DEPARTMENT OF FORENSIC MEDICINE - Hillsborough ...

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DEPARTMENT OF FORENSIC MEDICINE
GUY’S HOSPITAL
(UNIVERSITY OF LONDON)
WEST, MJB., Ch.B„ F.R.C.P*th„ DW J.
T. SHEPHERD B.Sc., MJ3., B.S., M.R.C.P*th„ DMJ.
. Telephone Line 071-407 0378
071-403 7292)
UNITED MEDICAL AND DENTAL SCHOOLS
GUVS AND ST. THOMAS'S HOSPITAL
LONDON BRIDGE. SE1 9RT
TELEPHONE: 071-955 5000 Exi: 3118/3119
e photographs of Kevin Williams appear to show the correct body. They
.nat.indicate the classic signs of traumatic asphyxia. There^i^no
eliing of the face although there js'll5ae1 cyanosis. The most prominent,
.ndings that can be seen on the photographs are the injuries _ o v e r the
idersurface of the chin and left jawline just below the prominence^of
le larynx (Adam’s apple). The photographs indicate one long a b r a s i o n
ider the right side of the chin and an abrasion under the left jawline
.id two abrasions over the region of the larynx. An additional abrasion
s visible just outside the left eye. There,also appears to be deformity
f ^ ) neck in the region of the larynx.
n / opinion there has been substantial damage to the front of Mr.
illiams neck as the result of compression of the neck possibly caused
>y his neck being crushed under the feet of individuals in the crowd or
I caused by his neck being crushed against some rigid object. The
Jeformity seen in the photographs and the fractures, found by Dr. Slater
I luring his post mortem examination, strongly suggest that damage to the
apper airway was an important contributory factor in the death of Kevin
Williams. Damage to the airway at this level may lead to obstruction and
swelling of the lining of the larynx which reduces the amount of air that
can reach the deceased's lungs. As I have stated in my previous report
I do not believe that this type of injury would lead to.unconsciousness
within a few seconds. Whilst death may occur repdily following such
laryngeal injuries this is not inevitably the case and death may be
delayed for a considerable period. This type of injury is amenable to
treatment in the form of an emergency tracheostomy or a cricothyroidotomy.
Whilst an emergency tracheostomy is a relatively major
p ^ f e d u r e , crico-thyroidotoray is a simpler procedure which involves the
pBLage of a tube through the membrane between the thyroid and cricoid
c tilages. It is possible that if one of these procedures had been
carried out at the scene then he would not have suffered from the fatal
asphyxia which led to his death.
Both cricothyroidotoray and emergency tracheotomy can be performed in the
field although, in the latter instance# with difficulties owing to an
increased likelihood of haemorrahge at the operation site.
I could find nothing, from the post • mortem report or from the
photographs, to refute the realistic possibility that this young man was
,still alive after 3.15 pm on the day. I do accept, however, that he is
/unlikely to have spoken the word "Muiti" if he had already suffeced
convulsions due to lack of oxygen. In my opinion, the primary cause of
death in this instance is damage to his neck which would not have been
inevitably rapidly fatal.