Asphyxia Not Suffocation

[watson]

I'm not starting a new medical thread, I hope! I'm just asking for a clarification here because of something that occurred to me while catching up on past posts. Really, no tricks, no debate intended, just fact clarification. We all know the cause of death of this victim was 'asphyxia by strangulation associated with craniocerebral trauma'.
Forget the craniocerebal trauma for now I'm not requesting clarification of that, but of the....'asphyxia by strangulation' or as the ME also says 'asphyxia by ligature strangulation'. We all know the part of this victims body that was 'strangled' (the extreme compression of a bodily tube) was the entire neck, which shut off blood cirulation and thus oxygen in and out of the victims brain, as well as interfering with the victims breathing, causing the brain (and victim) to die of lack of oxygen (asphyxia), right?
And we're not in this case talking about another kind of strangulation, the kind where someone grabs and crushes the front of your throat strangling (compressing) only your trachea tube (the bodily tube that runs down the front of your throat) so the victim can't breath (suffocates) causing the brain again to die of asphyxia because now there's no oxygen in the blood going to the brain. That this is not the type of asphyxia by strangulation we have in the case, because it it was the trachea would be damaged, the delicate bones in the front of the throat would be crushed, and the whole neck would not be involved. Right?
What we have here is the part that was strangled (or compressed) was the entire neck by a cord, which shut off blood flow to the brain as well as partially compressing the trachea, making the brain die of lack of lack of oxygen (asphyxia) because blood flow was cut off AND breathing was interfered with.
Can we all agree?
I just wanted to clarify this fact, especially for those who might be new to the case.

[Athena]

Just before this discussion is engaged in; I just wanted to clear up one thing re: JBR's hyoid bone. I had read this while doing research a couple of months ago and saved it just in case it came in handy:

Ligature marks are a clue that the hyoid bone may be broken. As a general rule, on a post mortem exam, if a hyoid bone is fractured the death will be a homicide from strangulation until proven otherwise.9 However, because the two halves of the hyoid do not fuse until age 30, the hyoid may not break in younger victims who die as the result of strangulation.10 One third of manual strangulation victims have fractured hyoids

http://209.85.165.104/search?q=cache...lnk&cd=5&gl=us

http://tinyurl.com/3atb9z

[andU]

I always related axphytia with a choking type of blocking to the airway; suffocation is also caused by lack of O2, but I associate that with something covering the mouth and nose to prevent O2 from entering the body at all. I'm not sure there is a difference, and one could be just medical terminology...

[thewhitewitch1]

Originally Posted by andU

I always related axphytia with a choking type of blocking to the airway; suffocation is also caused by lack of O2, but I associate that with something covering the mouth and nose to prevent O2 from entering the body at all. I'm not sure there is a difference, and one could be just medical terminology...

As I had mentioned on another thread, I was wondering if JB wasn't suffocated with a pillow first and the garrote used only in staging (meaning it was tightened around her neck after death). I am still waiting for an answer from Elvislives as to whether this could be possible.
I was also wondering if anyone else had any thoughts on this. It doesn't necessarily point to RDI. When JR mentioned JBs pillow a few times in the interviews and it was noted that the pillow was at the foot of the bed instead of the head, it just got me to thinking about the possibility of suffocation and if the use of the garrote was to cover this up.
Comments, please!

[Kor]

Umm, so JB's pillow was also brought down to the basement with JB and her blanket, after she died, her urine released from her bladder to the basement floor, then the killer was kindly enough to sneak back up two stories to her room again just to put her pillow back on her bed? Assuming JB's pillow was the one you guys are talking about.

[LindaA]

If JBR had been smothered with her pillow wouldn't there ahve been evidence on the pillow -- mucous such as was found on hre face post mortem.

[thewhitewitch1]

Originally Posted by LindaA

If JBR had been smothered with her pillow wouldn't there ahve been evidence on the pillow -- mucous such as was found on hre face post mortem.

