POSITIONAL ASPHYXIA – A RARE CASE IN THE FORENSIC PRACTICE

Abstract

Introduction: Positional asphyxia is a form of asphyxia, which occurs when someone's position prevents the person from breathing adequately. It may be a factor in a significant number of people who die suddenly during restraint by police, prison officers, military or health care staff. In the forensic practice, it is a rare cause of sudden death and a difficult diagnosis. Case presentation: We present a case of a 29year-old man who died during transportation due to the specific position he was put into by the police officers accompanying him. His hands were restrained with handcuffs on his back and he was made to bend his head and torso forward to his knees for a long period of time. Results: During the forensic autopsy, morphological findings showed the presence only of signs of sudden death - external and internal, frequently found in asphyxia. The toxicology analysis was positive for cocaine but the amount was not lethal. Discussion: Researches have suggested that restraining a person in a facedown and in a seated position pushed forward with the chest on or close to the knees may reduce the ability to breath. The current criteria for positional asphyxia are based on the obstruction of normal gas exchange caused by the body position, the impossibility to move to another position, and the exclusion of other causes of death.

Keywords

• positional asphyxia
• sudden death
• differential diagnosis