Italy. The victim was a 56-year-old woman whose body was found by the rescue team to be in the prone position and trapped inside an ottoman storage bed, which consisted of a mechanism that lifted the bed base and mattress to reveal a storage space beneath them.
Fig.1 The body, which had been removed from its original location by the rescue team, was lying supine on the floor near the bed.
Fig.2 The mattress was cluttered with clothes and blankets. At inspection, traces of blood were found on the lateral edge of the container.
Upon arrival, the body had already been removed from its original location for rescue purposes and was lying supine on the floor near the bed. Examination of the body revealed fixed purple hypostases dotted with petechiae located on the face, chest and upper abdominal quadrants, with a pale rectangular-shaped area extending from one arm to the other, including the anterior surface of the neck and bilateral clavicular regions. Fixed hypostasis was also distributed on the anterior surface of the upper limbs and the palms. Another area spared from hypostasis was recognizable at both wrists.
Fig.3 At autopsy, the distribution of postmortem lividities was comparable to that found at the time of death.
Fig.4 An oval-shaped abrasion was noticed under the chin on the right side.
Rigor mortis involved the jaw and both upper and lower limbs. The body temperature was equal to the environmental temperature. Inspection of the bed revealed traces of blood smearing the lateral edge of the container below the bed. The mattress was cluttered with clothes and blankets. The bed suspension mechanism was defective, as it was not equipped with the system designed to hold up the mattress. At room inspection, several packages of antidepressants and benzodiazepines were found.
A forensic autopsy was performed 3 days after death was pronounced. The deceased individual was 150 cm (4’11”) in height and 55 kg (121 lbs) in weight. At autopsy, the distribution of postmortem lividities was comparable to that found at the death scene investigation. The conjunctivae were completely engorged with blood, the face was swollen and congested, and the tongue protruded between the dental arches. Mouth and nose bleeding and cyanosis of the face and both hands were observed. An oval-shaped abrasion was noticed under the chin on the right side. On the posterior cervical region, an oval-shaped abrasion was detected.
Fig.5 On the posterior cervical region, an oval-shaped abrasion was present.
Fig.6 Dissection of the neck, soft tissues corresponding to the abrasions were infiltrated with blood, while the cervical vertebrae were not fractured. Jugular veins were dilated.
Upon internal examination, although diffuse haemorrhagic infiltration of the scalp over the frontal and bilateral temporoparietal regions was noticed, neither fractures of the cranial bones nor encephalic lesions were identified. Upon anterior and posterior dissection of the neck, the soft tissues corresponding to the above-described abrasions were infiltrated with blood, while the cervical vertebrae were not fractured. Both jugular veins were dilated. The lungs were markedly congested and overinflated. Hyoid bone and larynx specimens were collected to perform a micro-computed tomography (micro-CT) analysis, which is useful to detect any potential fractures or microfractures. Toxicological analyses in blood revealed subtherapeutic concentrations of diazepam, flurazepam and escitalopram, while no ethanol or drugs of abuse were detected.
Fig.7 Micro-CT scans showed no dislocations or fractures of the larynx and the hyoid bone.
Fig.8 Sketch depicting the most likely mechanism of compression of the neck between the left bed frame and the partially lifted bed base and mattress.
Based on external (massive congestion and oedema of the face, cyanosis of the hands) and internal findings (acute emphysema, oedema and vascular congestion of the lungs), death was attributed to asphyxia. The body temperature, fixation of hypostases and rigor mortis placed the time of death beyond 24 h before the discovery of the body. It was concluded that the woman’s death was caused by asphyxiation by three different mechanisms acting simultaneously: neck compression and traumatic and postural asphyxia.
The storage space of ottoman beds should be preferably emptied or loaded under the supervision of another person, although this could be unpractical. For ottoman storage beds it is recommended loading/unloading the storage space by positioning oneself on the side opposite to the lever fulcrum. Thus, although this would probably require a non-ordinary effort, in the event of a malfunction of the suspension system, the person would be in an advantageous lever position to lift the bed base and mattress.
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