- Types of Hanging
- Mode of Death
- POST-MORTEM APPEARANCES
- Forensic significance of Hanging
Forensic medicine is a vast field in forensic sciences. It implicates a systematized procedure to proceed in any civil or a criminal investigation. Forensic medicine includes medical examination, documentation and presentation in the court of law. It helps to examine the cause of death, time since death, injuries and age of injuries, type of weapon used in homicide. Hanging is one of the most common and easily accessible mode of death be it suicide or a homicide. Depression or mental stress is the strongest reason people choose to commit suicide. It is also used as the legal punishment in the Indian legal system. Another most commonly occurring deaths are due to road traffic accidents. Instant death due to hemorrhagic shock or death during hospitalization are frequent. Homicide by stabbing, medical negligence, electrocution, are some other reasons of death.
Definition: When a person is suspended in air through a ligature material tied around the neck, a force is applied on the neck causing blockage of air passage.
It is very common means of suicide opted by people specially, young adults due to one or the other reason such as depression, financial crisis, mental trauma or mentally disturbed.
Types of Hanging
By virtue of position of knot:
- If the knot is at the mid back line of neck or at the occipital bone it is called Typical hanging
- When the position of knot is located anywhere other than the occipital bone, it is termed as Atypical hanging.
On the basis of force of neck compression:
Complete Hanging: when the neck gets the force of the whole body.
Incomplete Hanging: when the neck gets the force only from the head.
Mode of Death
Clothes are examined for mud, sand, blood, vomitus, feaces, semen or other biological substances to collect evidences for representation in the court of law.
They form a basis for circumstantial evidences evident for the location of crime scene.
Starting from the head, a medical practitioner observes any head injury if present.
Neck is examined very carefully, ligature marks, abrasions on neck due to the ligature material and cross checking if the ligature mark and ligature material are same or not. All the measurements of ligature mark are very important.
Struggle marks are looked if any, for strangulation.
Then coming to the face: eyes, lips and all other facial characters are noted for any type of external injury.
A modified “Y“- shaped incision is made starting from neck till the abdomen to open body cavity.
Another incision is made in trachea and opened properly to show it to the doctor in charge for any occlusions around neck and any blood in tracheal cartilage.
“I” incision is made in cases other than hanging.
Stomach is opened for the last meal consumed and if there is any poisonous material, alcohol or drugs present.
If there is any indication towards strangulation or homicide, viscera collection is mandatory.
A part of:
liver, kidney, spleen, and small intestine and its contents are stored in clean glass jars with labelled information such as case no., investigating officer. Medical professional in charge, hospital’s address from where the autopsy & viscera collection has taken place.
In case of suicidal hanging
● Cyanosis of lips, and finger or toe nails, petechial hemorrhage in sclera and eyelids.
● Tongue protrusion is a very common founding.
● Hyoid bone fracture is also found in few cases and, tear of transverse intima of common carotid artery is the rarest finding.
● No effusions are observed around the cartilages of trachea and the trachea gets devoid of any blood traces in all the cases indicating a pure suicidal hanging.
In case of homicidal hanging or strangulation:
● Ligature mark will be un-even unlike in suicidal hanging.
● Occlusions are present in trachea and traces of blood are visible inside tracheal cavity
● Struggle marks are present.
● Petechia in skin is observed.
● Epidermis or the inner lining of body cavity might have the possibilities of bruises or abrasions.
In case of Judicial Hanging
● As the ligature knot is placed at the angle of jaw, this usually causes fracture-dislocation of second-third or, third-fourth cervical vertebrae.
● There may also be signs of fracture dislocation in occipital joint which leads to instantaneous and irreversible loss of consciousness.
● This fracture causes instant death and no signs of asphyxia are markedly seen in judicial hanging.
● Conjunctiva hemorrhage & Petechial hemorrhages observed.
● Bruises, abrasions and defense marks may also present.
Forensic significance of Hanging
Hanging is always considered suicidal, until it is proved to be homicidal. Circumstantial evidences play a crucial role in proving or disproving the hanging to be suicidal or homicidal. Foot stool used, ladder or any other material used to tie the ligature on fan or ceiling may be found fallen on ground.
