STRANGULATION *DIANA K. MAY County A1orney’s Office 1
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STRANGULATION
*DIANA K. MAY County A1orney’s Office
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Defini1on of Strangula1on
Strangula1on is a form of asphyxia characterized by closure of the blood
vessels and air passages of the neck as a result of external pressure on the neck
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Strangula1on vs. Choking
• Choking = an internal obstruc1on of the airway
• Strangula1on = is a form of asphyxia characterized by closure of the blood vessels and air passages of the neck as a result of external pressure on the neck
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Types of Strangula1on
• Hangings • Manual Strangula1on • Ligature Strangula1on
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Manual Strangula1on
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Ligature Strangula1on
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» WHY IS STRANGULATION SO
SERIOUS OF A CRIME?
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Clinical Sequence of Strangula1on
Severe pain Unconsciousness = Death
The vic1m will lose consciousness by any one or all of the
following: § blocking of the caro1d arteries
ú depriving the brain of oxygen § blocking of the jugular veins
ú preven1ng deoxygenated blood from leaving the brain § closing off the airway
ú causing the vic1m to be unable to breathe
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TWO STUDIES REGARDING STRANGULATION
• STOCKHOLM STUDY • SAN DIEGO STUDY
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Stockholm Study
• 1981 • 102 Surviving Vic1ms of Strangula1on • 296 Homicide Vic1ms – 37 died of Strangula1on (13%)
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Stockholm Study
• Surviving Vic1ms: 102 – 72 – vic1ms of strangula1on – 30 – vic1ms of strangula1on along with sexual assault
• Surviving Vic1ms: 6 Categories – One Hand *2nd Most Common
– Two Hands – back – Two Hands – front *Most Common
– Larynx with two thumbs – Ligature – Pressure to Neck with elbow or forearm
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Stockholm Study • Surviving Vic1ms: Injuries 102 – Injuries of strangula1on/sexual assault
• 23 (23%)– revealed no injuries • 79 (77%)– some injuries of strangula1on (64)/sexual assault (15)
– 34 (43%) had one or more hematoma/contusions on head – Type of Injuries
• 14 of 79 – Petechiae • 10 of 79 – Unconscious • 4 of 79 – Urina1on/Defeca1on
– Two Hands From Front Most Common (30)
• 15 of Defendants were Examined – 11 had injuries
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Stockholm Study • Murdered Vic1ms -‐ 37 – All had injuries:
• 18 Strangula1on Injuries • 19 Strangula1on and Other Injuries
– 4 had Bone Fractures (does not include Hyoid/Thyroid) – 35 of 37 – Petechiae – 22 of 37 – Urina1on/Defeca1on – 20 of 37 – Fracture of Hyoid Bone or Thyroid Car1lage
• Murdered Vic1ms – 37 – 20 Manual – 12 Ligature – 5 both Manual and Ligature
• 20 Defendants examined – 13 had injuries
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San Diego Strangula1on Study
• Ini1al study -‐ 100 Strangula1on cases – Visible signs of strangula1on
• 62% no visible injury • 22% minor visible injury • 16% major injury such as rope burns, red marks or bruising
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San Diego Strangula1on Study
• Subsequent study -‐ 300 Strangula1on cases – Visible signs of strangula1on
• 50% no visible injury • 35% minor visible injury • 15% major injury such as rope burns, red marks or bruising
• Prior history of D.V. (89%/90%) • Children present (50%)
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WHAT TO LOOK FOR IN STRANGULATION CASE?
