Question Re: Suffocation

stormie

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I did a search here but couldn't find the answer I need. I'll give a rep to anyone who answers, even if it's just to say "hi" or "shut up and drink your iced schnapps."

First, a backstory: Several years ago in my small town, within a year of each other, two married women were each found dead in their beds, one by the husband, the other by her son. No real answer was given except that there was no foul play. Neither woman was unhealthy, nor a smoker, druggie, or alchoholic. It was said (through the small town grapevine) that at least one of them maybe died of an asthmatic attack.

Now I'm formulating a story where a woman in her late 30s dies unexpectedly. Her death is ruled as being from an asthma attack in her sleep. Yet as the story unfolds, the reader finds out that the husband smothered her with a pillow.

My question--is that feasible that an autopsy wouldn't show someone was smothered? Or is there any other way someone would be murdered in their sleep but the autopsy wouldn't show it?

Thanks!
 
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agent.grey

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I think it would be reasonably believable if the woman was known to have severe asthma attacks. Also a lot more likely that suffocation would be overlooked if the husband and wife appeared to get along fine.

The coroner/medical examiner would need to be somewhat negligent to miss smothering, but if they already have an explanation (asthma) and are busy/lazy/have no resources then I would not think it too strange for the husband to get away with it.

My tuppence, but I am neither a coroner or a murderer :D
 

mgnme

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in the words of PubMed (http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001196/), "Asthma is caused by inflammation in the airways. When an asthma attack occurs, the muscles surrounding the airways become tight and the lining of the air passages swells. This reduces the amount of air that can pass by."

I'm not an expert, but I'm guessing that if they did an autopsy, there's a chance they'd know that it wasn't asthma. Especially since they'd be looking for signs that it was asthma. (swollen airways like that don't happen if you are being smothered. that much I can tell you for sure.) What about Sleep Apnea as a possible alternate? anyone with expertise want to take the ball on that one?
 

jclarkdawe

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This is somewhat going to depend upon how thorough is the autopsy and how good the pathologist is and how much time is spent on the autopsy.

Suffocation leaves very little sign in many instances. Usually in a suffocation case the pathologist can merely testify that the death was probably caused by suffocation. Other evidence is introduced at trial to support the diagnosis.

Asthma, on the other hand, involves constricted airways, as well as some other signs. However, asthma, in and of itself, should not be viewed as the cause of death without supportive information such as a medical history, as asthma can be caused by external stimuli.

All deaths involving breathing tend to the hardest to proof homicide, unless there are external indications such as bruising.

Best of luck,

Jim Clark-Dawe
 

Kitti

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Yet as the story unfolds, the reader finds out that the husband smothered her with a pillow.

Is it absolutely necessary that he smother her with a pillow? Could he deliberately induce an asthma attack instead? Or induce the attack then finish her off with a pillow? (Though I suppose that would require knowing something about forensics - maybe he Googles it first?)

Depending on how severe her asthma is, and what her triggers are, it would be very simple for hubby dearest to set off an attack in her sleep. I am asthmatic and have several specific triggers (including smoke) that are worse than all others. My old roommate, also asthmatic, is the same way - her worst trigger is Easter lilies, which might make a great murder weapon, though oddly enough the smell of eucalyptis does it too (most asthmatics find eucalyptis helps relax the airways, not close them up). None if it would wake us up from a sound sleep; even when awake you sort of gradually have more and more trouble breathing until you finally have to admit to yourself you are actually having an asthma attack and can you manage it on your own or do you really have to go get nebulized at the ER?
 

mccardey

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I'm a very brittle asthmatic - which is to say I do have the kind of quickly progressing asthma that one could die from, if I had run out of meds, and couldn't get to a hospital - but I don't think, unless she was very old, that a person would die in her sleep (if that's what you were thinking) from an attack. In my experience - but I don't know if it's general - a bad attack will wake you and send you in search of relief. Even in very brittle attacks I've had time to phone an ambulance - though I couldn't talk much by the time they answered.

So she could die of asthma, but she wouldn't look as though she'd died in her sleep. Though it would be perfectly possible for her husband to withhold the medical help and then claim he was panicking and couldn't help her.*
 
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shaldna

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People can drop dead for no reason, there is a thing called sudden adult death syndrome, which is similar to SIDS, but occurs in adults.