Homicidal hanging becomes difficult to establish in any cases until unless the person is alcoholic or in influence of any drug. In western countries also, it was used as a mode of punishment, the person was hanged in public for any criminal offense.
Judicial hanging is practiced in India for the legal punishment as death sentence.
Post mortem hanging
Hanging after murder can be done by an offender to disguise murder as suicide. Parchmentization, grooving in neck, patterned abrasion or bruises will be absent.
Case study 1
1.A home maker (female)- Age- estimated between 35-40 years.
Found hung in bedroom of her own house. Door was locked from inside.
Ligature mark was shallow and lesser abrasions.
Tongue protruded outside, livor mortis more in distal portions of the limbs, indicating upright hanging.
Tracheal rings devoid of any blood indicating it to be suicidal hanging.
2. A labor on contract basis (male)- Age- 33 years old. The police officer in charge reported about person, committed suicide at his workplace, at under construction building.
The police were informed by his co-workers about the case. It was about 28 hours after his death.
It was a complete suicidal hanging. Cyanosis, post mortem lividity was visible in the body and decomposition had begun around his eyes and mouth.
3. A teenage girl- Age- estimated about 17-18 years.
She was found hung in a bedroom on her own house.
No struggle marks, bruises, were observed.
Her reason for suicide was not clear as she did not leave a suicide note neither her parents knew anything about her death.
4. A male found hanging in his house- Age was about 35 years.
He used to work here in Delhi as a security guard at a private office.
Body was discovered after 28 hours of his death.
His younger brother said that he was in stress due to the loan of about 5 lacs.
Image courtesy: Isha (Deen Dayal Upadhyay Hospital)
5. A pregnant woman- Age-about 25 years.
She had run away from her home with her boyfriend about one year prior to her death.
She was six weeks pregnant as found in the post mortem examination.
Out of a sudden, she committed suicide. His husband said that, she was undergoing depression and mental illness also, he denied to be the biological father of that child in her womb.
Fetus was removed out of her body for the examination, it was a six-weeks old fetus.
Image Courtesy: Isha (Deen Dayal upadhyay Hospital)
6. A male found dead in his home- age about 52 years.
He hung himself in the store room of his house. He lived with his son and daughter in law.
His son was not able to find him the next morning.
Later that morning, the family members experienced some kind of awful smell and then they searched the store room and found his body hanging in the store room.
In the post-mortem, it was found that the dead body had been hanging since, 18 hours, he committed suicide during the last night itself. Doctor found all evidences of suicidal hanging.
No struggle marks or fresh injuries indicating any violence from his family members were present.
Cause of death- hypoxia caused by blockage of air passage and cerebral ischemia.
UNKNOWN DEAD BODIES
Unknown means, whose identity is not yet established. Forensic medicine thus, helps in identifying a dead body their age, time since death, location of death, any peculiarities which are unique to a person such as;
A birthmark or a tattoo- their likes and dislikes towards something, or favoring a group of people or a community.
Any kind of physical features being unique.
Bodies found unidentified on roads, near any water body, under a water body, people died in plane crash, mass explosions, riots, etc. come under the category of unknown dead bodies.
A dead body found at the Delhi-Haryana border: a male was found dead in a car, as reported by the investigating officer. A trespasser informed police about the person being dead.
The doors of car were locked from inside.
Stomach was opened to examine any kind of drugs or alcohol present. It was full of alcohol and his liver fatty indicating chronic liver disease due to excessive intake of alcohol.
Cause of death- myocardial infarction.
A decomposed body found at Dwarka mor near marshy inhabited area.
Autopsy was difficult to perform because of decomposition in its advanced stages.
Adipocere formation was observed clearly around the forearms and over the abdomen. Bloated belly due to microbial action forming gases, putrefaction was visible and blabs in epidermis were also visible.
Cause of death- unknown.
ROAD TRAFFIC ACCIDENT
Any type of tragic events that occur at any location such as road, public places, workplaces or under construction building, caused due to a vehicular force or any other non-living object such as boulders, rocks, or a sharp or blunt object.
