Café Coronary Deaths: Medicolegal Observations From a Tertiary Care Center

Introduction Café coronary syndrome, or food asphyxia, is a sudden and unexpected death caused by upper airway obstruction by food during eating. Often mistaken for cardiac arrest, it commonly occurs in individuals who eat rapidly, are under the influence of alcohol, or have impaired swallowing reflexes due to neurological or dental issues. Methods A retrospective descriptive study was conducted on nine (N=9) medicolegal autopsies showing complete airway obstruction by food. Each case was examined for external and internal findings, toxicological results, and circumstantial evidence, including the type of food, site of obstruction, and levels of alcohol. Results All nine victims (eight males and one female, aged 25-57 years) died suddenly during or shortly after eating. Alcohol intoxication was detected in six (66.6%) cases, with blood levels ranging from 169 to 256.9 mg/100 mL. The obstructing food, mainly a bolus of chicken or a piece of meat, was found at the epiglottis or tracheal bifurcation, with congested, edematous lungs. Conclusion Café coronary syndrome is a preventable cause of sudden death, diagnosed after a meticulous autopsy. Scene correlation is a part of history taking, which itself is part of autopsy. Public education, avoidance of alcohol during meals, and awareness of the Heimlich maneuver are crucial for prevention.