One common problem when dealing with sudden death concerns the interpretation of the presence of vomitus on the face. Many investigators have learned incorrectly that vomitus is an indication the decedent aspirated or choked on the vomitus and this is likely the cause of death. Or they conclude the aspiration at least played a part in the person's death. It is true that aspiration may play a part in a person's death, but this is rarely true when dealing with a sudden death. The presence of vomitus usually means nothing more than the decedent vomited as death was occurring.

Vomiting may also occur in the final process of dying when the decedent is unconscious for a considerable period such as under the influence of alcohol or other drugs. In this circumstance, the individual is unconscious long enough that vomitus is breathed back down into the lungs and an infection of the lungs (pneumonia) develops. The pneumonia which develops is rarely very impressive to the naked eye at the autopsy table and is usually considered to be a secondary factor when determining the cause of death.

Vomitus may cause suspicious-looking marks on the face and neck. Stomach acid may cause abrasions of the skin. These superficial injuries may appear as if the decedent ingested a caustic solution.

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