review
BACKGROUND
Venturing onto the water for business or pleasure is not a risk-free activity. Despite the dangers facing crew and passengers there is little data on the characteristics of fatal accidents involving vessels in the water. The goal of this study was to review accident reports from the National Transportation Safety Board (NTSB) to determine characteristics of fatal marine accidents.
MATERIALS AND METHODS
Data was obtained from the Marine Accident Reports issued by the NTSB. Information regarding the number of people involved, fatalities and the accident itself was collected.
RESULTS
Fifty-two accidents involving 5045 people from 1972 to 2019 were included in the study, with 468 fatalities reported. Of the fatalities, 155 (33.1%) were definitely on the vessel when they died, 49 (10.5%) were probably on the vessel, 65 (13.9%) were definitely or likely in the water, and the location of 199 (42.5%) was unknown. The most common cause of death was drowning (88, 18.8%), the most common accident cause was sinking (63.5%), and accidents most often started during nighttime hours (7pm-7am, 30, 57.7%).
CONCLUSIONS
This study found that sinking was the most common accident cause for fatal marine accidents, drowning the most common cause of death, and where fatality location was known most were on the vessel when they died. This suggests that, particularly when a ship is in the process of sinking, it is of paramount importance to ensure passengers and crew are familiar with exit routes, are able to exit the vessel, and are instructed to do so in a timely manner.
Topics: Accidents; Drowning; Humans; Nitrobenzoates; Ships; Water
PubMed: 36217975
DOI: 10.5603/IMH.2022.0022 -
Epilepsia Mar 2020The objective of this study was to investigate the accident-related mortality among people younger than 55 years of age with epilepsy compared with the general...
OBJECTIVE
The objective of this study was to investigate the accident-related mortality among people younger than 55 years of age with epilepsy compared with the general population and to study how psychiatric comorbidity influences this risk.
METHODS
This is a population-based cohort study of individuals born in Denmark between 1960 and 2015 (n = 3, 665 616). Persons diagnosed with epilepsy and psychiatric disorders were identified in the Danish National Patient Register and the Danish Central Psychiatric Central Register. We estimated the hazard ratio (HR) with 95% confidence intervals (CIs) of accidental death in people with epilepsy compared with persons without epilepsy.
RESULTS
We identified 61 330 persons (1.7%) diagnosed with epilepsy. Median age at end of follow-up was 27.8 years. In people with epilepsy, 5253 died during follow-up, 480 (9%) of whom died from accidents. Among people without epilepsy, 52 588 died during follow-up, of whom 1280 (2.4%) died from accidents. People with epilepsy had a 3.7-fold (95% CI 3.4-4.1) increased risk of accidental death compared with persons without epilepsy. When we adjusted for psychiatric disorders, the risk remained significantly elevated in people with epilepsy compared to people without epilepsy (adjusted HR [aHR] 2.44, 95% CI 2.22-2.69). When stratifying the analyses on epilepsy and psychiatric disorders, people with epilepsy and psychiatric disorders had an aHR of 4.95 (95% CI 3.82-6.41) when compared with persons without epilepsy and psychiatric disorders.
SIGNIFICANCE
The risk of accidental death was increased in people with epilepsy and was particularly high among people with epilepsy with psychiatric comorbidity. The findings highlight the need for awareness and prevention strategies in people with epilepsy, especially in people with comorbid psychiatric disorders.
Topics: Accidental Falls; Accidents; Accidents, Traffic; Adolescent; Adult; Asphyxia; Child; Child, Preschool; Cohort Studies; Comorbidity; Denmark; Drowning; Epilepsy; Female; Fires; Humans; Infant; Infant, Newborn; Male; Mental Disorders; Middle Aged; Proportional Hazards Models; Prospective Studies; Risk Factors; Sex Factors; Young Adult
PubMed: 32072623
DOI: 10.1111/epi.16453 -
Epilepsia 2005Epilepsy is associated with a two- to three-fold increase in mortality. Studies of cause-specific mortality show that deaths may be classified into those that are... (Review)
Review
Epilepsy is associated with a two- to three-fold increase in mortality. Studies of cause-specific mortality show that deaths may be classified into those that are directly or indirectly related to epilepsy, those that are related to the underlying pathology giving rise to epilepsy, and those that are unrelated to both epilepsy and its causes. Overall, direct epilepsy related deaths are infrequent. Pneumonia, especially in the elderly, central nervous system (CNS) and non-CNS neoplasias, and cerebrovascular disease are frequent causes of death. Suicides, accidental deaths, and ischemic heart disease do not appear to be significant contributors to mortality in community-based studies. In hospital/institution-based analyses, epilepsy-related deaths are common and sudden unexpected death in epilepsy (SUDEP) may account for up to 17% of all deaths in epilepsy. A small proportion of these deaths may be witnessed and most such witnessed deaths occur in relation to convulsive seizures. The exact pathogenetic mechanisms are unknown although it is very probable that lack of seizure control is an important risk factor. Patients who continue to suffer seizures appear to have an almost 40 times higher risk of mortality than those in remission.
Topics: Accidents; Aged; Aged, 80 and over; Cause of Death; Comorbidity; Cross-Cultural Comparison; Death, Sudden; Epilepsy; Humans; Incidence; Prospective Studies; Retrospective Studies; Risk Factors
PubMed: 16393177
DOI: 10.1111/j.1528-1167.2005.00406.x -
The Journal of Trauma Mar 1971
Topics: Accidents; Death; Emergency Medical Services; Health Planning; Humans; Organizations; Societies, Medical; United States; Wounds and Injuries
PubMed: 5545943
DOI: No ID Found -
Legal Medicine (Tokyo, Japan) Jan 2014
Topics: Accidental Falls; Chlorpheniramine; Drowning; Female; Forensic Pathology; Humans
PubMed: 24183968
DOI: 10.1016/j.legalmed.2013.09.006 -
Forensic Science International Dec 1990Autoerotic asphyxia is an increasingly recognised syndrome in which accidental death occurs during solitary sexual activity due to failure of an apparatus that was... (Comparative Study)
Comparative Study Review
Autoerotic asphyxia is an increasingly recognised syndrome in which accidental death occurs during solitary sexual activity due to failure of an apparatus that was designed to produce hypoxic augmentation of the victim's sexual response. Evidence of repetitive, secretive behaviour utilizing ropes and ligatures characterizes cases involving either males or females. Here the similarity in reported cases ends with males tending to utilize a far greater range of elaborate devices and props, often designed to cause real or simulated pain with pornographic material and evidence of cross-dressing and fetishism. Females, on the other hand, have usually been found naked with only a single ligature and no unusual or bizarre equipment. To further clarify the similarities and differences between typical cases involving males and females and to assist in the diagnosis of less obvious cases, the literature is reviewed and characteristic findings in both sexes compared and contrasted.
Topics: Accidents; Asphyxia; Erotica; Female; Humans; Hypoxia; Male; Masturbation; Paraphilic Disorders; Sex Characteristics
PubMed: 2283135
DOI: 10.1016/0379-0738(90)90103-6