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IMAGES IN FORENSICS

Fatal automobile door entrapment: a recurring problem Roger W. Byard1,2

Accepted: 27 March 2015 Ó Springer Science+Business Media New York 2015

Case report A 74-year-old man was trapped between the opened door and frame of his car at a drive through fast food outlet. Closed circuit television footage, supported by witness statements, showed that the victim had leaned out of the vehicle to pick up money that had been dropped after he had been given change. His foot had accidentally moved from the brake pedal to the accelerator causing the vehicle to move forwards, impacting the door against a fixed bollard and wall. His body had then become wedged between the door and frame by the forward motion of the car against the brick wall. This had resulted in the application of considerable force to his torso and death at the scene. External examination revealed a series of patterned injuries on the right shoulder from wedging between the door and frame. Anteriorly there were a series of parallel linear abrasions at right angles with a central circular abrasion (Fig. 1), and posteriorly there were paired tram track markings intersecting at right angles (Fig. 2). As well there was a rectangular abrasion and tram track marking of the left chest below the breast and a square area of purple punctate bruising over the left scapula. Features of crush asphyxia included marked congestion of the head and neck with petechial hemorrhages of the face, upper chest and back, and prominent subconjunctival hemorrhages (Fig. 3). Fresh blood was leaking from the left ear and both nostrils. & Roger W. Byard [email protected] 1

Discipline of Anatomy and Pathology, Level 3 Medical School North Building, The University of Adelaide, Frome Road, Adelaide 5005, SA, Australia

2

Forensic Science SA, Adelaide, SA, Australia

A flail chest was present with numerous bilateral rib fractures and bilateral hemothoraces. The lower lobe of the lung and hilum of the right lung were lacerated and there were fracture dislocations of thoracic vertebrae 4–5, and 9–10. Anterior epicardial bruising was present, with marked congestion of the thyroid gland and blood islands identified on microscopy (Fig. 4). The only injury in the abdomen was a superficial subcapsular laceration of the spleen with a minor hematoperitoneum. Toxicology was negative for alcohol and common drugs. Death was due to blunt chest trauma with crush asphyxia.

Discussion Lethal asphyxia related to motor vehicles may be associated with a wide range of circumstances. The most common involves suicidal carbon monoxide inhalation, however deaths have also occurred when a gas cylinder containing nitrous oxide has been opened with displacement of cabin oxygen, and from hanging from seat belts after a vehicle roll over. Suffocation/choking may result from either filling of the cabin with soil or the pressing of a victim’s face into soil after a rollover with entrapment [1–3]. Crush asphyxia refers to a situation where chest excursion is prevented by externally applied press