Q and A: Can My ME Distinguish Death From Asphyxia From Death Due to Head Trauma?

Q: Here’s my book situation: A man puts a plastic bag over his head to kill himself. His wife wakes up next to him (after he nearly strangled her to death and she discovers he’s killed their son) and in her horror and rage cracks him over the head with a blunt object.

Here’s my question: Can the police/coroner/forensics determine which was the cause of death–suffocation or blunt force trauma? If so, what would the signs be pointing to asphyxiation?  Also, if it matters, this is set in 1969.

Judy Merrill Larsen, author of All the Numbers

http://www.judymerrilllarsen.com

A: If the victim died first from the asphyxia, the ME would have no problem since the blow to the head would cause no bruising or bleeding. At death the heart stops and blood flow ceases and a corpse will not bleed or bruise easily. So the ME would see a mark where the victim was struck but no bleeding or bruising and know that the blow was delivered post-mortem.

If he was still alive when struck, things become a little more difficult for the ME but he should still be able to tell. Bruising and bleeding at the site of the blunt trauma would show that the victim was alive when struck but if there is no significant brain injury found at autopsy he would know that the force of the blow did not cause death and the asphyxia must have. If there is a brain injury such as cerebral contusion (brain bruise) or bleeding into or around the brain, he might have difficulty determining the actual cause of death. Of course any evidence of blunt trauma would point to homicide and not suicide since someone using a plastic bag for suicide would not likely also strike themselves in the head.

But I see a bigger problem with your scenario. If she was unconscious from being strangled, she would wake up within 10 seconds to a minute or so after the pressure was released unless she had significant brain injury from lack of oxygen. If she were simply strangled into unconsciousness, which is due to blocking blood flow thru the carotid arteries to the brain and not blocking breathing, as soon as the pressure was released and blood flow reestablished, she would wake up very quickly. Much sooner than he could put a bag on his head and die from asphyxia. For her to be out that long would require some degree of brain injury and I don’t think that’s what you want. Of course, if he drugged her first and then strangled her to the point he thought she was dead, but she in fact wasn’t, then she would awaken when the drug effect wore off. Here he could be dead for hours before she awakened.