Positional asphyxia: accidental death due to head-down position in a badger sett

Death from positional or postural asphyxia occurs when the decedent is found in a position that interferes with pulmonary gas exchange (1). Positional asphyxia in a head-down position is a rare event and is infrequently reported in the literature. This paper describes an unusual accidental death due to head-down position in a badger sett.

CASE REPORT

A 67-year-old hunter who had been missing for 2 days was found deceased trapped in a badger sett. He was last seen on a Friday afternoon after he went to borrow a camera trap from a friend. The badger sett was located on a meadow approximately 700 meters from the nearest town. A well-worn path was leading to the dome-shaped entrance of the sett which was situated almost one meter below the ground’s surface covered with densely growing wild rosehip bushes. A large spoil heap of soil and discarded bedding outside the entrance was evident. A hunting knife, plastic tightening tapes, binoculars and a textile bag were found leading up to the sett entrance. The deceased was found wedged at a 90-degree angle (Fig. 1) in the hole leading to the sett entrance in a head-down position with his head, right shoulder and right upper limb being stuck in the sett (Fig. 2). A pair of rubber boots were present next to the body. After removing the body from the entrance, a camera trap was found placed in the badger sett (Fig. 3). The deceased had hypertensive disease and a history of alcohol consumption on a regular basis.

At autopsy, the body was that of an adult white male of around the stated age of 67 years. External examination of the body showed hypersthenic habitus with body mass index of 30.4 kg/m2 (175 cm, 93 kg). The right side of the face and the hands were covered with soil and leaves. A small amount of blood-tinged fluid was oozing from the nostrils. Superficial bruises of the left hand and the right thigh were noted. Marked congestion, cyanosis and a multitude of pinpoint hemorrhages in the face, neck and upper chest were the most striking findings. Severe congestion of the right upper limb was evident (Fig. 4). Confluent scleral and conjunctival hemorrhage were observed (Fig. 5). Numerous petechial bleedings were found in the oral mucosa (Fig. 6) and within the reflected scalp. Internal examination demonstrated multiple scattered hemorrhages within the sternocleidomastoid and the intercostal muscles. The soft tissues of the neck were markedly congested. Severe pulmonary and cerebral edema were present. There were no significant injuries observed. The enlarged liver weighted 2180 g and showed mild fatty changes. The coronary arteries showed moderate atherosclerosis. The significantly enlarged heart weighted 570 g. Microscopic examination of the heart showed focal accumulation of amorphous eosinophilic material in the interstitium and in the intramural branches of the left ventricle. Congo red stain confirmed the presence of amyloid. Toxicological evaluation revealed a blood alcohol level of 1.25 g/kg. Death was attributed to positional asphyxia due to head-down position in a badger sett.

Fig. 1. The body was wedged at a 90-degree angle in the hole leading to the sett entrance in a head-down position.

Fig. 2. The victim’s head, right shoulder and right upper limb were stuck in the badger sett. A pair of rubber boots were found next to the body.

Fig. 3. The camera trap placed in the badger sett.

Fig. 4. Severe congestion and cyanosis of the right upper limb.

Fig. 5. Confluent scleral and conjunctival hemorrhage.

Fig. 6. Numerous petechial bleedings in the oral mucosa