International Journal of Pediatric Otorhinolaryngology
Accidental childhood strangulation by human hair
Introduction
In the early hours of August 5, 2002, a mother awoke to find her 13-month-old daughter entangled and strangling in her (the mother's) hair. The baby girl had been co-sleeping in her parent's bed. The baby was entangled on top of her head, and initially the mother and father were unable to untangle and remove the child. When the child was removed, she was found to be unconscious and cyanotic with a ligature mark around her neck.
She soon revived, and the parents immediately took the child to the local emergency room. The ER physician noted petechiae on the child's face and documented that a ligature mark extended three-quarters of the way around her neck, see Fig. 1. In all other aspects the child appeared to be fine. However, the physician deemed the story to be impossible and fearing child abuse, contacted local officials. The mother was arrested and all six of her children were removed from the house. She was facing up to 30 years in prison.
Unfortunately, the parents were low-income Hispanic migrant workers (the father is unable to speak or understand English) and unable to afford legal representation to defend themselves in court. However, a local attorney took on the case pro bono and contacted RAM Consulting to act as an expert witness [1]. We also agreed to help defend this family on a pro bono basis.
Section snippets
Materials and methods
Several key analyses were undertaken to prove or disprove the validity of this incident, namely:
- (1)
anthropometric analysis;
- (2)
strength of human hair;
- (3)
ligature mark characterization;
- (4)
airway occlusion force;
- (5)
conditions required to initiate petechiae;
- (6)
literature review.
A basic question must be answered by each of these analyses.
Anthropometric analysis
The length of the mother's hair was documented the night of the incident at the ER, and was found to range from 30.5 cm (12 in.) at the base of the skull, up to 50.8 cm (20 in.) at the crown of the head, see Fig. 2. Anthropometric data analysis [2] shows that children aged 13 months are likely to have a neck circumference ranging from 21.8 to 26.2 cm, with an average of 23.6 cm, see Table 1. The combination of these facts demonstrates that the mother's hair could have wrapped around the child's neck,
Discussion
Finally, we applied an actual sample of the mother's hair, as was described previously, to our anthropometric manikin, which also contains force sensors in the neck [8], see Fig. 10. The mother's hair not only easily entangled around the neck of the manikin, but it also resulted in a force on the neck greater than that required to occlude the airway.
Conclusion
It is possible for a strangulation incident to occur when a young child is co-sleeping with a parent with long hair. It is also possible for this scenario to result in an injury or death.
Upon review of this report and RAM's deposition in this matter, the prosecuting attorney's expert witness withdrew her testimony and the judge dismissed the case. The family has since been reunited.
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