Swati Tyagi Assistant Professor, Department of Forensic Medicine and Toxicology, All India Institute of Medical Sciences, New Delhi, India
Gokul G. Senior Resident, Department of Forensic Medicine and Toxicology, All India Institute of Medical Sciences, New Delhi, India
Abilash Srinivasa Murthy Assistant Professor, Department of Forensic Medicine and Toxicology, All India Institute of Medical Sciences, New Delhi, India
Mahalakshmi Narendira Babu Junior Resident, Department of Forensic Medicine and Toxicology, All India Institute of Medical Sciences, New Delhi, India
Karthi Vignesh Ra Assistant Professor, Department of Forensic Medicine and Toxicology, All India Institute of Medical Sciences, Guwahati, India
Sudhir K Gupta Professor and Head, Department of Forensic Medicine and Toxicology, All India Institute of Medical Sciences, New Delhi, India
Address for correspondence: Swati Tyagi, Assistant Professor, Department of Forensic Medicine and Toxicology, All India Institute of Medical Sciences, New Delhi, India E-mail: drswatijun20@gmail.com
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Swati Tyagi, et al. Diagnostic Intricacies in Positional Asphyxia: Insights from a Case Study and Literature Overview. J Forensic Chemistry Toxicol. 2025; 11(1): 58–64.
Timeline
Received : December 17, 2024
Accepted : June 12, 2025
Published : June 30, 2025
Abstract
Positional asphyxia may be defined as fatal ventilatory and circulatory failure caused by the fixation of the body in an abnormal position, which mechanically interferes with ventilation and venous return. This report describes a 30-yearold male who was found in a head-down position on a staircase. A thorough history and crime scene analysis unveiled that the deceased had fallen down the stairs and subsequently became unconscious. Autopsy revealed classical signs of asphyxia, and the injuries found were corroborated with crime scene evidence. The findings of the case were discussed by assessing Bell’s criteria for positional asphyxia. Improvisations of Bell’s criteria were suggested based on the case findings. Such cases present to forensic pathologists as sudden death, where crime scene examination, detailed history, and meticulous autopsy reveal evidence on the cause and manner of death.
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Data Sharing Statement
There are no additional data available. All raw data and code are available upon request.
Funding
This research received no funding.
Author Contributions
All authors contributed significantly to the work and approve its publication.
Ethics Declaration
This article does not involve any human or animal subjects, and therefore does not require ethics approval.
Acknowledgements
We would like to express our gratitude to the patients, their families, and all those who have contributed to this study.
Conflicts of Interest
No conflicts of interest in this work.
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Cite this article
Swati Tyagi, et al. Diagnostic Intricacies in Positional Asphyxia: Insights from a Case Study and Literature Overview. J Forensic Chemistry Toxicol. 2025; 11(1): 58–64.
This license enables
reusers to distribute, remix, adapt, and build upon the material in any medium
or format for noncommercial purposes only, and only so long as attribution is
given to the creator.
This license enables
reusers to distribute, remix, adapt, and build upon the material in any medium
or format for noncommercial purposes only, and only so long as attribution is
given to the creator.
Description: Crime scene photograph showing the position of the victim when the body was discovered. Pink-colored paint particles are present at the back of the vest and trouser (arrowheads), and brown-colored vomitus is present below the level of the face (arrow)
Heading
Description: (a) External examination of the head showing two fresh abrasions (arrows) over the occipital
region corresponding to the resting position of the head in the crime scene; (b) A fresh abrasion over the
back of the trunk corresponding to the paint scratch marks; (c) Two fresh abrasions over the front of
the left leg corresponding to the position of impaction with stairs
Heading
Description: (a) External examination showing hyposphagma in the right eye; (b) Hyposphagma in the left eye;
(c) Internal examination of the scalp showing extensive subgaleal petechiae