Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
Forensic Science, Medicine and Pathology
Published in: Forensic Science, Medicine and Pathology 2/2011

01-06-2011 | Case Report

Unique drowning in an atypical medium: paraffin wax in the setting of a motor vehicle crash—case report and literature survey

Authors: Theresa M. Mullan, Eric Lee Vey

Published in: Forensic Science, Medicine and Pathology | Issue 2/2011

Login to get access

Abstract

Among the various modes of death due to asphyxiation, drowning is unique. Unlike other types of suffocation associated with occluding airway obstructions (i.e. choking and smothering); with drowning, there is typically filling and involvement of the majority of the tracheobronchial tree and aerodigstive tract. Although the usual drowning medium is water, it can also occur in other media. Moreover, although drowning sometimes occurs in the setting of a motor vehicle accident, an element of vehicular submersion or immersion is usually operative in such instances. The case presented here is that of a motor vehicle crash which resulted in drowning where no immersion of the vehicle occurred. Moreover, the drowning medium was paraffin wax, rather than water. Other cases in the literature of drowning in atypical media and also those which are reported in the concomitant presence of a motor vehicle accident are presented.
Literature
1.
2.
3.
4.
5.
Bierens JJ. Handbook on Drowning: Prevention, Rescue, Treatment. New York: Springer; 2006.CrossRef
6.
7.
8.
9.
10.
11.
Spiers M, Finnegan OC. Near death due to inhalation of slurry tank gases. Ulster Med J. 1986;55:181–3.PubMed
12.
13.
Capovilla M, Durigon M, de la Grandmaison GL. An original cause of drowning in an industrial environment. Am J Forensic Med Pathol. 2007;28:91–3.PubMedCrossRef
14.
Azmak D. Asphyxial deaths: a retrospective study and review of the literature. Am J Forensic Med Pathol. 2006;27:134–44.PubMedCrossRef
15.
Patetta MJ, Biddinger PW. Characteristics of drowning deaths in North Carolina. Public Health Rep. 1988;103:406–11.PubMed
16.
Agócs MM, Trent RB, Russell DM. Activities associated with drownings in Imperial County, CA, 1980–90: implications for prevention. Public Health Rep. 1994;109:290–5.PubMed
17.
Smith GS, Langley JD. Drowning surveillance: how well do E codes identify submersion fatalities. Inj Prev. 1998;4:135–9.PubMedCrossRef
18.
Wintemute GJ, Kraus JF, Teret SP, Wright MW. Death resulting from motor vehicle immersions: The nature of the injuries, personal and environmental contributing factors, and potential interventions. Am J Public Health. 1990;80:1068–70.PubMedCrossRef
19.
Centers for Disease Control and Prevention, National Center for Health Statistics. Compressed Mortality File 1979–1998. CDC WONDER On-line Database, compiled from Compressed Mortality File CMF 1968–1988, Series 20, No. 2A, 2000 and CMF 1989–1998, Series 20, No. 2E, 2003. http://​wonder.​cdc.​gov/​cmf-icd9.​html Accessed on 13 May 2010.
20.
Stjernbrandt A, Oström M, Eriksson A, Björnstig U. Land motor vehicle-related drownings in Sweden. Traffic Inj Prev. 2008;9:539–43.PubMedCrossRef
21.
Winek CL, Wahba WW, Winek CL Jr, Balzer TW. Drug and chemical blood-level data 2001. Forensic Sci Int. 2001;122:107–23.PubMedCrossRef
22.
DiMaio VJ, DiMaio DJ. Asphyxia. In: DiMaio VJ, DiMaio DJ, editors. Forensic pathology. 2nd ed. Boca Raton: CRC Press; 2001. p. 229–77.
23.
Knight B, Saukko P. Suffocation and ‘asphyxia’. In: Knight B, Saukko P, editors. Forensic pathology. 2nd ed. New York: Oxford University Press; 1996. p. 352–67.
24.
Knight B. Immersion and drowning. In: Knight B, editor. Simpson’s forensic medicine. 11th ed. New York: Oxford University Press; 1997. p. 96–9.
25.
Adelson L. Homicide by cervical compression and homicide by drowning–“asphyxial deaths”. In: Adelson L, editor. The pathology of homicide: a vade mecum for pathologist, prosecutor and defense counsel. Springfield: Charles C. Thomas; 1974. p. 521–75.