• SYMPTOMS OF STRANGULATION
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Symptoms of Strangula1on
• SubjecJve symptoms – Subjec1ve to vic1m – Requires specific inquiry by interviewer to disclose specific symptoms
• ObjecJve symptoms – Objec1ve to examiner
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Subjec1ve Symptoms
• Voice changes • Difficul1es in swallowing • Breathing difficul1es • Mental status changes
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Sonya’s 911 Call:
• 911 Call_Watkins_97cr3979 .wav
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Objec1ve Symptoms
• Neck – Normal appearance (50% to 62% of the 1me In San Diego Study; 23% Stockholm)
– Redness, bruising, swelling, scratches, ligature marks
– Neck acute trauma (can close off airway, internal bleeding, laryngeal fracture, hyoid bone fracture, thyroid fracture)
– Follow – Up Photos Cri1cal
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• Neck: What Type of Strangula1on? – Manual • Approach?
– Ligature • Can you determine type of ligature?
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• Neck – What Else Can Cause Injuries? – Jewelry – Clothing – Fingernails – Bite Marks – Furniture
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Objec1ve Symptoms
• Face – Petechiae (capillary rupture)
• Around face • Around eyes • Eyelids • Forehead
– Blood-‐red eyes (subconjunc1val hemorrhage)
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Objec1ve Symptoms
• Respiratory system – Breathing changes – Coughing up blood (hemoptysis)
• Raspy Voice
• Bi1ng Tongue
• Seizures
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Objec1ve Symptoms
• Involuntary urina1on and/or defeca1on
• Miscarriage
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Objec1ve Symptoms • Neurological changes – Restlessness (early) to psychosis (late) – Unconsciousness, simply drowsy
• Unconsciousness – Caro1d artery occlusion – Jugular vein occlusion – Tracheal occlusion
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Objec1ve Symptoms
§ Unconsciousness ú Caro1d Artery Occlusion
most common 11 lbs. of pressure for 10 seconds
ú Jugular Vein Occlusion second most common 4.4 lbs. of pressure to occlude
ú Tracheal Occlusion third most common 33 lbs. of pressure to occlude
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Objec1ve Symptoms
• Brain Death – If strangula1on persists, as quick as “minutes” – Fracture of the trachea/ hyoid bone
• Age Issue
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Objec1ve Symptoms: Other Corrobora1ng Injuries
• Bite Marks • Injuries to Head • Injuries to Arms • Injuries to Torso • Injuries to Defendant too!
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STRANGULATION...
• Law Enforcement Response
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• Encourage vic1m to seek medical treatment
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• Obtain a medical release ASAP -‐see handout
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• Obtain Serious Bodily Injury Form -‐ see handout
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• Document other injuries ( photos with scale) – Vic1m • Neck • Head • Chin • Behind Ears • Back • Scratch marks • Bite Marks
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• Document other injuries – Suspect • Hands • Scratch Marks • Bite Marks
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• Document emo1onal state of vic1m
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• Document Scene
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§ CollecJon of Evidence ú Ligature ú Fingernail Clippings ú Swab for DNA (neck/hands/fingers/bite marks) ú *Forensic Research on this is mixed!
ú Prints ú Possible
ú Jewelry ú Clothing ú Evidence of urina1on/defeca1on ú Broken items ú Corrobora1on of Crime
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• Research on Prints/DNA • ALS (Alterna1ve Light Source)
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• Tes1ng of Evidence – DNA – Human Serology Tes1ng – Prints
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• Interviews – Vic1m • What was the Defendant saying? – showing of intent… • Interview about other incidents of domes1c violence(par%cularly strangula%on incidents) • What other Witnesses to prior events?
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• Interviews – Suspect – Ac1on and Words
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• Interviews of Witnesses – Fire Department/Ambulance personnel – Neighbors – Children – Similar Witnesses – Any other person vic1m spoke to (Comba%ng Crawford Issues)
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• Educate Doctor/Medical Personnel • SANE/FNE PROGRAM!
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Suggested Ques1ons to Ask…SEE HANDOUT
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STRANGULATION...
• ProsecuJon
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• ALL STRANGULATION CASES SHOULD BE A MINIMUM OF THIRD DEGREE ASSAULT!