I do recall a stain being mentioned on the pillow case but I'm sure I'll have a heck of a time finding the source. It was in one of the interviews, I am sure.
Would the mucous be any different from, say a runny nose? If there was a stain on the pillow case, it could have been explained away as that. I am of the opinion that the bedding was changed, though...and that includes the pillow case. It would also explain why the pillow is not at the head of the bed.
Kor...no one knows what room the ordeal actually began in. I'm not saying anyone took the pillow downstairs. What is this urine thing you keep bringing up? Do you have a link? I have read nothing about that anywhere.

[Kor]

Originally Posted by thewhitewitch1

Kor...no one knows what room the ordeal actually began in. I'm not saying anyone took the pillow downstairs. What is this urine thing you keep bringing up? Do you have a link? I have read nothing about that anywhere.

I have brought up about JB's urine on basement floor one or two times, including a link, I thought it was pretty important. Here's link;

http://jonbenetramsey.pbwiki.com/Int...g-the-Evidence

"Hallway Outside Wine Cellar Room. There was a urine stain on the floor immediately outside that room, and a few feet away was the paint tote containing the remaining piece of the paintbrush used for a garrote; small bits of paintbrush handle also were found at the same location, suggesting this is where the garrotte was made. Jameson asserts "most investigators" believe this is the area in which she was killed."

I don't know which room the ordeal first begun, but I am assuming the first ordeal of "kidnapping" started in JB's room since the blanket was also taken and I believe JB was sleeping. Then second ordeal of assault or killing happened in the basement because of JB's urine stained on basement floor among with pieces from paintbrush stick, and maybe some more clues at that areas that we yet know about, which made the investigators believe it was the area where JB died.

[thewhitewitch1]

Originally Posted by Kor

I have brought up about JB's urine on basement floor one or two times, including a link, I thought it was pretty important. Here's link;

http://jonbenetramsey.pbwiki.com/Int...g-the-Evidence

"Hallway Outside Wine Cellar Room. There was a urine stain on the floor immediately outside that room, and a few feet away was the paint tote containing the remaining piece of the paintbrush used for a garrote; small bits of paintbrush handle also were found at the same location, suggesting this is where the garrotte was made. Jameson asserts "most investigators" believe this is the area in which she was killed."

I don't know which room the ordeal first begun, but I am assuming the first ordeal of "kidnapping" started in JB's room since the blanket was also taken and I believe JB was sleeping. Then second ordeal of assault or killing happened in the basement because of JB's urine stained on basement floor among with pieces from paintbrush stick, and maybe some more clues at that areas that we yet know about, which made the investigators believe it was the area where JB died.

I am sorry but I do not consider Jameson to be a reliable source, but thanks.
I have never heard of a urine stain on the actual floor anywhere. I would need something besides Jamesons statement that one was actually found there. The paintbrush could have been broken in the basement at any time that night and carried elsewhere but it does stand to reason that that's the area where JB was ultimately killed. That doesn't tell us much about "whodunnit", though.

[LindaA]

Actually, it does say a lot. Can you relate a scenario in which the parents would need to take her to the basement to kill her, TWW1? And could accomplish that within a few minutes of hitting her on the head first or discovering Burke had done so?

Originally Posted by thewhitewitch1

As I had mentioned on another thread, I was wondering if JB wasn't suffocated with a pillow first and the garrote used only in staging (meaning it was tightened around her neck after death). I am still waiting for an answer from Elvislives as to whether this could be possible. I was also wondering if anyone else had any thoughts on this. It doesn't necessarily point to RDI. When JR mentioned JBs pillow a few times in the interviews and it was noted that the pillow was at the foot of the bed instead of the head, it just got me to thinking about the possibility of suffocation and if the use of the garrote was to cover this up.
Comments, please!

TWW- If you asked me this question in another thread, I apologize...I must have missed it. But according to the autopsy she died of ligature strangulation. Asphixia from 'smothering' or from placing a plastic bag over someone's head or from manual strangulation leaves different evidence. Pathologists are trained to distinguish the specific type of asphixia...they dont just see a ligature around a victims neck then determine it was ligature strangulation. They look at the pleural, cardiac and cerebral tissue microscopically. There are very specific differences. There is a great website out there that describes this--I'll try and find it and post a link. It may be too technical for some, but others might find it interesting.

