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Anthony Bray, MD
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Hello, I had a question about an autopsy finding of "traumatic

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Hello, I had a question about an autopsy finding of "traumatic asphyxiation do to neck compression" for a cause of death. Would this be considered strangling, in common vernacular and is it possible you strangle a victim, but release the pressure, and have the person still suffocate do to damage or swelling internally of the throat from the previous pressure applied?


Anthony Bray, MD : Hello,
Anthony Bray, MD : I'm sorry for your loss ...
Anthony Bray, MD : the report to me sounds consistent with some form if strangulation in the common vernacular -- yes , I would agree ...
Anthony Bray, MD : The statement does not itself necessarily distinguish the cause of this... It could be a homicide as a person may have physically strangled as a possible cause...
Anthony Bray, MD : the report itself would not appear to rule out something such as a self hanging as a potential cause either ...
Anthony Bray, MD : I suppose some accidental injury or wrapping of the neck could be theoretically compatible with the pathology report but would not seem likely...
Anthony Bray, MD : this sort of report would need to be joined I think by forensic information gathered by police in such a case...
Anthony Bray, MD : I think that the autopsy report is being very specific to the anatomib



sorry for the late response


thankfully, this is not a reletive


but a case i am researching and interested in

Anthony Bray, MD : Anatomical findings but leaving out specifics as to the cause if the trauma... I suspect this is purposeful to limit the scope of this specific report as to what happened to the person in terms of physiology but not making judgment as to cause such as ?? Rope/ chain/ hands strangling a person's neck or homicide or suicide or some potential question of accident...

hello, thanks very much for your incite


can you explain further what you mean

Anthony Bray, MD : I think the science of determining the cause and the intent and potential criminal nature of this death is being left to forensics specialists and the police...



so you are saying they are releasing the cause, but not the how, because of the criminal nature of the case?


how hard is it to receive that injury, and is it possible for someone to cause that injury on another person by accident? not meaning to kill them?

Anthony Bray, MD : Ok I will try to explain more plainly by example... I think that the medical aspect of the information may be that death was caused by asphyxiation ( oxygen deprivation) this may have been associated with hyoid bone fracture ( common findings in manual strangulation ) the medical examiner is limiting the scope to very objective medical information ...

wold a break of that bone cause asphyxiation?

Anthony Bray, MD : if this was a murder for example then the medical information may support that conclusion but proving that would need police investigation as well... Hand marks? Finger prints? Suspect information.. Etc...
Anthony Bray, MD : a whole body of evidence would need to be built if this were a death due to murder... The medical information is key to this investigation but it alone needs to be fitted with other information...

i see

Anthony Bray, MD : No not by itself... If a person were hit by a baseball to the neck and had a fracture of the hyoid bone for that reason it would not cause asphyxia ( death by oxygen deprivation)

is there a large range as to how painful or cruel this form of death would be, or is it always a very lengthy and personal attack to cause death

Anthony Bray, MD : Asphyxia by being choked does commonly cause a fracture if this bone however...
Anthony Bray, MD : the body would hold clues as to the order of events...

can you explain the difference between choking someone and strangling them

Anthony Bray, MD : the breaking if this bone after death would not have the same result in appearance though due to bleeding response ....
Anthony Bray, MD : Well I would apply both terms to the same scenario ... You could have someone being choked but it be only temporary and not fatal. ... As with many things it could vary as to degree...

but choking would not usually break that bone, but strangling would

Anthony Bray, MD : from a criminal investigation standpoint it could mean a lot if there were other signs of trauma ... If there are evidence of intent ( manslaughter could be a fight that went too far -- you know ?? 2nd degree murder...?? 1st degree murder might be potential charges connected with such a case....

so is it possible for the victim to die from swelling and damage to the throat even if the attacker stopped the attack


and if that were the case, would the medical examiner still descrbe the cause of death in such a way

Anthony Bray, MD : well as I said I would basically equate "chocking" and " strangulation " but perhaps they could have distinguishing legal inplicatiions..( I'm not sue about this possible legal distinction)
Anthony Bray, MD : some people include asphyxia as part of sexual arousal for example ... ( ok weird to me but anyway...) this type is a recognized behavior and might be used by some defendants as example...
Anthony Bray, MD : from the autopsy report it could have been findings from a hanging too... This would be apparent from the police report but not the autopsy report for example....
Anthony Bray, MD : Yes I think the description if the cause if death may be described in as objective way possible by the medical examiner... It could in certain circumstances be actually labeled as " homicide" or "suicide"....

i see

Anthony Bray, MD : to give you an example let's imagine a different case and the medical examiner finds death due to gunshot wound to head ..

can you speak to my question about the person dieing from injury after the stanglation even if the attacker stopped the attack

Anthony Bray, MD : the medical examiner might not know if the wound were self inflicted ( suicide ) or inflicted by another ( homicide) --- it could also be accidental ... So the description if the wound and this wound were the cause of death would be the medical examiner's job... Figuring out who pulled the trigger and why would be the police job...
Anthony Bray, MD : Possible if the person were too compromised that death could have followed the initial strangulation but this would seem less likely...
Anthony Bray, MD : bleeding into airway could be a factor... Swelling causing airway compromise might be a factor but the actual act of strangulation sounds to be the cause of death in this case...
Anthony Bray, MD : deprivation of the brain from oxygen for 5 minutes is all it takes ...

5 minutes is a long time though to hold a person down


and actually deprive oxygen

Anthony Bray, MD : Yes that is true ... It also shows how fragile our life really is too...

i think i need more information from the report to really understand what happened


thanks so much


it sounds like we are missing a lot of details


thanks again


i was hoping she didnt suffer too much, but it sounds like the act was most likely deliberate and painful to endure


i know the police did label it a homicide

Anthony Bray, MD : Ok , well I'm sorry that you know someone in such a terrible circumstance. I agree that if you have the opportunity to speak with the medical examiner then that may help fill gaps in information, if I may be of further service to you then let me know. I will be happy to get back with you. Take care and best regards,
Anthony Bray, MD : Anthony Bray MD
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