Accidental childhood strangulation by human hair.

A low-income mother is accused of child abuse after co-sleeping with, and then waking to find her 13-month-old daughter entangled and apparently strangling in the mother's hair. The baby was initially unconscious and cyanotic; revived by the time the parents reached the ER, clinical examination revealed a ligature mark on the neck and petechiae on the face. In a pro bono effort, her attorney teamed with RAM Consulting as an expert witness. RAM performed a six-part investigation including: (1) an anthropometric analysis, (2) determination of the strength of human hair, (3) characterization of the ligature mark, (4) an investigation into airway occlusion forces, (5) an investigation into the conditions required to initiate petechiae, and (6) a review of the literature. Our conclusion was that it is possible for a strangulation incident to occur when a young child is co-sleeping with a parent with long hair, and that this scenario may result in injury or death. Upon review of this report and RAM's deposition on this matter, the prosecuting attorney's expert witness withdrew her testimony and the judge dismissed the case.