All that said however, it may be possible that she was smothered with a pillow to unconsciousness (not death) then was strangled with the ligature, etc. I'll have to do a little research to confirm that.

[Jayelles]

Thank you. It would be fascinating to find out how the medical detectives work in determining the difference between the different deaths by asphyxiation. I didn't realise they could tell by looking at heart, brains and lungs.

[andU]

I also think it would be interesting. Do we dare think that any of these things were investigated? I doubt it, some of them may not even have been available ten years ago.

[thewhitewitch1]

Originally Posted by LindaA

Actually, it does say a lot. Can you relate a scenario in which the parents would need to take her to the basement to kill her, TWW1? And could accomplish that within a few minutes of hitting her on the head first or discovering Burke had done so?

Actually, I can. I would think they would want her in a place where Burke would be least likely to see or hear what was going on. This also includes if Burke dealt the blow to the head because if he did, I don't think he knew anything about what transpired afterwards. I am iffy on the Burke involvement, though.

[thewhitewitch1]

Originally Posted by elvislives

TWW- If you asked me this question in another thread, I apologize...I must have missed it. But according to the autopsy she died of ligature strangulation. Asphixia from 'smothering' or from placing a plastic bag over someone's head or from manual strangulation leaves different evidence. Pathologists are trained to distinguish the specific type of asphixia...they dont just see a ligature around a victims neck then determine it was ligature strangulation. They look at the pleural, cardiac and cerebral tissue microscopically. There are very specific differences. There is a great website out there that describes this--I'll try and find it and post a link. It may be too technical for some, but others might find it interesting.

All that said however, it may be possible that she was smothered with a pillow to unconsciousness (not death) then was strangled with the ligature, etc. I'll have to do a little research to confirm that.

Thanks, Elvis. I can't help but wonder, though...might it be possible that because of the obviousness of the garrote, the coroner never even checked to see if suffocation may have been the cause of her death? It just seems to me that the autopsy didn't delve very deeply into anything, including what made the marks on her body. Is there any chance they may have overlooked this possibility? How different are the signs of suffocation than strangulation?

[Jayelles]

Originally Posted by thewhitewitch1

Thanks, Elvis. I can't help but wonder, though...might it be possible that because of the obviousness of the garrote, the coroner never even checked to see if suffocation may have been the cause of her death? It just seems to me that the autopsy didn't delve very deeply into anything, including what made the marks on her body. Is there any chance they may have overlooked this possibility? How different are the signs of suffocation than strangulation?

Well this is one of the reasons why I welcome Elvislive's website link being posted because I have hunted for information about this and the websites I found seem to indicate that there isn't a lot of difference in the signs of the various forms of asphyxia and that the coroner/investigator often looks to the crime scene for help in drawing conclusions.

I knew about the fractured hyoid (sp) bone being a sign in adults and also that facial colour and facial swelling can be an indication of the length of time it has taken to die (longer time = more swelling). However, I was singularly unsuccessful in finding anything which indicated that it was possible to look at a person's heart. lungs and brain and tell whether they'd been strangled as opposed to suffocated.

It's an interesting discussion.

[Jayelles]

Here's an article from 2001 which discusses microscopic differences in tissue between suffication victims and strangulation victims.

Not sure whether this kind of examination was done in the Ramsey case - or even if the knowledge was available in 1996.

I did come across a website which said that bloody mucous in the nose was often present in suffocation. It was a website about SIDS vs suffocation.

[andU]

Wikipedia explains both and the differences. More stuff that makes ya go hmmmmmm:

http://en.wikipedia.org/wiki/Asphyxia

[LindaA]

Originally Posted by thewhitewitch1

Actually, I can. I would think they would want her in a place where Burke would be least likely to see or hear what was going on. This also includes if Burke dealt the blow to the head because if he did, I don't think he knew anything about what transpired afterwards. I am iffy on the Burke involvement, though.