26.
Reay DT. Mechanical asphyxia. In: Froede RC, editor. Handbook of forensic pathology. 2nd ed. Northfield: College of American Pathologists; 2003. p. 189–93.
27.
Lunetta P, Modell JH, Sajantila A. What is the incidence and significance of “dry-lungs” in bodies found in water? Am J Forensic Med Pathol. 2004;25:291–301.PubMedCrossRef
28.
DiMaio VJ, DiMaio DJ. Death by drowning. In: DiMaio VJ, DiMaio DJ, editors. Forensic pathology. 2nd ed. Boca Raton: CRC Press; 2001. p. 399–407.
29.
Knight B, Saukko P. Immersion deaths. In: Knight B, Saukko P, editors. Forensic pathology. 2nd ed. New York: Oxford University Press; 1996. p. 395–411.
30.
Modell JH, Bellefleur M, Davis JH. Drowning without aspiration: is this an appropriate diagnosis? J Forensic Sci. 1999;44:1119–23.PubMed
31.
Shepherd R. Asphyxia. In: Shepherd R, editor. Simpson’s forensic medicine. 12th ed. London: Hodder Arnold; 2003. p. 94–102.
32.
33.
Talwar V, Sood N, Verma PK. Drowning in concentrated syrup. Indian Pediatr. 2009;46:352–3.PubMed
34.
Singh B. A case report of ‘drowning’ in a bitumen tank. Med Sci Law. 1982;22(1):51–2.PubMed
35.
Cameron JM. Drowning: Immersion. In: Camps FE, Robinson AE, Lucas B, editors. Gradwohl’s Legal Medicine. 3rd ed. Bristol: John Wright & Sons; 1976. p. 349–51.
36.
James WR. A case of drowning in a vat of beer and two other short case reports. Med Sci Law. 1966;6:164–5.PubMed
37.
Machi T, Nakazawa T, Nakamura Y, Okeie K, Horita Y, Hirai H, Miyamori H, Saito Y, Kitagawa S. Severe hypercalcemia and polyuria in a near-drowning victim. Intern Med. 1995;34:868–71.PubMedCrossRef
38.
Fromm RE Jr. Hypercalcemia complicating an industrial near-drowning. Ann Emerg Med. 1991;20:669–71.PubMedCrossRef
39.
Coombs CF. Printed circuits handbook. 6th ed. New York: McGraw-Hill; 2008.
40.
Jubran A, Greenberg SD, Solomon MD, Noall MW, Tobin MJ. Aspiration injury due to polyacrylamide. Chest. 1992;101:576–8.PubMedCrossRef
41.
Apic R, Gasparec Z, Weber K. Drowning in gasoline. Forensic Sci. 1976;7:181.CrossRef
42.
Richmond AC. Commandant’s Action on Marine Board of Investigation; explosion and fire on board the SS Amoco Virginia, tank barges H.T. Co. No. 40 and 46 and Gissel 1601 and 2001, Houston ship channel, 8 November 1959 with loss of life. United States Coast Guard. August 22, 1960. www.​uscg.​mil/​hq/​cg5/​docs/​boards/​amocovirginia.​pdf. Accessed 13 June 2010.
43.
Singh B. A case report of ‘drowning’ in a bitumen tank. Med Sci Law. 1982;22:51–2.PubMed
44.
Pedersen MB, Simonsen J. Accidental death in fermentation tanks: report of two cases. Med Sci Law. 1982;22:283–4.PubMed
45.
Osbern LN, Crapo RO. Dung lung: a report of toxic exposure to liquid manure. Ann Intern Med. 1981;95:312–4.PubMed
46.
Knoblauch A, Steiner B. Major accidents related to manure: A case series from Switzerland. Int J Occup Environ Health. 1999;5:177–86.PubMed
47.
Fahy JV, Walley T, Gibney RT, McCabe M, FitzGerald MX. “Slurry lung”: a report of three cases. Thorax. 1991;46:394–5.PubMedCrossRef
48.
Centers for Disease Control and Prevention (CDC). Fatalities attributed to entering manure waste pits–Minnesota, 1992. MMWR Morb Mortal Wkly Rep 1993;42:325–9.
49.
Kadanoff LP. Built upon sand: theoretical ideas inspired by granular flows. Rev Mod Phys. 1999;71:435–44.CrossRef
50.
51.
Menon N, Durian DJ. Particle Motions in a Gas-Fluidized Bed of Sand. Phys Rev Lett. 1997;79:3407–10.CrossRef
52.
Terasaki H, Higashi K, Takeshita J, Tanoue T, Morioka T. Resuscitation by extracorporeal lung assist of a patient suffocating after inhalation of sawdust particles. Crit Care Med. 1990;18:239–40.PubMedCrossRef
53.
Linegar AG, Hayhurst MD, Cooke R. Near-fatal asphyxiation in sawdust—an unusual tracheobronchial foreign body. S Afr Med J. 2001;91:221–2.PubMed
54.
Jurek T, Szleszkowski L, Maksymowicz K, Wachel K, Drozd R. Lethal accidents in storage equipment: a report of two cases. Ann Agric Environ Med. 2009;16:169–72.PubMed
