Accidental autoerotic death

Autoerotic death has been defined as a solitary accidental death that occurs during an individual’s sexual activity in which some type of device mechanism used to increase pleasure fails or malfunctions, which in turn causes unintended death. We present two cases of accidental autoerotic death due to suffocation by hanging in two males aged 25 years and 59 years. Both victims were using homemade sexual devices and wearing unusual outfits, with erotic magazines found on the scene. In one case, the incaprettamento-like position of the corpse was likened to the ritual strangulation homicide typical of the Italian Mafia. Between 1997 and 2020 there were an average of 0.9 deaths per year recorded due to accidental asphyxia without suicidal intention in Slovenia, representing approximately 0.46 deaths per 1 million of the general population. Making a definite estimate for the exact mortality number due to autoerotic death is challenging, because there is no operational definition provided by the “International Classification of Diseases 10” (ICD10). From a forensic point of view, it is necessary to differentiate accidental autoerotic death from covert murder and natural death. Close cooperation between the police examiner and forensic pathologist is essential in performing an autopsy. To the best of our knowledge, no cases of autoerotic asphyxia have been published in the Slovenian forensic literature so far.