How does a handcuffed woman strangle herself?

(CNN) -- An autopsy will be performed Tuesday on a 45-year-old mother of three who died in police custody at Phoenix's Sky Harbor International Airport, the acting director of the medical examiner's office said.
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Carol Ann Gotbaum, in an undated family photo, may have accidentally strangled herself while in custody.

The release of the official cause of death could be delayed if investigators need toxicology or other extensive testing reports, because those tests can take up to three weeks, Dave Boyer said.

Police say Carol Ann Gotbaum apparently strangled as she tried to maneuver her way out of the handcuffs that had been secured behind her back.

Gotbaum was arrested Friday at the airport for alleged disorderly conduct, said Phoenix Police Department spokesman Sgt. Andy Hill.

A US Airways spokesman told the New York Daily News that Gotbaum's flight was preparing to leave when she arrived at the gate.

Traveling alone, Gotbaum rebooked on a later flight, but "she became extremely irate, apparently running up and down the gate area," airline spokesman Derek Hanna told the New York Daily News.
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Michael Manning, a Phoenix attorney retained by Gotbaum's family, said she had "an emotional reaction" after she was denied permission to board a flight from Phoenix to Tucson, Arizona, where she planned to check herself into an alcohol treatment center. He did not say why the woman was not allowed to board the plane.

Manning said the family had not decided whether to file action against the police.

Airport workers who witnessed the arrest told the Daily News that Gotbaum was screaming, "I'm not a terrorist! I'm a sick mom! I need help!"

A police officer put his knee in Gotbaum's back to restrain her while other arresting police grabbed her flailing arms, one worker told the Daily News.

"I believe she was a little not-there," the worker told the newspaper. "She kept punching. She kept screaming. She kept kicking. She looked really scared, really frightened. I think she was afraid to go to jail."

Airport witnesses told police Friday that Gotbaum was "very loud, she was yelling and screaming and running around the concourse area," Hill said. Video Watch police describe woman's death »

He said police "could not calm her down" and "it was very difficult for them to get her handcuffed."

Arresting officers "did not have to pepper spray her or [use a stun gun] on her or anything else," Hill said.

Gotbaum was handcuffed and taken to a holding cell. She continued "to be vocally and physically disruptive in the holding room," leading officers to further restrain her, Hill said.

Officers used a 16-inch chain, called a shackle, that was attached to the bench she sat on and to the handcuffs.

About 15 minutes later police "found her with the handcuffs up by her neck area," Hill said. Gotbaum was unconscious, and police and firefighters tried to revive her by CPR and other means, Hill said.

"They could not revive her and, tragically, she died."

Hill said many people are "able to get handcuffs around their back and get them up and around."

But Hill said authorities don't know how the handcuffs "got placed on that neck area."

On Saturday, Hill said investigators guessed that "Gotbaum had possibly tried to manipulate the handcuffs from behind her to the front, got tangled up in the process and they ended up around her neck area."

When Gotbaum was found the handcuffs were in front of her body and the shackle was still attached to her handcuffs, officials said. They said the chain was not wrapped around her neck.

"It was pulled against the front of her neck area," Hill said.
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Gotbaum lived in New York. She was the mother of three children and the daughter-in-law of longtime New York City Public Advocate Betsy Gotbaum.

Betsy Gotbaum called her daughter-in-law "a wonderful, wonderful person" and a great mother. She said the family was dealing with the situation "the best way we can."