Fatal accidental asphyxia in a jack-knife position

Accidental death from postural or positional asphyxia takes place when the abnormal position of the victim’s body compromises the process of respiration. Diagnosis is largely made by circumstantial evidence supported by absence of any other significant pathology or trauma explaining death. This case report is about a 50-year-old male who had been drinking the previous night and was found dead in the morning inside a tire repair shop. His jack-knifed body had been encompassed, buttocks-down, within the hollow core made by 3 big tires stacked on top of each other. The author was called to the scene of death and had hands-on encounter with the body in-situ where scene photographs were taken. Apart from a blood alcohol of 290 mg/100 ml, marked congestion of the face, petechial hemorrhages on the conjunctivae and lung edema and congestion, autopsy findings were unremarkable. Abrasions on shoulders, lateral aspects of arms and posterior aspects of lower legs indicated friction with internal rims of tires while slipping down. There were no other injuries or pathology to account for his death. Death was determined to be due to accidental postural asphyxia secondary to intoxication by alcohol.