title: Accidental strangulation of a mentally retarded patient by a clothing collar: a case report.
abstract: A 40-year-old mentally retarded woman died of accidental strangulation in a nursing home. She was found in a kneeling position with her hands on her knees and the collar of her clothing compressing the front and sides of the neck. Before the accident, a nurse had dressed the patient in one-piece overall-style pyjamas put on back to front so that she could not remove the garment herself. The post-mortem findings and reconstruction of the scene of death suggested that the patient had been strangled by the collar of her backward-facing clothing while in a kneeling position. Because patients with psychiatric illnesses may have a limited ability to recognize or communicate symptoms of physical danger, they must be closely monitored by knowledgeable medical and nursing staff. This case highlights the importance of preventing the accidental deaths of mentally retarded patients in nursing homes.
authors.affiliation: Department of Legal Medicine, Dokkyo University School of Medicine, Tochigi, Japan. hitosugi@dokkyomed.ac.jp
authors.forename: Masahito
authors.initials: M
authors.lastname: Hitosugi
authors.forename: Tomoko
authors.initials: T
authors.lastname: Yokoyama
authors.forename: Masahito
authors.initials: M
authors.lastname: Kido
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Kawato
authors.forename: Kazumi
authors.initials: K
authors.lastname: Matsushima
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Nagai
authors.forename: Shogo
authors.initials: S
authors.lastname: Tokudome
mesh_terms: D000061:Accidents, Home; D000328:Adult; D001237:Asphyxia / Q000209:etiology*; D003020:Clothing / Q000009:adverse effects*; D005260:Female; D005554:Forensic Medicine; D006801:Humans; D008607:Intellectual Disability