Unusual cause of death in a case of assault

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Introduction In a case of assault, death occurs as a consequence of single or multiple injuries. However, death can occur if a person is asphyxiated sufficiently after incapacitation due to alcohol intoxication and concussion. Case Report A 37yr old male went to play cricket with friends. Five bottles of arrack were consumed by them. Apparently, they had left the grounds at 6.30pm. However, the owner of a restaurant had seen the deceased drinking and singing with some people around 7.30pm. At 8.20pm a customer patronizing the restaurant had noticed a person fallen on the beach, face down. Immediately, police headquarters was informed. The relevant police arrived within 30minutes and rushed the person to hospital where he was pronounced dead. At autopsy, 43 injuries were detected. They were mainly abrasions and contusions, predominantly on the head, face, neck, chest and abdomen. The upper and lower limbs were totally devoid of injuries. The only fracture that was present was of the nasal bone. The body was covered with sand. The hands and feet had a moderate amount of wrinkled skin. The trachea had excessive amounts of sand. The primary bronchi too had sand but to a lesser degree. The secondary bronchi were devoid of sand or froth. The face and neck were congested. Ecchymoses was evident in both eyes. All internal organs were congested; Lungs were markedly congested. There were petechial haemorrhages in both lungs, without hyperinflation or emphysema aquosum. Government Analyst's report indicated the presence of 308mg of Ethyl alcohol per lOOml of blood. Other common poisons were excluded. Conclusion The injuries, injury pattern and asphyxia features confirmed smothering and pressure on the neck as cause of death. Although there was evidence of contact with water, there was no conclusive evidence of drowning. However, attempted forced drowning could not be excluded.