Makes sense, but could it be done within the time frame? Just a few minutes between head blow and garotting?

Originally Posted by elvislives

TWW- If you asked me this question in another thread, I apologize...I must have missed it. But according to the autopsy she died of ligature strangulation. Asphixia from 'smothering' or from placing a plastic bag over someone's head or from manual strangulation leaves different evidence. Pathologists are trained to distinguish the specific type of asphixia...they dont just see a ligature around a victims neck then determine it was ligature strangulation. They look at the pleural, cardiac and cerebral tissue microscopically. There are very specific differences. There is a great website out there that describes this--I'll try and find it and post a link. It may be too technical for some, but others might find it interesting.

All that said however, it may be possible that she was smothered with a pillow to unconsciousness (not death) then was strangled with the ligature, etc. I'll have to do a little research to confirm that.

The specific site I was referring to turns out to be a member site that requires a password. But I found another that will work for anyone. I think it only discusses the changes in the lungs--I just scanned thru it--I'll read it more thoroughly later on Here it is:

http://www.charlydmiller.com/LIB03/2...rphologic.html

I'll look for some other sites that describe some of the other differences. A few that come to mind are that circumfrential asphixia can cause reflex cardiac arrest (smothering will not cause this). Also circumfrential asphixia will often cause injury to the cervical spine and will also disrupt blood flow into and out the brain (smothering or asphixia via plastic bag over the head wont do this). I'll try and find some other sites.

Originally Posted by thewhitewitch1

Thanks, Elvis. I can't help but wonder, though...might it be possible that because of the obviousness of the garrote, the coroner never even checked to see if suffocation may have been the cause of her death? It just seems to me that the autopsy didn't delve very deeply into anything, including what made the marks on her body. Is there any chance they may have overlooked this possibility? How different are the signs of suffocation than strangulation?

I doubt they overlooked it. These procedures have been available to pathologists for a long time--at least a decade or more. However, the ME in this case had very little experience with murder cases.
I am making assumptions here, but I presume he consulted with some of the world's best forensic pathologists, considering this was a very high profile case and the potential defendents had the resources to hire a 'dream team' of defense experts. I would be surprised if he didn't dot all his i's and cross his t's. After all he didn't release his report to the public for 8 months after JB died. My assumption is that he was getting multiple expert opinions during this time. jmo

[Athena]

Originally Posted by elvislives

I doubt they overlooked it. These procedures have been available to pathologists for a long time--at least a decade or more. However, the ME in this case had very little experience with murder cases.
I am making assumptions here, but I presume he consulted with some of the world's best forensic pathologists, considering this was a very high profile case and the potential defendents had the resources to hire a 'dream team' of defense experts. I would be surprised if he didn't dot all his i's and cross his t's. After all he didn't release his report to the public for 8 months after JB died. My assumption is that he was getting multiple expert opinions during this time. jmo

I would think the same as you say here elvis. Also every expert who interjected their comments whether consulted or not did not offer any conjectures that she may have been smothered. But as complex as this case is..... there are no cut and dry answers it seems.

BTW -- I haven't posted alot recently but just wanted to add my name to the growing list of those who respect your opinions immensely. It is a pleasure reading your posts that appear to be factual and without bias. Glad to have a FS on the board.

[Athena]

I did find this article which basically says the findings in the lungs is what differentiates which type of asphyxia has occurred:

CITATION: Delmonte C, Capelozzi VL; Morphologic determinants of asphyxia in lungs: a semiquantitative study in forensic autopsies. Am J Forensic Med Pathol (United States), Jun 2001, 22(2) p139-49.

