Cyanide fatalities: case studies of four suicides and one homicide

Deaths due to cyanide poisoning are relatively rare, largely owing to the restricted availability of cyanide. Nevertheless, the authors report five cases of cyanide fatalities occurring within a few months. Cyanide is one of the most rapidly acting poisons known and is still used for suicide and homicide. The discussion focuses on the circumstances, metabolic changes, pathophysiology, blood levels, diagnosis, and management of cyanide poisoning.     

Alcohol ingestion and age of death in hanging suicides

Retrospective review of 100 consecutive, nondecomposed cases of suicide because of hanging was conducted at Forensic Science SA, Australia. Alcohol was detected in 38 cases (38%). The percentage of victims who had ingested alcohol significantly decreased with age (r(2)=0.81), with alcohol detected in 57.1% of those aged ≤24 years, compared to 28.5% of those aged between 55 and 64 years, and 0% of those aged ≥65 years. A similar linear relationship between alcohol ingestion and age was found for cases with blood alcohol levels >0.05 g/100 mL (r(2)=0.73). The mean ages of those with detectable alcohol (35.2 years) levels >0.05 g/100 mL (35.1 years) and levels >0.1 g/100 mL (37.2 years) were all significantly less than in those with no detectable alcohol (44.4 years) (p<0.005, <0.005, <0.05 respectively). A clear relationship between alcohol ingestion and younger age was shown in hanging suicides.     

Case series of completed suicides by burning over a 13-year period

Suicide by burning is an extreme act that is uncommon in the United States and throughout the Western world. The characteristics of people who complete such acts are not well understood. To address this issue, we examined the death records of the King County Medical Examiner's Office in Washington State over the 13 years from 1996 to 2009. Twenty-five cases of suicide by burning were identified and used to characterize decedent demographics, circumstances of death, and motivating factors. Compared to other methods of suicide, burning demonstrated a significant overrepresentation of decedents who were women, 40-59 years of age, and Asian/Pacific Islander. They also tended to have previous psychiatric illness and/or substance abuse issues. Self-burning predominantly occurred at the decedent's residence with the intent of suicide given. There was no unifying theme in motivating factors. Together, these data represent the characteristics of people whose death is because of suicide by burning in King County, Washington.     

Production of Cyanide in a Sodium Nitrite Poisoning Case Using an Acid Distillation Screening Test

A recent case involving sodium nitrite poisoning gave a positive result for cyanide when post-mortem samples were examined for volatile poisons.     

Teenage suicide in King County, Washington. II. Comparison with adult suicides

The 25 teenage suicides that occurred in King County, Washington, during 1983 and 1984 were compared with the 158 adult suicides that occurred during 1984. The comparison included the following features: sex, race, declaration of intent, motive, method, isolation, alcohol or drug intoxication at the time of death, prior suicide threats and attempts, counseling history and diagnosis, and family history of suicide. For the teens, we also queried school or employment status, anxiety-producing experiences, symptoms of depression, marital history of the parents, and number and order of siblings.     

Jail suicides by hanging. An epidemiological review and recommendations for prevention

This article reviews 17 cases of jail suicide occurring in Oklahoma in calendar years 1981 through 1983. Significant variables are reviewed, and recommendations for prevention are presented.     

Case studies in forensic soil examinations

The examination and comparison of forensic soil samples is discussed. The origin of a simple and easy to learn procedure used and modified by the authors is reviewed. The process begins with a preliminary observation, removal of artifacts, and sieving of each specimen. A specific size fraction is split into three fractions for color matching, polarized light microscopy (PLM) examination (particle counting) and optional gradient comparison. Next, several cases are reviewed in which the modified method was used to evaluate the likelihood of common origin for questioned and known specimens.     

Colchicine poisoning: case report of two suicides

Colchicine overdose is uncommon but potentially life threatening because of the high toxicity of the drug. Poisoning by colchicine may occur following ingestion of medication used in acute attacks of gout and inflammatory diseases. We describe two cases involving suicide by the ingestion of medications marketed in France. In case 1, only heart blood was taken after body external examination. In case 2 an autopsy was performed and heart blood, urine, gastric contents and bile were taken for toxicological analysis. Colchicine was assayed in biological specimens by an HPLC-DAD method, after extraction by dichloromethane at pH 8, adding prazepam as internal standard (IS). Analyses were performed on a Symetry C-8 column. Mobile phase was a gradient of acetonitrile/pH 3.8 phosphate buffer. Colchicine is eluted at 13.1 min and the method is linear for blood, urine and bile over the range 4-1000 ng/mL. LOQ is 4 ng/mL. The concentrations of colchicine detected are: case 1: heart blood 13 ng/mL; case 2: heart blood 66 ng/mL, urine 500 ng/mL, gastric content 12 ng/mL, bile 5632 ng/mL. Our findings are in the range of lethal concentrations previously described, but there is no correlation with the amount of ingested drug. Even after massive overdose, it could be impossible to detect colchicine in blood, and as there is a widespread enterohepatic recirculation before excretion in bile and feces, bile is the target sample to analyse. We conclude in both cases that the cause of death was suicide with colchicine. It appears very important to perform an autopsy in order to obtain bile, urine, heart blood and femoral blood.     

William R. Maples, forensic historian: four men, four centuries, four countries.

