Suicidal hanging versus homicidal hanging – A case report
Author(s): B. L. Chaudhary, R. K. Sharma, Deepak Singh
Vol. 2, No. 2 (2008-07 - 2008-12)
B. L. Chaudhary٭, R. K. Sharma٭٭, Deepak Singh٭٭٭
٭ Senior Resident, Department of Forensic Medicine and Toxicology, AIIMS, New Delhi, ٭٭ Addl. Professor, Department of Forensic
Medicine and Toxicology, AIIMS, New Delhi, ٭٭٭Assistant Professor, Department of Forensic Medicine and Toxicology, CIMS, Bilaspur
Abstract
Suicidal hangings are rarely encountered by crime scene
investigators, while evidence of suicidal deaths are usually more
common and recognizable. There have been cases where the
victim has attempted to disguise suicidal hanging as a case of
homicide with suspicion of foul play.
Sometimes it poses difficult challenges to investigating
officers. Most of the reported cases of suicidal deaths staged as
homicide involve death by gun shot. Few authors have reported
suicidal deaths staged as accidents. Most of such suicides staged
as accidents involved the use of motor vehicle.
The following case is a case of a suicidal hanging in which
the victim has tied his upper limbs behind his back, which creates
a suspicion of homicide. But the findings from the scene of crime
investigation and autopsy made it evident that the manner of
death by hanging was suicidal in nature.
Key words: Hanging, Suicide, homicide, death
Case history
A 40 year old male body was brought in the department of
forensic medicine with the alleged history of hanging. The victim
was found suspended from a branch of tree in a jungle, by a
cotton rope with a running knot present over the occipital region.
In addition, the victim’s hands were restrained behind his back
at the level of hips with the (same type) cotton rope. A suicide
note was recovered by police from his pocket (as shown).
Visit to scene of crime
A team of doctors visited the scene of crime, who found a
dead body hanging from a branch of a tree by a cotton rope
with the running knot which was placed over the occipital region
and both the hands were restrained behind his back at hip level
with two separate running knots and there was a gap of 40 cm
between the two arms. The feet were not touching the ground.
The tongue was protruding out of lips and was dark bluish in
colour. It was also reported that one of the footwear was present
near body and the other was about 10 feet away. There were few
fibers of rope, which were lying on a sharp cutting edge stone
kept nearby indicating. Perhaps it was used for cutting rope.
Post-mortem Findings
External findings
Rigor mortis was present in all parts of body. The postmortem
staining was present and fixed over the dependent parts viz. both
legs and distal portion of upper limbs and area of waist above
the belt. Both the eyes were partially open and the conjunctiva
congested while the cornea was hazy. The mouth was partially
open and a dark bluish tongue was protruding out of the lips.
The face was congested. The tip of penis showed evidence of
emission of semen. Besides this, there was also an evidence of
defecation. The ligature material was a cotton rope, which was
present in situ around the neck with the running knot placed
over the occipital region.
Both the hands were tied behind his back with the same
type of cotton rope with two separate running knots and the
gap between the two hands was of 40 cm.
Ante-mortem injuries
Ligature mark
A ligature mark was present encircling the whole neck except
a small gap present beneath the knot. In front of the neck, the
ligature mark with 3 cm width, was placed over the thyroid
cartilage, about 5 cm above suprasternal notch and 8 cm below
chin. The ligature mark was running backwards, upwards and
towards occipital region. On the right side of the neck, the ligature
mark with 2.8 cm width, was placed about 5 cm below the
mastoid process. On the left side of the neck, the ligature mark
with 2.5 cm width, was placed about 4 cm below the mastoid
process. The base of the ligature was dark brown in color,
ecchymosed and parched.
An abrasion of size 5 × 2 cm was present over the medial
aspect of left leg, about 3 cm above medial malleolus.
Internal findings
On dissection of the neck, the underneath soft tissues were
soft, whitish and glistening. There was no evidence of any
extravasation of blood in the neck tissues. Also, there was no
evidence of fracture of thyroid cartilage or hyoid bone. The scalp
showed diffuse multiple petechial hemorrhages. The skull was
within normal limit. The meninges were intact and congested. The
brain was congested and edematous, with its parenchyma
showing petechial hemorrhages. Other organs were also
congested. The stomach was congested and contained about 200
ml thick yellowish color food particles without any specific smell.
Cause of death
The opinion regarding the cause of death was asphyxia due
to suicidal hanging by ligature.