Asphyxia is a name given to different kinds of lesions that can produce similar histologic findings. Thus, because of the varied nature of the different kinds of lesions, as well as the incidence of similar qualitative histologic findings with different causes, the aim of this work was to study special kinds of injuries with particular subsequent impairment. These include some diagnostic problems of sudden death of natural causes, including aspiration, suffocation, drowning, and strangulation. Ranking was made of 167 victims based on the diagnosis as having: aspiration (n = 35), suffocation (n = 88), drowning (n = 27), and strangulation (n = 17). Stepwise discriminant analysis of the resulting data showed that lung necropsies from victims of these four events could be distinguished from one another. Statistical differences among the four groups were observed for eight morphologic parameters. A robust discriminant function permitted an adequate classification of the four groups of disease in 85.03% of the cases. Lung autopsies with congestion, septal hemorrhage, and foreign body showed a specificity of 100% for victims of aspiration, whereas ductal overinsufflation, interstitial edema, and bronchiolar constriction showed a specificity of 81.8% in victims of suffocation. Intraalveolar edema and dilatation of the alveolar spaces with secondary compression of the septal capillaries characterized drowning. Victims of strangulation showed a strong alveolar hemorrhage, with alveolar collapse and overinsufflation, associated with bronchiolar dilatation. It is concluded that semiquantitative analysis of lung autopsies might be a useful supplementary histologic criterion to support the diagnosis of asphyxia.

http://www.charlydmiller.com/LIB03/2...rphologic.html

[Athena]

I so apologize for creating that link to a site that Elvis already pointed out. I did not read all of the posts before I posted. Sorry for taking up board space here! It was too late to delete when I realized it.

[thewhitewitch1]

I'll admit I find medical jargon hard to decipher but after reading this, I am not convinced that the ME actually did investigate whether she'd been suffocated.

DISCUSSION

Asphyxia can be defined as the injuries caused by oxygen deficiency (hypoxia) that involve all conditions and sequelae caused by impairment or interruption of the oxygen supply or utilization in the tissues. Conversely, the term suffocation in forensic medical usage is restricted, for practical purposes, to cases in which environmental suffocation (inadequate oxygen in the atmosphere due to environmental conditions), smothering (due to mechanical obstruction of the nose and mouth), choking (due to blockage of the internal airways), and mechanical (due to pressure on the chest). In forensic practice, the recognition of death through asphyxiation can present problems if there are no indicative external or internal injuries or obstruction of the respiratory tract, and the conditions of death are not known in detail. In addition, the known macroscopic and histologic signs of general damage through hypoxia, e.g., edema, hemorrhage, pulmonary emphysema, passive congestion, and degenerative cellular changes, are usually diverse and are not conclusive as individual findings.(10-11) Similar findings can also arise through injuries leading to impairment of the circulation, or ischemia, thereby reducing or interrupting the tissue oxygen supplies. The extent of terminal hypoxia is also relevant to the postmortem detectable changes.(12) Therefore, the differential diagnosis of asphyxia has been limited by the qualitative similarity of the gross and histopathologic features in pulmonary involvement. In the absence of specific criteria, interpretation of a morphologic picture in asphyxia challenges the pathologist mainly when the same morphologic parameter is a common feature among the cases.

(Sorry to put yet another paragraph up from the one Elvis gave)
I believe this statement pretty much says that it is NOT so easy to differenciate between suffocation and strangulation. I believe they saw the garrote and that was that: cause of death.
Does the autopsy on her lungs say anything conslusively to you, Elvis? I was looking for specific terms given in the link you provided and I did not make a connection. What do you think?
http://www.acandyrose.com/12271996jonbenet05.gif (see lungs).

[Jayelles]

The link that Elvislives and Athena have posted is the same one that I posted about above. The article was written in 2001 so I'm not sure whether they hjad this knowledge in 1996.

[Athena]

Originally Posted by thewhitewitch1

I'll admit I find medical jargon hard to decipher but after reading this, I am not convinced that the ME actually did investigate whether she'd been suffocated.