Also, there are physical issues with suffocation - adults struggle, and there would be signs of this that show up on the autopsy, such as bruising etc, to the hands and arms.
 

stray

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Asthma and panic go hand in hand. An asthma attack wakes the sufferer, as Maccardey pointed out.. Asthmatics (I am one myself), often also have alergies. Cat hair for example. An asthmatic would wake up if he or she had an attack. They would not die in their sleep. They might suffocate trying to get help. A victim found dead with the phone in her hand would be a good frame. Especially if the murderer had elicited the asthma attack with say cat hair, smothered her and then put her in a chair with the telephone in her hand.
 

mccardey

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My question--is that feasible that an autopsy wouldn't show someone was smothered? Or is there any other way someone would be murdered in their sleep but the autopsy wouldn't show it?

Thanks!

I'm pretty sure the differences between asthma and smothering would be clear via autopsy. I think I read that suffocation would result in burst blood vessels etc, whereas asthma is an inflammatory condition.
 
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My question--is that feasible that an autopsy wouldn't show someone was smothered? Or is there any other way someone would be murdered in their sleep but the autopsy wouldn't show it?

Whatever you do, don't let the forensic researcher rule the death the result of suffocation due to petechiae in the conjunctiva [burst blood vessels in the white of the eye]. This has been disproved by Ely and Hirsch.

http://www.charlydmiller.com/LIB04/2000petechiaereview.pdf

By the way, don't read the conclusion on wikipedia, because it says:
Forensics

Petechiae on the face and conjunctiva (eyes) can be a sign of a death by asphyxiation. Petechiae are thought to result from an increase of pressure in the veins of the head and hypoxic damage to endothelia of blood vessels.[3]
Petechiae can be used by police investigators in determining is strangulation has been part of an attack. The documentation of the presence of petechiae on a victim can help police investigators prove the case.[4] Petechiae resulting from strangulation can be relatively tiny and light in color to very bright and pronounced. Petechiae may be seen on the face, in the whites of the eyes or on the inside of the eyelids.

This is not true. Petechiae can even be the result of vigorous resuscitation. And petechiae are also often noticable in sudden heart infarct victims.
 

mccardey

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Whatever you do, don't let the forensic researcher rule the death the result of suffocation due to petechiae in the conjunctiva [burst blood vessels in the white of the eye]. This has been disproved by Ely and Hirsch.

http://www.charlydmiller.com/LIB04/2000petechiaereview.pdf

By the way, don't read the conclusion on wikipedia, because it says:


This is not true. Petechiae can even be the result of vigorous resuscitation. And petechiae are also often noticable in sudden heart infarct victims.

That might be what I was referrring to when I said
I think I read that suffocation would result in burst blood vessels etc,
- sorry if it was wrong. I thought I'd read it somewhere, but it could be decades out of date...
 
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That might be what I was referrring to when I said - sorry if it was wrong. I thought I'd read it somewhere, but it could be decades out of date...

That assumption has persisted for a long time, even made it into a couple of court cases, and after that into fiction. However, unless there are other indicators, petechiae in the conjunctivae alone are not an indication of homicidal asphyxiation.
 

jclarkdawe

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Forensically, suffocation can be extremely difficult to prove. Many of the signs of suffocation are shared with other conditions, which may be fatal or may in fact be signs of nothing to do with death. Unfortunately, many attorneys were not aware of this and allowed pathologists to testify without subjecting them to effective cross-examination.

Suffocation should be viewed in the totality of the circumstances. For example, bruising of the wrists can be caused by someone holding the victim down. Or it could be caused by a rescuer grabbing the victim by the wrists and trying to stand them up to get them breathing (not everyone is trained in what to do in this sort of circumstance). For the pathologist, he/she should be testifying that the bruising indicates the possibility of suffocation. The statement (or lack of the statement) by the person who caused the bruising should be used by the jury in its ultimate determination.

Best of luck,

Jim Clark-Dawe
 

stormie

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I've read through each post (thank you and I am in the process of giving more reps out :) ).

As some said, asthma attacks in the sleep usually wake the person up. I had forgotten--my sister had severe asthma and it'd wake her up at night, so yes, I agree. As I said, these reports were through the small town grapevine. Basically the two of them were "They just died." So maybe sudden adult death syndrome took place.

Some mentioned that with suffocation, there would be signs of a struggle. Yes, you're right. I can see that.

As for petechiae, my older son had that in the eyes when he had a blood disorder, so in and of itself, I know that wouldn't be a deciding factor in suffocation.

Here are two scenarios--could the husband have encouraged her to drink well over her usual limit of alcohol while they're in a restaurant where a lot of patrons see her walking out very drunk, then since she was so inebriated, she doesn't wake up when he puts the pillow over her face? Autopsy would show a lot of alcohol in her system and it would be backed up by the customers and wait staff at the restaurant. Or she has too much to drink and when they get home the husband in some way, causes her to have an asthmatic attack so that the autopsy would show inebriation w/ asthma attack.

