Suicidal ligature strangulation utilizing doubled cable ties - A case report

The Botswana Police Pathology unit records show that a total of 368 cases of suicide were reported between 2016 and 2019. A total of 367 of these cases were suicide by hanging while only 1 was of suicide by self-strangulation. Literature shows that suicidal ligature self-strangulation is uncommon and, in most cases, common household items such as scarves, belts, neckties and rope are used. We report an instance where a 25-year-old African male used two black plastic ligatures, each with self-locking mechanisms to commit suicide by self-strangulation. The ligatures were found in situ completely encircling the neck of the victim. The ligature material deployed in this case was unique. The victim’s bedroom door was found locked and secured from the inside. Examination of the crime scene, autopsy findings and toxicological analysis confirmed the manner of death. Literature review revealed that double cable tie self-ligature strangulation is rare. We describe the mechanism of death, review of the literature and associated factors.