DISCUSSION

Asphyxia can be defined as the injuries caused by oxygen deficiency (hypoxia) that involve all conditions and sequelae caused by impairment or interruption of the oxygen supply or utilization in the tissues. Conversely, the term suffocation in forensic medical usage is restricted, for practical purposes, to cases in which environmental suffocation (inadequate oxygen in the atmosphere due to environmental conditions), smothering (due to mechanical obstruction of the nose and mouth), choking (due to blockage of the internal airways), and mechanical (due to pressure on the chest). In forensic practice, the recognition of death through asphyxiation can present problems if there are no indicative external or internal injuries or obstruction of the respiratory tract, and the conditions of death are not known in detail. In addition, the known macroscopic and histologic signs of general damage through hypoxia, e.g., edema, hemorrhage, pulmonary emphysema, passive congestion, and degenerative cellular changes, are usually diverse and are not conclusive as individual findings.(10-11) Similar findings can also arise through injuries leading to impairment of the circulation, or ischemia, thereby reducing or interrupting the tissue oxygen supplies. The extent of terminal hypoxia is also relevant to the postmortem detectable changes.(12) Therefore, the differential diagnosis of asphyxia has been limited by the qualitative similarity of the gross and histopathologic features in pulmonary involvement. In the absence of specific criteria, interpretation of a morphologic picture in asphyxia challenges the pathologist mainly when the same morphologic parameter is a common feature among the cases.

(Sorry to put yet another paragraph up from the one Elvis gave)
I believe this statement pretty much says that it is NOT so easy to differenciate between suffocation and strangulation. I believe they saw the garrote and that was that: cause of death.
Does the autopsy on her lungs say anything conslusively to you, Elvis? I was looking for specific terms given in the link you provided and I did not make a connection. What do you think?
http://www.acandyrose.com/12271996jonbenet05.gif (see lungs).

There is a substance found in the lungs called haemosiderin as well as blood in the mouth and nose when one is suffocated and I did not see that in the autopsy report and it appears she was checked.

From autopsy report:

"The nostrils are both patent and contain a small amount of tan mucous material. The
teeth are native and in good repair. The tongue is smooth, pink-tan and granular. No buccal mucosal trauma is seen. The frenulum is intact. There is slight drying artifact of the tip of the of tongue. On the right cheek is a pattern of dried saliva and mucous material which does not appear to be hemorrhaic."

To respond to Jayelle's statement re: 1996; according to the SIDS studies that have been done it was realized by 1996 tht many of SIDS cases actually turned out to be death by suffocation for the reasons stated in the first paragraph.

I read the article as I was looking for the other link I posted (that elvis had already posted LOL) and will attempt to find a link to it.

[Jayelles]

Originally Posted by Jayelles

The link that Elvislives and Athena have posted is the same one that I posted about above. The article was written in 2001 so I'm not sure whether they hjad this knowledge in 1996.

Sorry - correction, the research paper was submitted in 2000. Still years after the JBR murder.

I don't think we can rely on these forensic findings to support any assumption that Meyer would have been able to distinguish between suffocation and strangulation based upon examination of her lungs!

[LindaA]

Originally Posted by Jayelles

Sorry - correction, the research paper was submitted in 2000. Still years after the JBR murder.

I don't think we can rely on these forensic findings to support any assumption that Meyer would have been able to distinguish between suffocation and strangulation based upon examination of her lungs!

Good point, Jayelles, apparently he had little experience with murder victims.

[Jayelles]

Originally Posted by LindaA

Good point, Jayelles, apparently he had little experience with murder victims.

...and could therefore have ASSumed that she'd been strangled ala staged garotte when in fact she had been suffocated ....

Actually, I think it isn't the coroner's job to establish the circumstances of her death - but rather to collect and record clinical information at autopsy. I think a lot of people think that Quincy and Silent Witness are true to life.

[LindaA]

I'm not sure about the difference between the job of a coroner and a ME, but I think there are some major ones. I believe a ME is required to render an opinion on the cause of death. Beyond that, I don't know where the line is.

I disagree with you about the smothering vs. strangulation. I believe there is obvious evidence that JBR was strangled, and no evidence that she was smothered. As always, though, there is evidence we have not seen or heard, and that could prove one or both of us wrong on this and any other fact about the case. JMO.

