A special case of bolus fatality

The case of a 58-year-old man is reported, who had been hospitalized for almost 30 years for paranoid-hallucinatory schizophrenia. He was found unconscious in the clinic with a scarcely perceptible pulse and irregular breathing. Attempts at resuscitation were not successful. Looking at the corpse, no findings of particular value were noted. At the court-ordered autopsy, a mouse was found in the oral cavity; the head of the mouse was stuck in the laryngeal inlet. The cause of death was ascribed to asphyxia by alimentary bolus; the cause of death was apparently the effect of choking combined with a reflex action. In the large colon (megacolon) many metal objects were found. On the basis of the evidence, it was assumed that the mouse was already dead when the patient choked on it. A disturbance in the ability to swallow as a result of alcohol or medication was ruled out, as were neurological diseases.