Journal of Chmcal Forensic Medicine ( 19981 5, 27-3 l ,c~, APS/Harcourt Brace & Co Ltd 1998 SHOR T REP OR T Examination and significance of 'tied up' dead bodies M. A. Elfawal*, M. H. M. Higazi * • Department of Pathology, King Faisal UniversiO; Dammam, Saudi Arabia," ~The Medico-legal Center; Riyadh, Saudi Arabia SUMMARY Examination of dead bodies found with parts of the body tied or bound can pose a real problem for the investigators in that it may not be possible to differentiate between suicide, homicide or accidental death. This article reports five such cases. Journal of Clinical Forensic Medicine (1998) 5, 27-31 INTRODUCTION Committing suicide with the hands tied or bound together is uncommon, ' but there are many reported cases of accidental death as a result of auto-erotic activity where the hands and/or other parts of the body are tied or bound. 2~4 In both situations, initial examination of the scene can give rise to suspicion of homicide, particularly if the hands are tied and the head or the face is covered. This paper reports five such cases in which the body was tied or bound up. In one case, a conclusion of suicide was clear. In two cases, suicidal death was the most likely conclusion, although accidental death could not be ruled out. In the other two cases, it was difficult to confirm whether the death was a homicide or an accident. CASES Case 1 A 23-year-old Indonesian housemaid spent an unusu- ally long time in the bathroom on the day of the inci- dent. The wife of the household became suspicious and called her husband. He broke open the door and found the girl apparently dead inside the bath tub. There was a ligature (head scarf) around her neck and attached to the shower unit that had been dislodged M.A. Elfawal MB, ChB, MSc, PhD, Department of Pathology, College of Medicine and Medical Sciences, King FaisaI University, Dammam, Saudi Arabia M. H. M. Higazi MB, BCh, MSc, MD, The Medico-legal Center, Riyadh, Saudi Arabia. Correspondenceto. Dr M. A. Elfawal, Mail Box 90, College of Medicine and Medical Sciences, King Faisal University,PO Box 2114, Dammam 31451, Saudi Arabia. from the wall (Fig. 1). Her two hands were loosely bound together by a cotton cloth, presumably prior to placing her neck inside the noose, which she had fixed earlier to the shower unit. The cloth was wrapped three times around her left wrist and then tied before it was turned twice around the right wrist. The remaining free end of the cloth was turned several times around the part binding the two wrists in a com- plex manner forming a loose knot and then inserted between the cloth parts wrapped around the right Fig. 1 The body of a young female inside a bath tub with hands tied, presumablyprior to suspension to the shower unit.