[Zoey]

Originally Posted by Jayelles

...and could therefore have ASSumed that she'd been strangled ala staged garotte when in fact she had been suffocated ....

Actually, I think it isn't the coroner's job to establish the circumstances of her death - but rather to collect and record clinical information at autopsy. I think a lot of people think that Quincy and Silent Witness are true to life.

I watched a show the other night on TV. I honestly don't know on what channel or what the show was. A murder victim was thought to have committed suicide, but it turns out he had been suffocated with a pillow. The detail that stuck out the most was the fact that because he was suffocated, fibers from the pillow were found in his throat and down in his airway.

I do not know if this is common with suffocation, but reading everyone's posts about this, I wonder if it is something that is common, hence the reason the coroner knew suffocation was not involved in this??

[Jayelles]

Originally Posted by Zoey

I watched a show the other night on TV. I honestly don't know on what channel or what the show was. A murder victim was thought to have committed suicide, but it turns out he had been suffocated with a pillow. The detail that stuck out the most was the fact that because he was suffocated, fibers from the pillow were found in his throat and down in his airway.

I do not know if this is common with suffocation, but reading everyone's posts about this, I wonder if it is something that is common, hence the reason the coroner knew suffocation was not involved in this??

Yes there was a programme on tv here last night about a child murder victim (Trial and Retribution). The suspect was trying to put the blame on the child's mother and she suggested that the mother might have suffocated the child with her blanket and the investigator countered that with the fact that there were no fibres in the child's airways to suggest suffocation with a blanket. However, a child can be suffocated with more than just a pillow or a blanket. A plastic bag for example would not leave fibres.

All I've been able to find regarding suffocation was that bloody mucous is often present in the nose.

[Jayelles]

Originally Posted by LindaA

I'm not sure about the difference between the job of a coroner and a ME, but I think there are some major ones. I believe a ME is required to render an opinion on the cause of death. Beyond that, I don't know where the line is.

I disagree with you about the smothering vs. strangulation. I believe there is obvious evidence that JBR was strangled, and no evidence that she was smothered. As always, though, there is evidence we have not seen or heard, and that could prove one or both of us wrong on this and any other fact about the case. JMO.

Yes but the evidence that she was strangled is the presence of the garotte - which could have been placed there after death. There is also the unexplained triangular bruise on her neck which some people believe could have been caused by a knuckle twisting against her neck. A few years ago, my little daughter suffered a neck injury which totally shocked me because it looked so much like the injury to JonBenet's neck. My daughter's injury was caused by the leg of a stool. She had been playing with a little three legged stool and had turned it upside down and fallen on it - hitting her neck as she fell. The legs were turned wood - circular. I was so shocked at the similarity of the injury that I took photos of it, but I decided not to post these on the public boards.

[thewhitewitch1]

I know this sounds a bit out there but other signs of suffocation include wounds in the region of the mouth and nostrils but these may not be present if the victim couldn't resist or struggle. I was wondering if perhaps there were some wounds and the duct tape was used to cover these. Yeah...I know it's out there but it was just a thought.
Would the mucous on her cheek be a sign of strangling? I was thinking that the abscence of the bloody mucous usually found in the nostrils from suffocation may not have been present if she had been hit over the head first and as a result, it may not have taken very long to suffocate her, as opposed to suffocation being the primary cause of the murder and the head blow coming afterwards to "make sure she was dead".
From what I've gathered about strangling, her body seems to lack a lot of signs of that having happened. "Alveolar collapse" is one of them and her autopsy states "intact alveolar architecture".
Damn, I wish I was a doctor! I am not disputing that the garrote was tightly around her neck but I am really starting to think it was only staging and was placed there after her death. IMO
Of course, I'm not really sure about anything. Just tossing some ideas out there. Feel free to ridicule away.

[LindaA]

Jayelles, how awful for your little girl. I think you were wise not to post those photos.

