Inquest into the death of Bosco Toufalous

35y · Male·Combined effects of positional asphyxiation and intoxication

A 35-year-old man with severe alcohol use disorder died from positional asphyxiation while intoxicated. With a blood alcohol level of 0.293 g/100mL, he fell near stairs outside a neighbour's unit, landing with his head and neck against a railing. His intoxication severely impaired his ability to protect his airway and reposition himself. Pre-existing knee injuries amplified his instability. No evidence supported assault. Clinical lessons include recognizing that severe alcohol intoxication impairs protective airway reflexes and mobility, making positional asphyxiation a significant risk. Chronic alcoholics with frequent falls and injuries warrant assessment for safe housing, fall prevention strategies, and addiction treatment. Early intervention for alcohol use disorder could have prevented this death.