Seat belt asphyxia as a lethal mechanism in motor vehicle crashes
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Seat belt asphyxia as a lethal mechanism in motor vehicle crashes Roger W. Byard 1
&
Siobhan O’Donovan 1 & John D. Gilbert 1
Accepted: 18 August 2020 # Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract A 28-year-old driver was found dead in his car after impact with a truck. At the scene he was seated in the driver’s seat partially hanging out of the vehicle with the sash component of the seatbelt tightly pressed into his neck. At autopsy there was evidence of neck compression with bilateral conjunctival petechial hemorrhages and fracture of the right superior horn of the thyroid cartilage. Limb fractures and internal injuries were not associated with significant hemorrhage. There was no evidence of brain trauma. Death was, therefore due to neck compression from the seatbelt demonstrating an additional rare lethal mechanism that may be encountered in vehicle crashes. External bruises and abrasions may not be present around the neck due to padding from clothing, however conjunctival petechiae and neck injuries are supportive of the diagnosis. Keywords Seatbelt . Hanging . Neck compression . Asphyxia . Vehicle crash
Case report A 28-year-old man was a single occupant driving an early model sedan at approximately 110 km/h (68 miles/h) when he suddenly veered to the other side of the road, impacting a truck travelling in the opposite direction at approximately 100 km/h. He had sent a text message shortly before the crash stating that he was extremely tired and felt that he should not be driving. He had travelled approximately 550 km in 5½ hours. At the scene there was damage to the right front of each vehicle. The driver’s door of the decedent’s vehicle had been torn off and he was located wearing a seatbelt, seated in the driver’s seat partially hanging out of the vehicle (Fig. 1). The sash component of the seatbelt was tightly applied around his neck (Fig. 2a & b). At autopsy the body was that of an obese white male (weight 114 kg; length 178 cm; BMI 35.98) with a relatively minor laceration and abrasion over the forehead and compound fractures of the mid-shaft of the right femur and the
* Roger W. Byard [email protected] 1
Forensic Science SA and Adelaide Medical School, The University of Adelaide, Frome Road, Adelaide, South Australia 5005, Australia
upper shafts of the right tibia and fibula. Internal examination revealed minor superficial capsular tears of the right lobe of the liver, a small intestinal mesenteric laceration, a small laceration of the upper pole of the right kidney and incomplete avulsion of the right renal artery from the aorta. None of these injuries were associated with significant hemorrhage. Formal neuropathological examination of the brain showed no evidence of brain injuries such as cerebral contusions, hemorrhage or lacerations. Review of photographs taken at the accident scene showed the sash component of the deceased’s seatbelt extending around his upper neck. There were no abrasions or bruises to the neck (which had been padded
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