Discussion
A variety of staged crime scenes are encountered by the
investigating officers. Suicide may be staged as homicide by family
members or friends in an attempt to avoid the embarrassment
or for other personal, social or religious reasons. Staging a suicide
as a homicide, may be a final effort by the victim to gain
popularity, attention or to take revenge against friends or family
or to ensure his killing. In this particular case suicide was
committed in unusual form of ligature hanging, where victim
tied his both the upper limbs by rope on back. Similar cases were
also reported by other authors; Cooke et al found circumstances
and medical findings of four unusual hanging deaths.
Clark MA et al reported four unrelated hanging deaths, one
scene revealed as a suicide note equivalent with the unmistakable
message of extreme defiance toward military regulations. In another case medical history reveals that the victim had an eight
to ten year history of compressing his neck to cause
unconsciousness, perhaps for stimulation he left a suicidal note
which concluded hanging was the cause of death.
Blanco Pampin JM et al 2001 described two suicidal hanging
deaths in an automobile which is very unusual. In one case, the
deceased used his belt as a ligature and the point of attachment
was the window of the car. The second victim used the safety
belt of the passenger seat. In both cases, the automobile engine
was turned off, all the windows were closed and doors were
locked.
Krzyzonowski M et al 2002, observed 6 cases of suicidal
hanging and in each case limbs of the victim were bound. These
findings always raise a suspicion of homicide.
Avis SP 1993 also reported few cases of unusual hanging
deaths.
Adair TW et al 1999, described case of suicidal hanging
staged as homicide.
Cingolani M 2000 reported three cases of planned complex
suicide in a three-year period. A 40-year man was found dead in
his garage, hanging by his neck, with a gunshot in the head from
a pen gun. A 50-year man was found dead in the sea with the
gunshot to his head. A third was found in a field hanging by a
tree and burned. All cases after through investigation showed
suicidal etiology.
Madea H 1993, found a case of suicidal by hanging in which
multiple deep stab wounds were observed in neck and chest.




Reference
- Adair TW, Doberson MJ: A case of suicidal hanging staged
as a homicide. J Forensic Sci 1999 Nov; 44 (6): 1307 – 9.
- Avis SP: An unusual suicide – The importance of the scene
investigation. Am J Forensic Med Pathol 1993 Jun; 14 (2): 148 –
50.
- Blanco Banpin JM, Lopez Abazo Rodrigue BA: Suicidal
hanging in automobile. Am J Forensic Med Pathol 2001 Dec; 22
(4): 367 –9.
- Cingolani M, Tsakri D: Planned complex suicide – Report of
three cases. Am J For Med Pathol 2000 Sept; 21 (3): 255 –
60.
- Clark MA, Kerr FC: Unusual hanging deaths. J forensic Sci,
1986 Apr; 31(2): 747 – 55.
- Cooke CT, Cadden GA, Hilton JM: Unusual hanging deaths.
Am J For Med Pathol, 1998 Dec; 9 (4): 277 – 82.
- Goonetillete UK: Two unusual cases of suicidal hanging.
Forensic Sci Int, 1984 Dec; 26(4): 247 – 53.
- Krzyzanowski M, Jankowski Z, Piesniale D, Wilmanowska A:
Cases of hanging with bound limbs – suicide, homicide or
accident. Arch Med Sadowej kryminal, 2002 0ct – Dec; 52
(4); 371 – 9.
- Laczkowsk G, Rohrich T, Bratzke H: Suicidal excess –
presentation of unusual cases. Arch Kriminol 1998 Sept –
Oct; 2002 (3-4): 100 – 8.
- Leth P, Vesterby A: Homicide hanging masquerading as
suicide. Forensic Sci Int 1997 Feb; 85 (1): 65 – 71.
- Madea H, Imura M, Higuchi T, Noguchi K: An autopsy case
of suicide by hanging with multiple stab wounds of the neck
and chest. Med Sci Law 1993 Jan; 33 (1): 67–9.
- Marsh TO, Burkharelt RP, Swinchant JW: Self inflicted hanging
with bound wrist and a gag. Am J Forensic Med Pathol 1982
Dec; 3 (4): 367 – 9.
- Mc Dowell CP: Suicide disguised as murder: a dimension of
manchausen syndrome. J Forensic Sci 1983; 32:254 – 61.
- Puschel K, Holtz W, Hinderbrand E, Naeve W, Brickmann B:
Suicide or homicide. Arch Kriminol 1984 Nov – Dec; 174 (5-
6): 141 – 53.