Case Study 2
Road accident of a women- Age- around 35 years.
She was reported travelling at a motorbike with her brother and a truck hits the motorbike.
Injuries- She had minor abrasions on her shoulder, forearms, feet and at the buttock area.
Graze abrasion on the left hand.
Degloving injury was on the right hand’s medial region.
She was hospitalized immediately and had surgical sutures starting from the right thigh covering mons pubis till the left side of lower abdomen.
Cause of death- died within 16 hours of her hospitalization due to hemorrhagic shock.
A labor on contract basis-
Age estimated about 45 years.
Met with an accident with a big boulder at construction site and got hit with a force. He accidently hit with this stone while working on a building standing on a ladder and fell.
Injuries- minor abrasions on the feet and abdominal region. Major internal injury inside the head caused hemorrhagic shock.
One injury at the lateral side of left chest.
Cause of death- hemorrhagic shock.
It is any kind of act performed by a medical professional, or a doctor in handling a patient while their treatment or a surgery. This is often included under tort, meaning any reckless act causing harm to the patient.
Protected under the Consumers Protection Act, 1986.
Case study 3
A neonate – this was a case of a neonate which was in the process of being born. The doctor assisted this delivery, using some instrument for creating a suction on head of the baby as crowning was visible.
This injured the head of the baby causing bleeding and the neonate died during the delivery. It was reported as a case of medical negligence.
The autopsy was conducted- inverted Y incision was made starting from chest to the abdomen protecting the umbilical region for examination. His large intestine had fecal matter.
Heart, lungs, kidney, spleen and liver were intact and showed no abnormalities.
Head was sectioned and the hemorrhagic shock was visible.
Viscera was photographed and collected.
Cause of death- hemorrhagic shock.
Electrocution is derived from two words, electric meaning current, and cause meaning death due to electric current or shock.
In many cases it is fatal, specially if the voltage of current entering the body is high, it causes: Cardiac arrest and, burns in skin.
There is always a principle of electric current to enter into the body, leave a wound in form of burns, and leave the body at a certain location forming an exit wound. Entry wound will always be there however, exit wound is sometimes not visible on the body.
Case study 4
An electrician, around 26 years old died due to electric shock while repairing some electrical faults at the pole of wires.
Autopsy- heart was abnormal showing cardiac arrest, other vital organs were intact. Entry and exit wounds were clearly visible in his left hand’s fingers
The little finger had three degree burns as his epidermis and dermal layers with muscles were burned and 2nd degree burn was seen in the left hand’s index finger, showing entry and exit wound respectively. Brain was intact and no abnormalities were detected.
Cause of death- Cardiac failure and three degree burn on the little finger.
Forensic medicine is a field in forensic science which implicates medical knowledge in law. Medicine is very important in terms of examination of different cases of living or a dead victim or a suspect. Doctor’s examination and their supervision is very important as the court of law accepts appropriate evidences produced by experienced professionals for their objectivity and authenticity. Medical professionals examine and analyze injuries in a live or a dead person, to know the weapon used for attacking a person in homicide or attempt to murder case, cause of death, time since death, location of death, by conducting an autopsy and transporting it to the forensic labs. In this report, there is a deep study of all the autopsy conduction in a mortuary, in a hospital located at Hari Nagar, Delhi, the Deen Dayal Hospital.
- Youtube channel StupireMed.: hanging in forensic medicine and toxicology by DR. Vishwajeet.
- Journal from Research gate.
- Figure 1: Google stock images- Quora digests “how does it feel to conduct a past mortem?”
- Figure 2: References in neurological disorders: The Lancet Neurology.
- Figure 3, 4,5,6,7,8, & 9: Image Captured by Isha Thakur (Article Author) at Deen Dayal Upadhyay Hospital, Clock Tower, Hari Nagar, Delhi-110064.
About The Author
This Project work is submitted by Isha Thakur, pursuing B.SC. (H) Forensic Sciences (5th semester) from Amity Institute of Forensic Science, Amity University, Noida, Uttar Pradesh.