Korean J Leg Med.  2020 Feb;44(1):31-36. 10.7580/kjlm.2020.44.1.31.

Unusual Suicide Cases of Asphyxiation by Ligature within the Vehicle

Affiliations
  • 1Scientific Investigation Department, Gyeongbuk Provincial Police Agency, Andong, Korea.
  • 2Department of Forensic Medicine, School of Medicine, Kyungpook National University, Daegu, Korea. sanghan1@knu.ac.kr

Abstract

One of the most common methods of suicide is hanging, and suicide by ligature strangulation is quite rare. Vehicles have a confined space, making them an unusual place for committing suicide by hanging or ligature strangulation, because they are more typically the location of suicide by carbon monoxide intoxication by briquette or drug intoxication. Here, we present three cases of unusual suicide by ligature strangulation, discuss the mechanism of asphyxia in each case, and review the literature. In case 1, the victim used a backpack to perform reverse hanging by wrapping the shoulder strap of the backpack around his neck and then tossing the backpack behind the backrest of the driver's seat. In case 2, the victim did not use the internal structures of the vehicle, but pulled down on a ligature wrapped around both his knees and neck. In case 3, the victim hanged himself using a package line fixed to the roof handle grab of the back passenger seat.

Keyword

Vehicle; Hanging; Strangulation; Backpack; Reverse hanging

MeSH Terms

Asphyxia
Carbon Monoxide
Confined Spaces
Knee
Ligation*
Neck
Shoulder
Suicide*
Carbon Monoxide

Figure

  • Fig. 1. (A) The victim was sitting in the driver’s seat with his neck tilted backward. The victim showed severe facial congestion. (B) The backpack was placed behind the backrest of the driver’s seat.

  • Fig. 2. (A) The victim was seated in the driver’s seat and his head had moved forward at the driver’s handle. (B) The ligature crossed and wrapped once around the neck and was connected with ligatures wrapped separately around his legs.

  • Fig. 3. (A) The victim was found sitting on the floor of the back seat with his legs extended. A nylon rope was tied to a handle inside the vehicle, and a knife and bundle of the rope used were found on the back seat. (B) Based on the fact that three suspension points were found on the handle, his two previous attempts had failed.


Reference

1. DiMaio DJ, DiMaio VJ. Forensic pathology. Boca Raton, FL: CRC Press. 1993; 207–51.
2. Kim DY, Lee S, Kim DJ. Review of suicidal electrocution in South Korea from 2008 year to 2018 year. Korean J Leg Med. 2019; 43:138–43.
Article
3. Kim DY, Lee S. Self-ligature strangulation by utilizing recliner. Korean J Leg Med. 2019; 43:111–4.
Article
4. Koops E, Brinkmann B. Suicidal strangulation by ligature (author's transl). Z Rechtsmed. 1982; 88:221–31.
5. Maxeiner H, Bockholdt B. Homicidal and suicidal ligature strangulation: a comparison of the postmortem findings. Forensic Sci Int. 2003; 137:60–6.
6. Vanezis P. Pathology of neck injury. London: Butterworth & Co;1989. p. 65–71.
7. Saukko P, Knight B. Knight’s forensic pathology. 3rd ed.London: Arnold;2004. p. 379–83.
8. Dolinak D, Matshes EW. Asphyxia. Dolinak D, Matshes EW, Lew EO, editors. Forensic pathology: principles and practice. Burlington: Elsevier Academic Press;2005. p. 201–24.
9. Atilgan M. A case of suicidal ligature strangulation by using a tourniquet method. Am J Forensic Med Pathol. 2010; 31:85–6.
Article
10. Tzimas I, Bajanowski T, Pollak S, et al. Suicidal ligature strangulation using gymnastics bands. Int J Legal Med. 2014; 128:313–6.
Article
11. Pramod Kumar GN, Arun M, Manjunatha B, et al. Suicidal strangulation by plastic lock tie. J Forensic Leg Med. 2013; 20:60–2.
Article
12. Badiadka KK, Kanchan T, D'Souza DH, et al. An unusual case of self-strangulation by ligature. J Forensic Leg Med. 2012; 19:434–6.
Article
13. Pramanik P. An unusual method of suicidal ligature strangulation. J Forensic Sci. 2016; 61:274–6.
Article
14. Lo Pinto S, Tacchella T, Fossati F, et al. Self-strangulation through a sphygmomanometer: an uncommon suicide. J Forensic Sci. 2017; 62:528–30.
Article
15. Azmak D. Asphyxial deaths: a retrospective study and review of the literature. Am J Forensic Med Pathol. 2006; 27:134–44.
16. Russo MC, Verzeletti A, Piras M, et al. Hanging deaths: a retrospective study regarding 260 cases. Am J Forensic Med Pathol. 2016; 37:141–5.
17. Tugaleva E, Gorassini DR, Shkrum MJ. Retrospective analysis of hanging deaths in Ontario. J Forensic Sci. 2016; 61:1498–507.
Article
18. Uzun I, Buyuk Y, Gurpinar K. Suicidal hanging: fatalities in Istanbul retrospective analysis of 761 autopsy cases. J Forensic Leg Med. 2007; 14:406–9.
19. Blanco Pampin JM, Lopez-Abajo Rodriguez BA. Suicidal hanging within an automobile. Am J Forensic Med Pathol. 2001; 22:367–9.
Article
20. Durso S, Del Vecchio S, Ciallella C. Hanging in an automobile: a report on a unique case history. Am J Forensic Med Pathol. 1995; 16:352–4.
Article
21. Byard RW, James RA. Unusual motor vehicle suicides. J Clin Forensic Med. 2001; 8:1–4.
Article
22. Madea B, Schmidt P, Kernbach-Wighton G, et al. Strangulation: suicide at the wheel. Leg Med (Tokyo). 2015; 17:512–6.
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