Prior to 1984, William R. Maples, Ph.D. worked primarily with Medical Examiners in the State of Florida in investigation of and testimony in criminal cases. In 1984 the Republic of Peru requested him to identify skeletal remains thought to be those of Francisco Pizarro, conqueror of Peru and the Incas in the early 16th Century. Dr. Maples made a positive identification of those remains as Pizarro, resulting in their substitution in a glass-sided coffin in the Cathedral of Lima, where other remains had been displayed as those of Pizarro for a hundred years. In addition, it was proved that the remains removed could not have been those of Pizarro. In 1988, Dr. Maples examined the skeletal remains of Joseph Merrick ("The Elephant Man") at Royal London Hospital, Whitechapel, and made photographic studies of them for comparison with death casts of limbs and skull to ascertain depth of tissue by video-superimposition. In 1991, Dr. Maples, headed a team which removed President Zachary Taylor (1779-1842) from his tomb in Louisville, Kentucky. The purpose was to determine if he had been poisoned, as had been proposed by some at the time. Test results showed that he had not been. In 1992, Dr. Maples and a team of forensic specialists went by invitation to Ekaterinburg, Russia to study skeletal remains which the Russians had tentatively identified as the Russian Royal Family, and entourage, murdered in 1918. The American team identified them as Tsar Nicholas II, his wife, three of his children, his physician, and three of his servants. William Ross Maples died in Gainesville, Florida, 27 February 1997.     

Poppy seed ingestion: the Oregon perspective.

Numerous articles have been published regarding the positive morphine and codeine urinalysis results from the ingestion of poppy seeds. Oregon's perspective towards ingestion of controlled substances focuses around driving under impaired conditions. To determine the influence of the residual opium on poppy seeds to impairment, seven volunteers each ingested 25 grams of poppy seeds baked into bundt cakes. Urine samples were screened by EMIT using 300 ng/ml cutoff levels. All of the urine specimens were found to be opiate positive shortly after consuming the cake; however, after administering a series of standardized drug recognition evaluation tests, no subjects were found to exhibit symptoms of opiate impairment.     

Death due to baclofen and dipyrone ingestion.

A fatal suicidal intoxication with unusual drugs is reported. A 56-year-old man was found dead in his house; near by the corpse several empty drugs boxes were found. An autopsy was performed and the biological fluids were submitted to a full toxicological work-up.The analytical results supported the hypothesis of a death due to the acute baclofen (4-amino-3-(p-chlorophenyl)butyric acid) and dipyrone (sodium [N-(1,5-dimethyl-3-oxo-2-phenylpyrazolin-4-yl)-N-methylamino] methanesulfonate) intoxication.     

Analysis of gunshot residue test results in 112 suicides

The results of gunshot residue (GSR) tests in 112 suicide cases investigated by the U.S. Army Criminal Investigation Command over a ten-year period are described. Only suicide cases in which there was certainty that the victim fired a weapon were examined in an effort to reduce ambiguous results. Previous case work research by Rudzitis indicated that positive GSR test results were encountered in suicides 62% of the time using various combinations of neutron activation analysis (NAA) and atomic absorption spectrophotometry (AAS). Threshold values of 0.2-micrograms antimony and 0.3-micrograms barium (0.2-micrograms antimony and 0.5-micrograms barium after 1985) used by the U.S. Army Criminal Investigation Laboratory resulted in positive GSR results in suicide cases 38% of the time. The effects of time, location of body, handling of the body, weapon type, caliber, and condition of the hands on GSR results are examined. Case studies involving suicides by unit armorers are discussed.     

A case of suicide by ingestion of sodium nitroprusside.

The study reports a case of suicide by ingestion of sodium nitroprusside which resulted in acute cyanide poisoning. Analyses carried out on body fluid yielded the quantitation of total (5.00 mg/L) and free (3.30 mg/L) cyanide in blood and of methemoglobin (blood = 10.5%). At the scene, some solid reddish-brown material was found in a glass, which on toxicological analysis was found to contain sodium nitroprusside; about 9 g of the same substance was identified in stomach contents. The detection and quantification of cyanide and methemoglobin in biological samples from the case indicated that the lethal effect was due to both metabolic products (cyanide and methemoglobin).     

Acute fatal poisoning cases due to furathiocarb ingestion.

Seven cases involving acute fatalities due to ingestion of furathiocarb, a carbamate insecticide, are presented. Furathiocarb was detected in the gastric contents using thin layer chromatography (TLC) and gas chromatography/mass spectrophotometry (GC/MS), and quantified in the blood using a gas chromatograph equipped with a nitrogen-phosphorus detector (NPD). The fatal levels of furathiocarb in the blood ranged from 0.1 to 21.6 micrograms/ml.     

The family strategies concept: An evaluation of four empirical case studies

In this article, the preceding case studies are evaluated from the perspective of the family strategies concept. The studies have yielded new insights in the relationship between the family and the labor market and in the labor allocation within families. In addition, they have shown the tensions between individual life plans and collective needs. It has been difficult, however, to reach firm conclusions about which strategies were deployed by families. One of the problems is that the motives of the family members remain hidden. In addition, our databases need to be more finely tuned to the strategies concept. In particular, we know too little on the range of (strategic) options of families in the past.