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Slović, Živana; Todorović, Miloš; Andrić, Ivana; Čanović, Vanja; Mihajlović, Filip; Vitošević, Katarina; Todorović, Danijela
Legal medicine (Tokyo, Japan), March 2024, 2024-Mar, 2024-03-00, 20240301, Volume: 67Journal Article
•Autopsy findings reveal that the cause of death is a combination of hypothermia, postural asphyxia, carboxyhemoglobin, and benzodiazepine intoxication.•Chemical toxicological analyses support the conclusion that the victim's demise resulted from the synergistic effects of multiple factors.•The manner of death is determined to be a combination of accidental and suicidal, reflecting the victim's attempted suicide and subsequent exposure to low external temperatures.•The autopsy suggests that the fatal outcome is a consequence of the interplay between environmental conditions and the presence of toxic substances in the body.•The investigation underscores the complexity of the case, highlighting the importance of considering various factors contributing to the tragic event, including both intentional and unintentional elements. Suicide is the intentional and voluntary act of destroying one's own life, while an accident is an unintended event that involuntarily causes injury to one's health or destruction of life. We report a case of a 54-year-old male who was found in a forest in late November, approximately 500 m away from his car. He was positioned bent over a trunk of a tree with his head beneath the rest of his body. His pants were down to his knees, and there were soiled blades of grass and leaves on his body. Investigation of the case circumstances revealed that he had attempted suicide by carbon monoxide poisoning, using a hose connected to the exhaust pipe and running it through the window into the cabin. Window on the driver’s side was broken with glass particles on the driver's seat. Wrappers from “Rivotril” tablets, a generic benzodiazepine, were also found in the car. Autopsy revealed the following: postmortem hypostasis was of a cherry red color and well pronounced on the upper part of the front of the body and face. Numerous bruises, contusions, and erosions were present all over the body. Frostbites were especially pronounced in the knees and elbows area. The synovial membranes were partially bloodstained and reddish in color. Opening the stomach revealed erosions of the gastric mucosa (Wischnewsky sign). Chemical toxicological analysis detected presence of benzodiazepines and carboxyhemoglobin (25%). Based on the autopsy findings, chemical toxicological analyses, and investigation of the case circumstances, it has been concluded that the death occurred due to the combined effects of hypothermia, postural asphyxia and carboxyhemoglobin and benzodiazepine intoxication. The manner of death in this case is a combination of accidental and suicidal, as the victim attempted suicide but ultimately died due to exposure to low external temperature.
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