Homicide by a combination of three different asphyxial methods

A case of death of a healthy male in his early forties is described, where three different asphyxial methods, i.e., manual strangulation, smothering and traumatic asphyxia by thoracic compression were used. The interest in the case is generated because all this three methods were carried out by a single assailant. Nail scratch abrasions were present on the cheek and neck. Internal examination revealed haemorrhagic infiltration into the muscles of the neck, contusion of the inner wall of upper respiratory tract and fracture of the hyoid bone. The autopsy findings helped the forensic pathologist in reconstructing the sequence of events and the manner in which the act was carried out. This case highlights the possibility of the involvement of a single person only, in the homicide of a healthy adult male by the application of three different asphyxial methods.