Would either be plausible?
 
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PinkAmy

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My understanding is that smothering usually lives an impression of the upper front teeth on the gums (I can't remember where I read it, but it was a true crime book that talked about how the death was determined.) If the pillow is inserted into the mouth there is often residue from the pillow in the mouth and DNA on the pillow. Also the blood vessels in the eyes usually burst so that's another sign. If the murderer presses on the throat that will cause bruising and possible broken bones in the neck. (I read way too much true crime ;))
 

jclarkdawe

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I've read through each post (thank you and I am in the process of giving more reps out :) ). You're welcome and rep points are always appreciated and never have a problem with fitting just right.

As some said, asthma attacks in the sleep usually wake the person up. I had forgotten--my sister had severe asthma and it'd wake her up at night, so yes, I agree. As I said, these reports were through the small town grapevine. Basically the two of them were "They just died." So maybe sudden adult death syndrome took place. Basically anything that interferes with breathing can produce a violent reaction on the part of the victim. Lack of oxygen frequently produces a strong and fierce reaction to remedy that situation. It tends not to be a quiet death, although it can be.

Not all deaths can be explained. Nor are all autopsies as thorough as they could be. For example, there a literally thousands of toxins that can show up in the blood stream. Think they're all tested for in each autopsy? Or even most autopsies? Nor is science that exact.

Some mentioned that with suffocation, there would be signs of a struggle. Yes, you're right. I can see that. There CAN be signs of a struggle. There may be no signs of a struggle. There may be no struggle. It depends. Don't think in terms of absolutes here.

As for petechiae, my older son had that in the eyes when he had a blood disorder, so in and of itself, I know that wouldn't be a deciding factor in suffocation.

Here are two scenarios--could the husband have encouraged her to drink well over her usual limit of alchohol while they're in a restaurant where a lot of patrons see her walking out very drunk, then since she was so inebriated, she doesn't wake up when he puts the pillow over her face? Autopsy would show a lot of alchohol in her system and it would be backed up by the customers and wait staff at the restaurant. Definitely possible, but it's not predictable. Even drunks (BAL about .20%) can fight. Including fighting suffocation. On the other hand, some drunks' need for breathing goes down, and lying/falling face down on a pillow is enough to cause suffocation. (Ever felt the need to roll a drunk on their side? There's two reasons for this and this is one of them. The other is choking on their vomit.) The husband could definitely get away with this, but all sorts of things could go wrong in the process. But criminals tend to be optimistic people who don't think about things going wrong.

Or she has too much to drink and when they get home the husband in some way, causes her to have an asthmatic attack so that the autopsy would show inebriation w/ asthma attack. Does the person have a history of asthma? Asthma attacks with no history tend to show the sign of a sudden introduction of a chemical to the victim. Whether this is accidental or intentional is a separate matter.

Assuming a known history of asthma, you'd start looking for the agent (such as a cat or whatever produces the reaction). Presuming it is naturally there, the question then becomes whether it is strong enough to produce a fatal reaction. I'd be less inclined to believe a fatal result than with the previous method, and the result would again be unpredictable for the husband, but it's definitely possible.

Would either be plausible?

Remember that criminals tend to be dumb (or think that cops are dumber than they are which equals the same thing) and do plans that a smarter person would realize has some big risks to it. And yet they can be lucky and succeed.

Best of luck,

Jim Clark-Dawe
 

jclarkdawe

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My understanding is that smothering usually lives an impression of the upper front teeth on the gums (I can't remember where I read it, but it was a true crime book that talked about how the death was determined.) It can, especially in compression suffocations. It doesn't appear in all suffocations, but its presence is a strong indication in suffocation.

If the pillow is inserted into the mouth there is often residue from the pillow in the mouth and DNA on the pillow. Yes, a pillow will frequently leave residue in the mouth, but not always. Material of the pillow (goose down is probably most likely) and exactly how it is held will influence this. DNA on the pillow depends upon whether it's that person's pillow. On your pillow, you will have had surface contact and probably some drooling between each washing. This can result in anything from minimal to a crap load of DNA on a pillow. DNA on the pillow is going to be thrown into the mix at trial, but is actually rather meaningless.

Also the blood vessels in the eyes usually burst so that's another sign. They can, and frequently do, but this is also indicative of other conditions as well. The result is that this is just supportive of a diagnosis of suffocation, but is not conclusive by itself.

If the murderer presses on the throat that will cause bruising and possible broken bones in the neck. (I read way too much true crime ;)) This is strangulation, not suffocation. Both are dead, but the cause of death is different. Strangulation is much easier to detect than suffocation.

Best of luck,

Jim Clark-Dawe