- Tokal S, Bundakov B, Stojanovic P: A suicide by hanging
suspected to be a homicide. Med Prgl. 1997 Jul – Aug; 50(7-
8): 315 – 8.
B. L. Chaudhary٭, R. K. Sharma٭٭, Deepak Singh٭٭٭
٭ Senior Resident, Department of Forensic Medicine and Toxicology, AIIMS, New Delhi, ٭٭ Addl. Professor, Department of Forensic Medicine and Toxicology, AIIMS, New Delhi, ٭٭٭Assistant Professor, Department of Forensic Medicine and Toxicology, CIMS, Bilaspur
Abstract
Suicidal hangings are rarely encountered by crime scene investigators, while evidence of suicidal deaths are usually more common and recognizable. There have been cases where the victim has attempted to disguise suicidal hanging as a case of homicide with suspicion of foul play.
Sometimes it poses difficult challenges to investigating officers. Most of the reported cases of suicidal deaths staged as homicide involve death by gun shot. Few authors have reported suicidal deaths staged as accidents. Most of such suicides staged as accidents involved the use of motor vehicle. The following case is a case of a suicidal hanging in which the victim has tied his upper limbs behind his back, which creates a suspicion of homicide. But the findings from the scene of crime investigation and autopsy made it evident that the manner of death by hanging was suicidal in nature.
Key words: Hanging, Suicide, homicide, death
Case history
A 40 year old male body was brought in the department of forensic medicine with the alleged history of hanging. The victim was found suspended from a branch of tree in a jungle, by a cotton rope with a running knot present over the occipital region. In addition, the victim’s hands were restrained behind his back at the level of hips with the (same type) cotton rope. A suicide note was recovered by police from his pocket (as shown).
Visit to scene of crime
A team of doctors visited the scene of crime, who found a dead body hanging from a branch of a tree by a cotton rope with the running knot which was placed over the occipital region and both the hands were restrained behind his back at hip level with two separate running knots and there was a gap of 40 cm between the two arms. The feet were not touching the ground.
The tongue was protruding out of lips and was dark bluish in colour. It was also reported that one of the footwear was present near body and the other was about 10 feet away. There were few fibers of rope, which were lying on a sharp cutting edge stone kept nearby indicating. Perhaps it was used for cutting rope.
Post-mortem Findings
External findings
Rigor mortis was present in all parts of body. The postmortem staining was present and fixed over the dependent parts viz. both legs and distal portion of upper limbs and area of waist above the belt. Both the eyes were partially open and the conjunctiva congested while the cornea was hazy. The mouth was partially open and a dark bluish tongue was protruding out of the lips. The face was congested. The tip of penis showed evidence of emission of semen. Besides this, there was also an evidence of defecation. The ligature material was a cotton rope, which was present in situ around the neck with the running knot placed over the occipital region.
Both the hands were tied behind his back with the same type of cotton rope with two separate running knots and the gap between the two hands was of 40 cm.
Ante-mortem injuries
Ligature mark
A ligature mark was present encircling the whole neck except a small gap present beneath the knot. In front of the neck, the ligature mark with 3 cm width, was placed over the thyroid cartilage, about 5 cm above suprasternal notch and 8 cm below chin. The ligature mark was running backwards, upwards and towards occipital region. On the right side of the neck, the ligature mark with 2.8 cm width, was placed about 5 cm below the mastoid process. On the left side of the neck, the ligature mark with 2.5 cm width, was placed about 4 cm below the mastoid process. The base of the ligature was dark brown in color, ecchymosed and parched.
An abrasion of size 5 × 2 cm was present over the medial aspect of left leg, about 3 cm above medial malleolus.
Internal findings
On dissection of the neck, the underneath soft tissues were soft, whitish and glistening. There was no evidence of any extravasation of blood in the neck tissues. Also, there was no evidence of fracture of thyroid cartilage or hyoid bone. The scalp showed diffuse multiple petechial hemorrhages. The skull was within normal limit. The meninges were intact and congested. The brain was congested and edematous, with its parenchyma showing petechial hemorrhages. Other organs were also congested. The stomach was congested and contained about 200 ml thick yellowish color food particles without any specific smell.
Cause of death
The opinion regarding the cause of death was asphyxia due to suicidal hanging by ligature.
