# Chewing Gum in the Larynx: Foreign Body Aspiration or Iatrogenic Artifact? Challenges in Determining the Cause of Death in a Road Traffic Accident Victim With Resuscitation Intervention

## TL;DR

A man died in a car accident, and chewing gum found in his throat raised questions about whether it caused the crash or was a result of resuscitation.

## Contribution

This case highlights the diagnostic challenges of distinguishing foreign body aspiration from iatrogenic artifacts in trauma victims.

## Key findings

- Chewing gum found in the larynx complicated the determination of the cause of death.
- The gum could have been aspirated before the accident or pushed deeper during resuscitation.
- The cause of death was attributed to head trauma, but the gum's role remains uncertain.

## Abstract

Identifying the cause of death in road traffic incidents and the contributing factors is crucial for forensic investigations, public health research, and epidemiological studies. In this case, the discovery of chewing gum in the larynx during an autopsy complicated the forensic diagnostic process and challenged the determination of the primary cause of death. Our case report details a 53-year-old male driver involved in a fatal road traffic accident. First responders found him unconscious and unresponsive. Despite resuscitative efforts, including endotracheal intubation, he could not be revived. The autopsy revealed multiple blunt force injuries from the collision and chewing gum in the larynx. The gum may have been aspirated while driving, potentially causing choking, severe coughing, or reflex cardiac arrest, which could have led to sudden incapacitation and the accident. Alternatively, the gum might have been overlooked during intubation, possibly pushing it deeper into the airway and creating an iatrogenic artifact. The cause of death was attributed to multiple blunt force injuries, specifically head trauma. However, the possibility of foreign body aspiration leading to the accident or the gum being an iatrogenic artifact cannot be ruled out. This case report highlights the potential impact of airway foreign bodies on road accidents and the risk of iatrogenic artifacts during resuscitation. It underscores the importance of thorough airway evaluation, prompt recognition of potential obstructions, and accurate documentation in prehospital settings to prevent worsening obstructions, misdiagnoses, delays in diagnosis, and complications in future cases.