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Agonal Sequences in 14 Filmed Hangings With Comments on the Role of the Type of Suspension, Ischemic Habituation, and Ethanol Intoxication on the Timing of Agonal Responses

Sauvageau, Anny MD, MSc*; LaHarpe, Romano MD; King, David MD; Dowling, Graeme MD*; Andrews, Sam MD§; Kelly, Sean MD; Ambrosi, Corinne MD; Guay, Jean-Pierre PhD; Geberth, Vernon J. MS, MPSfor the Working Group on Human Asphyxia

The American Journal of Forensic Medicine and Pathology: June 2011 - Volume 32 - Issue 2 - p 104-107
doi: 10.1097/PAF.0b013e3181efba3a
Original Articles

The Working Group on Human Asphyxia has analyzed 14 filmed hangings: 9 autoerotic accidents, 4 suicides, and 1 homicide. The following sequence of agonal responses was observed: rapid loss of consciousness in 10 ± 3 seconds, mild generalized convulsions in 14 ± 3 seconds, decerebrate rigidity in 19 ± 5 seconds, beginning of deep rhythmic abdominal respiratory movements in 19 ± 5 seconds, decorticate rigidity in 38 ± 15 seconds, loss of muscle tone in 1 minute 17 seconds ± 25 seconds, end of deep abdominal respiratory movements in 1 minute 51 seconds ± 30 seconds, and last muscle movement in 4 minutes 12 seconds ± 2 minutes 29 seconds. The type of suspension and ethanol intoxication does not seem to influence the timing of the agonal responses, whereas ischemic habituation in autoerotic practitioner might decelerate the late responses to hanging.

From the *Office of the Chief Medical Examiner, Edmonton, Alberta, Canada; †Centre Universitaire Romand de Médecine Légale-Site Genève, Unité de Médecine Forensique, Geneva, Switzerland; ‡Regional Forensic Pathology Unit, Hamilton General Hospital, Hamilton, Ontario, Canada; §Office of the Chief Medical Examiner, Calgary, Alberta, Canada; ¶Office of the Chief Medical Examiner, Jamaica, NY; ∥School of Criminology, Faculty of Arts and Sciences, University of Montréal and Montreal Philippe-Pinel Institute, Montreal, Quebec, Canada; and **P.H.I. Investigative Consultant Inc, Garnerville, NY.

Manuscript received June 7, 2010; accepted June 22, 2010.

Reprints: Anny Sauvageau, MD, MSc, Office of the Chief Medical Examiner, 7007, 116 St, Edmonton, Alberta T6H 5R8, Canada. E-mail:

© 2011 Lippincott Williams & Wilkins, Inc.