Discussion
A variety of staged crime scenes are encountered by the investigating officers. Suicide may be staged as homicide by family members or friends in an attempt to avoid the embarrassment or for other personal, social or religious reasons. Staging a suicide as a homicide, may be a final effort by the victim to gain popularity, attention or to take revenge against friends or family or to ensure his killing. In this particular case suicide was committed in unusual form of ligature hanging, where victim tied his both the upper limbs by rope on back. Similar cases were also reported by other authors; Cooke et al found circumstances and medical findings of four unusual hanging deaths. Clark MA et al reported four unrelated hanging deaths, one scene revealed as a suicide note equivalent with the unmistakable message of extreme defiance toward military regulations. In another case medical history reveals that the victim had an eight to ten year history of compressing his neck to cause unconsciousness, perhaps for stimulation he left a suicidal note which concluded hanging was the cause of death.
Blanco Pampin JM et al 2001 described two suicidal hanging deaths in an automobile which is very unusual. In one case, the deceased used his belt as a ligature and the point of attachment was the window of the car. The second victim used the safety belt of the passenger seat. In both cases, the automobile engine was turned off, all the windows were closed and doors were locked.
Krzyzonowski M et al 2002, observed 6 cases of suicidal hanging and in each case limbs of the victim were bound. These findings always raise a suspicion of homicide. Avis SP 1993 also reported few cases of unusual hanging deaths.
Adair TW et al 1999, described case of suicidal hanging staged as homicide.
Cingolani M 2000 reported three cases of planned complex suicide in a three-year period. A 40-year man was found dead in his garage, hanging by his neck, with a gunshot in the head from a pen gun. A 50-year man was found dead in the sea with the gunshot to his head. A third was found in a field hanging by a tree and burned. All cases after through investigation showed suicidal etiology.
Madea H 1993, found a case of suicidal by hanging in which multiple deep stab wounds were observed in neck and chest.
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Reference
- Adair TW, Doberson MJ: A case of suicidal hanging staged as a homicide. J Forensic Sci 1999 Nov; 44 (6): 1307 – 9.
- Avis SP: An unusual suicide – The importance of the scene investigation. Am J Forensic Med Pathol 1993 Jun; 14 (2): 148 – 50.
- Blanco Banpin JM, Lopez Abazo Rodrigue BA: Suicidal hanging in automobile. Am J Forensic Med Pathol 2001 Dec; 22 (4): 367 –9.
- Cingolani M, Tsakri D: Planned complex suicide – Report of three cases. Am J For Med Pathol 2000 Sept; 21 (3): 255 – 60.
- Clark MA, Kerr FC: Unusual hanging deaths. J forensic Sci, 1986 Apr; 31(2): 747 – 55.
- Cooke CT, Cadden GA, Hilton JM: Unusual hanging deaths. Am J For Med Pathol, 1998 Dec; 9 (4): 277 – 82.
- Goonetillete UK: Two unusual cases of suicidal hanging. Forensic Sci Int, 1984 Dec; 26(4): 247 – 53.
- Krzyzanowski M, Jankowski Z, Piesniale D, Wilmanowska A: Cases of hanging with bound limbs – suicide, homicide or accident. Arch Med Sadowej kryminal, 2002 0ct – Dec; 52 (4); 371 – 9.
- Laczkowsk G, Rohrich T, Bratzke H: Suicidal excess – presentation of unusual cases. Arch Kriminol 1998 Sept – Oct; 2002 (3-4): 100 – 8.
- Leth P, Vesterby A: Homicide hanging masquerading as suicide. Forensic Sci Int 1997 Feb; 85 (1): 65 – 71.
- Madea H, Imura M, Higuchi T, Noguchi K: An autopsy case of suicide by hanging with multiple stab wounds of the neck and chest. Med Sci Law 1993 Jan; 33 (1): 67–9.
- Marsh TO, Burkharelt RP, Swinchant JW: Self inflicted hanging with bound wrist and a gag. Am J Forensic Med Pathol 1982 Dec; 3 (4): 367 – 9.
- Mc Dowell CP: Suicide disguised as murder: a dimension of manchausen syndrome. J Forensic Sci 1983; 32:254 – 61.
- Puschel K, Holtz W, Hinderbrand E, Naeve W, Brickmann B: Suicide or homicide. Arch Kriminol 1984 Nov – Dec; 174 (5- 6): 141 – 53.
- Tokal S, Bundakov B, Stojanovic P: A suicide by hanging suspected to be a homicide. Med Prgl. 1997 Jul – Aug; 50(7- 8): 315 – 8.