Asphyxial Deaths Due to Hanging in Children

Abstract

A review of the records for five years from the Coroner's Offices of Marion County, Indiana and Franklin County, Ohio, which have a combined population of 2.4 million, yielded 12 cases of hanging deaths in children 13 years of age or younger. The age range was 2½ to 13 years and only two of the 12 victims were female. There were three unequivocal suicides, five accidental deaths and four cases where, despite extensive investigation, the manner of death remained undetermined. The scene and autopsy findings are presented and the cases discussed with regard to determination of manner of death. Additionally, the significance and pathophysiology of petechiae are discussed.

Suicide in young people under 15 years: Problems of classification

“…To differentiate between accidents and suicides, when children die by hanging, is problematic (7). Most children have witnessed hanging in cartoons, pictures and on television, and the method does not require elaborate skills.…”

“…The suicides may be reported as accidents or undetermined deaths (5). More seldom, accidents are wrongly seen as suicides (6,7), and this problem has received little attention. The possible effect of misclassification will, however, need special attention in child suicide research, as the impact on the family is considerable.…”

Characterization of Lesions in Hanging Deaths

“…The vast majority of hangings are suicidal and only occasionally are accidental or homicidal cases reported (5)(6)(7)(8)(9)(10)(11)(12). Internationally, death by hanging ranks among the most common method of suicide (13), accounting for more than 50% of all suicides in Saudi Arabia (14,15) and Hungary (16,17), while in Norway and Denmark it falls to second place with a frequency of 25% and 17%, respectively (18).…”

Accidental hanging: A report of four cases and review of the literature

“…In the first case, the bond was the child's garment (collar of the pullover). In the literature review, similar cases were found as the hanging to a swing by necklace (Chin and Berns, 1995) or a jacket (Clark et al, 1993). Senard et al (1992) published two cases of hanging to toboggan with a scarf and a hood.…”