55.
Arneson M, Jensen A, Grewal H. A Kansas wheat harvest: near-fatal asphyxiation with wheat grains. J Pediatr Surg. 2005;40:1354–6.PubMedCrossRef
56.
Slinger P, Blundell PE, Metcalf IR. Management of massive grain aspiration. Anesthesiology. 1997;87:993–5.PubMedCrossRef
57.
West JB. Structure and function. In: West JB, editor. Respiratory physiology. 7th ed. Philadelphia: Lippincott, Williams & Wilkins; 2005. p. 1–11.
58.
59.
Bonilla-Santiago J, Fill WL. Sand aspiration in drowning and near drowning. Radiology. 1978;128:301–2.PubMed
60.
Kettner M, Ramsthaler F, Horlebein B, Schmidt PH. Fatal outcome of a sand aspiration. Int J Legal Med. 2008;122:499–502.PubMedCrossRef
61.
62.
Benomran FA, Hassan AI. Accidental fatal asphyxiation by sand inhalation. J Forensic Leg Med. 2008;15:402–8.PubMedCrossRef
63.
Avital A, Springer C, Mogle P, Godfrey S. Successful treatment after ‘drowning’ in sand. Arch Dis Child. 1989;64:615–6.PubMedCrossRef
64.
Van Dyke JJ, Lake KB. Survival after asphyxia secondary to gravel aspiration. Arch Intern Med. 1976;136:471–3.PubMedCrossRef
65.
Bergeson PS, Hinchcliffe WA, Crawford RF, Sorenson MJ, Trump DS. Asphyxia secondary to massive dirt aspiration. J Pediatr. 1978;92:506–7.PubMedCrossRef
66.
67.
Conroy C, Stanley C, Eastman AB, Vaughan T, Vilke GM, Hoyt DB, Pacyna S, Smith A. Asphyxia: a rare cause of death for motor vehicle crash occupants. Am J Forensic Med Pathol. 2008;29:14–8.PubMedCrossRef
68.
Conroy C, Eastman AB, Stanley C, Vilke GM, Vaughan T, Hoyt DB, Pacyna S. Fatal positional asphyxia associated with rollover crashes. Am J Forensic Med Pathol. 2007;28:330–2.PubMedCrossRef
69.
Vega RS, Adams VI. Suffocation in motor vehicle crashes. Am J Forensic Med Pathol. 2004;25:101–7.PubMedCrossRef
70.
Centers for Disease Control and Prevention (CDC). Flood-related mortality–Georgia, July 4–14, 1994. MMWR Morb Mortal Wkly Rep 1994;43:526–30.
71.
Yale JD, Cole TB, Garrison HG, Runyan CW, Ruback JK. Motor vehicle-related drowning deaths associated with inland flooding after hurricane Floyd: a field investigation. Traffic Inj Prev. 2003;4:279–84.PubMedCrossRef
72.
Dunagan DP, Cox JE, Chang MC, Haponik EF. Sand aspiration with near-drowning. Radiographic and bronchoscopic findings. Am J Respir Crit Care Med. 1997;156:292–5.PubMed
73.
Jougon J, Minniti A, Velly JF. Acute respiratory distress caused by gravel blocking the bronchial tree. Eur J Cardiothorac Surg. 2005;28:768.PubMedCrossRef
74.
Hanson KA, Gilbert JD, James RA, Byard RW. Upper airway occlusion by soil—an unusual cause of death in vehicle accidents. J Clin Forensic Med. 2002;9:96–9.PubMedCrossRef
75.
76.
77.
78.
Nishino T, Hiraga K. Coordination of swallowing and respiration in unconscious subjects. J Appl Physiol. 1991;70:988–93.PubMedCrossRef
Metadata
Title
Unique drowning in an atypical medium: paraffin wax in the setting of a motor vehicle crash—case report and literature survey
Authors
Theresa M. Mullan
Eric Lee Vey
Publication date
01-06-2011
Publisher
Springer US
Published in
Forensic Science, Medicine and Pathology / Issue 2/2011
Print ISSN: 1547-769X
Electronic ISSN: 1556-2891
DOI
https://doi.org/10.1007/s12024-010-9194-5

Other articles of this Issue 2/2011

Forensic Science, Medicine and Pathology 2/2011 Go to the issue

Book Review

David Canter: Forensic psychology—A very short introduction

Differential Diagnosis

Heat-induced post-mortem defect of the skull simulating an exit gunshot wound of the calvarium

Original Article

Age estimation and the medial clavicular epiphysis: analysis of the age of majority in an Australian population using computed tomography

Case Report

Sudden death from ruptured intracranial vascular malformation

Review

Review: Pharmacogenetic aspects of the effect of cytochrome P450 polymorphisms on serotonergic drug metabolism, response, interactions, and adverse effects

Images in Forensics

Hydrogen sulphide discoloration of the brain