Anyway, back to the issue. I wonder if a ME could tell if a garotte had been applied post mortem and if the ME in this case could have been able to tell the difference. I have this feeling that the more we analyze in this case the less we are sure of.

[Athena]

Originally Posted by Jayelles

Yes but the evidence that she was strangled is the presence of the garotte - which could have been placed there after death. There is also the unexplained triangular bruise on her neck which some people believe could have been caused by a knuckle twisting against her neck. A few years ago, my little daughter suffered a neck injury which totally shocked me because it looked so much like the injury to JonBenet's neck. My daughter's injury was caused by the leg of a stool. She had been playing with a little three legged stool and had turned it upside down and fallen on it - hitting her neck as she fell. The legs were turned wood - circular. I was so shocked at the similarity of the injury that I took photos of it, but I decided not to post these on the public boards.

The triangular bruise could have been left by his forearm or knee or as you say some other object. I'm just glad that your little girl is OK. Actually Shill had offered pictures on how a wonder bar actually matched the traingular bruise as well.

I still believe if suffocation occurred it would have left bloody mucous in the nose and/or mouth and according to the autopsy report there was mucous but it was not bloody. Also after reading several articles now it appears that iron (haemosiderin) is found in the lungs as well as indicated by this article and the one I posted above. This article also states that medical advances were made by 1996 to detect suffocation:


In 1988, when his first son, Kyle, died, it was not yet the practice for specialist paediatric pathologists to carry out post-mortem examinations on children.

And not as much was known about haemosiderin, iron deposits which, when found in the lungs, indicate bleeding and which, when there is no other obvious illness or injury, are a clear marker of suffocation.

http://news.scotsman.com/topics.cfm?...6&id=823552002

[Athena]

Originally Posted by thewhitewitch1

I know this sounds a bit out there but other signs of suffocation include wounds in the region of the mouth and nostrils but these may not be present if the victim couldn't resist or struggle. I was wondering if perhaps there were some wounds and the duct tape was used to cover these. Yeah...I know it's out there but it was just a thought.
Would the mucous on her cheek be a sign of strangling? I was thinking that the abscence of the bloody mucous usually found in the nostrils from suffocation may not have been present if she had been hit over the head first and as a result, it may not have taken very long to suffocate her, as opposed to suffocation being the primary cause of the murder and the head blow coming afterwards to "make sure she was dead".
From what I've gathered about strangling, her body seems to lack a lot of signs of that having happened. "Alveolar collapse" is one of them and her autopsy states "intact alveolar architecture".
Damn, I wish I was a doctor! I am not disputing that the garrote was tightly around her neck but I am really starting to think it was only staging and was placed there after her death. IMO
Of course, I'm not really sure about anything. Just tossing some ideas out there. Feel free to ridicule away.

Not a doctor either so this is only my opinion; but I don't think the head injury would have hidden the fact had she been suffocated because she was still alive. It would have just indicated she could not have struggled.

[thewhitewitch1]

Originally Posted by Athena

Not a doctor either so this is only my opinion; but I don't think the head injury would have hidden the fact had she been suffocated because she was still alive. It would have just indicated she could not have struggled.

The head injury wouldn't have hidden it but the garrote may have.

[Athena]

Originally Posted by Jayelles

Yes there was a programme on tv here last night about a child murder victim (Trial and Retribution). The suspect was trying to put the blame on the child's mother and she suggested that the mother might have suffocated the child with her blanket and the investigator countered that with the fact that there were no fibres in the child's airways to suggest suffocation with a blanket. However, a child can be suffocated with more than just a pillow or a blanket. A plastic bag for example would not leave fibres.

All I've been able to find regarding suffocation was that bloody mucous is often present in the nose.

Seems suffocation by a plastic bag leaves different evidence as well:

Summary Some deaths caused by suffocation in a plastic bag are described and certain aspects to be considered in the evalution of these cases are discussed. It is stressed that these cases do not usually show marked signs of asphyxia, i.e., petechiae in the usual sites.