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STATUTES COMMONLY CHARGED
• 1st Degree Murder • 2nd Degree Murder • 1st Degree Assault • 2nd Degree Assault • Felony Menacing • 3rd Degree Assault • Arempt to Commit…
ATTEMPT: “Substan1al Step”
• Any conduct, whether act, omission, or possession, which is strongly corrobora1ve of the firmness of the actor’s purpose to complete the commission of the offense.
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C.R.S. 18-‐1-‐901(3)(p). Defini1on of Serious Bodily Injury:
• Bodily injury which, either at the 1me of the actual injury or at a later 1me involves: – A substan1al risk of death, – A substan1al risk of serious permanent disfigurement,
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C.R.S. 18-‐1-‐901(3)(p). Defini1on of Serious Bodily Injury (Cont.):
– A substan1al risk of protracted loss or impairment of the func1on of any part or organ of the body,
– Breaks, – Fractures, – Or burns of the second or third degree.
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C.R.S. 18-‐3-‐203. Assault in the Second Degree: (F4)
• A person commits the crime of assault in the second degree if: – b) With intent to cause bodily injury to another person, he or she causes the injury to any person by means of a deadly weapon, or..
– c) He recklessly causes serious bodily injury to another person by means of a deadly weapon
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C.R.S. 18-‐3-‐203. Assault in the Second Degree: (F4)
• A person commits the crime of assault in the second degree if: – g) With intent to cause bodily injury to another person he causes serious bodily injury to that person
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C.R.S. 18-‐3-‐206 Felony Menacing (F5):
• A person commits the crime of felony menacing if: – Threat or Physical Ac1on – Knowingly places another in – Fear of SBI or Death – By use of Deadly Weapon
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FELONY MENACING “Deadly Weapon”
• In the manner it is used or intended to be used is capable of producing death or SBI:
• (IV) any other weapon, device, instrument, material, or substance, whether animate or inanimate.
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• Deadly weapon can be hands. See People v. Ross, 831 P.2d 1310 (Colo. 1992).
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C.R.S. 18-‐3-‐204. Assault in the Third Degree: (M1)
• A person commits the crime of assault in the third degree if he knowingly or recklessly causes bodily injury to another person or with criminal negligence he causes bodily injury to another person by means of a deadly weapon.
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PROSECUTION CHECKLIST
• Proper Charges Cri1cal • Strong Rela1onship with Vic1m • Execute Release ASAP! • Follow-‐up Photos • Meet with Trea1ng Doctor Early – determine if need other expert – Blind Expert?
• Aggressive Mo1on Prac1ce 59
• SEE PROSECUTION CHECKLIST
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EXPERT TESTIMONY
• Medical Expert – Qualifica1ons – SANE/FNE – Ques1ons -‐ see handout
• Law Enforcement Expert – Qualifica1ons – Ques1ons -‐ see handout
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MISC.
• CCADV – STRANGULATION SUBCOMMITTEE • POST – ADDING STRANGULATION (hopefully)
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STRANGULATION...
• Advocacy
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Advocate role is cri1cal..
• You may be the first person vic1m discloses to • Remember to use the word “strangle” not choke
• Always encourage vic1m to seek medical treatment
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Stress to vic1m how serious this is...
• Very in1mate crime • Perpetrator knows what they are doing-‐ deliberate act
• Not “heat of the moment” crime • There could be effects days later • DOCUMENT DOCUMENT DOCUMENT
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REMEMBER…..
• Encourage Vic1m to Seek Medical Treatment (future medical complica1ons)
• Prosecu1on prefers medical assessment
• STRANGLE, not “choke”
• Treat these Crimes Seriously
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REMEMBER…..
VISIBLE INJURIES ARE NOT ALWAYS PRESENT!!!
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CONCLUSION/ QUESTIONS
CONTACT INFORMATION
• DIANA K. MAY • SENIOR ASSISTANT COUNTY ATTORNEY
• 719-‐520-‐6409
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