Death by potassium chloride intravenous injection: evaluation of analytical detectability

Potassium chloride intravenous injection is used in suicide attempts and lethal procedures for state-sanctioned punishment. Owing to its relatively high concentrations in hemolyzed blood (25-80 mM) compared to serum (about 4 mM), it is difficult to conclude potassium poisoning by postmortem analysis of biologic samples. A 41-year-man was found dead with an injection sign on his foot and a syringe close to the corpse. No particular signs were noted during the autopsy. Blood, bile, and urine were submitted to xenobiotic screening procedures used in the laboratory. Syringe content was found positive to potassium ions. Blood potassium concentration was determined by ion-selective electrode measurement (range 3.0-150 mM). Blood was found positive for diazepam at therapeutic level. Potassium concentration was 160.0 (cardiac) and 87.3 mM (femoral blood). Our results show that potassium concentration was significantly higher in heart blood in a suicide case. Hence, the general issue of considering potassium poisoning hardly demonstrable by toxicology needs to be questioned and thoroughly studied.     

Death caused by a signal rocket--not an isolated case*

Fatalities related to sporting events are predominantly caused by blunt force injuries especially due to the emotional involvement of crowd, but occasionally other types of trauma are reported as well. A case of very rare trauma caused by shooting with a hand-held parachute signal rocket during a football match is presented. A 17-year-old football fan sustained fatal injuries, a combination of mechanical trauma caused by rocket penetration, as well as extensive thermal burning of the thoracic viscera. Analysis of the event was based on autopsy findings and evidence produced by medicolegal and ballistic experts. Improper use of a hand-held signal rocket, designed for marine distress signals, may cause serious injuries either mechanically, due to explosion, or as a result of thermal discharge. In the reported case, pattern of injuries is discussed, and medical finding corroborated to other available evidence. The presented case is a reminder that the forensic pathologist should be informed accordingly on the type and features of weapon suspected to produce injury, to be able to understand traumatic changes, and look for potential presence of foreign bodies at postmortem examination.     

Death caused by orphenadine poisoning

The number of deaths as a consequence of orphenadine poisoning seems to increase, mostly among severely psychotic males. The lethal dose corresponds to the weekly average dose used in the treatment of neuroleptic extrapyramidal side effects. Based on the literature, the serious, rapidly incipient, cardiac, and neurologic symptoms of poisoning are emphasized. The handing out of orphenadine to suicidal persons must be restricted, and even small overdoses (1-2 g) ought to result in the immediate initiation of observation at an intensive care unit.     

Death caused by ingestion of endosulfan

This paper reports the autopsy and toxicological findings of a death caused by ingestion of endosulfan dispersed in a colorless liquid containing about 55% of xylene (w/v). For isolation of endosulfan, the biological material was homogenized and the drug was isolated by extraction with ether. Quantitative determinations were carried out by gas chromatography. The following concentrations of endosulfan were found: Blood 30 mg/L Gastric contents 0.5 g in the total 50 mL Liver 20 mg/kg Kidney 2.0 mg/kg Brain 0.3 mg/kg Xylene (solvent) was detected only in stomach contents (0.4 g in the total 50 mL).     

Death caused by hurling a truck plate spring into the interior of an automobile

On the highway, a part of a truck's plate-spring of uncertain origin hurls into the interior of a car. Despite of resuscitation efforts the driver dies on the way to the hospital. With at first missing extensive exterior injuries, death due to pre-existing cardiac rhythm disturbances was assumed. Legal autopsy presented contusion of the heart as cause of death. By the kind of sternum fracture, cardiac contusions could be clearly separated from resuscitation injuries.     

Homicide by intravenous injection of naphtha

A case of homicide by the intravenous injection of Energine, a petroleum distillate spot remover, is presented. This case is the only known homicide committed with naphtha. This elderly man had severe natural disease in addition to chest trauma sustained in the assault leading to death; however, the rapid injection of approximately 25 mL of Energine was the overwhelming cause of death.     

Suicide by intravenous injection of sublimate solution

A 19-year-old drug-dependent man tried to commit suicide by intravenous self-injection of 5 ml concentrated mercury II chloride solution. He arrived at an intensive-care unit 2 h later with predominantly gastrointestinal symptoms and died 70 h later, despite hemodialysis and antidote therapy. The pathologic-anatomical picture was dominated by severe acute sublimate nephrosis and a coagulation disorder. The highest Hg content was found in the kidneys (5.69 mg%); in the gastrointestinal tract the Hg concentration lay between 1.12 and 3.26 mg%.     

静滴莪术油注射液过敏致死的法医学鉴定(附2例报告)

莪术油葡萄糖注射液（Zedoary Turmeric Oil and Glucose Injection，ZNG）是以莪术油为主药，加葡萄糖配制而成的一种新型中药抗病毒制剂，以病毒颗粒溶解方式抗病毒，对呼吸道合胞病毒有直接抑制作用，对A1和A3型流感病毒有直接杀灭作用，同时对金黄色葡萄球菌、溶血性链球菌、大肠杆荫等也有抑制作用，目前在临床应用较广泛。然而，莪术油注射液有多种不良反应，可引起过敏性休克和死亡，造成医疗纠纷。目前有关莪术油注射液过敏致死法医学鉴定的报道尚不多见。本文复习有关文献资料，结合2例莪术油注射液过敏致死法医尸体解剖发现，对莪术油过敏原因、配伍禁总、检测方法、法医学鉴定原则进行了分析。     

静滴莪术油注射液过敏致死的法医学鉴定(附2例报告)

莪术油葡萄糖注射液(Zedoary Turmeric Oil andGlucose Injection,ZNG)是以莪术油为主药,加葡萄糖配制而成的一种新型中药抗病毒制剂,以病毒颗粒溶解方式抗病毒,对呼吸道合胞病毒有直接抑制作用,对A1和A3型流感病毒有直接杀灭作用,同时对金黄色葡萄球菌、溶血性链球菌、大肠杆菌等也有抑制作用,目前在临床应用较广泛。然而,莪术油注射液有多种不良反应,可引起过敏性休克和死亡,造成医疗纠纷。目前有关莪术油注射液过敏致死法医学鉴定的报道尚不多见。本文复习有关文献资料,结合2例莪术油注射液过敏致死法医尸体解剖发现,对莪术油过敏原…     

Death through injection of barbiturates

The authors report two cases of lethal intoxication due to barbiturates in two male individuals, respectively 24 and 35 years old. They stress the comparatively rare mode of administration of such drugs in the absence of another party, i.e. the parenteral way.     

Death caused by DF-2, following a dog-bite

The Gram-negative rod DF-2 was isolated from blood-cultures, the blood sample taken 3 days after death from a 65-year-old woman who had been bitten in her finger by her dog. At the medico-legal external examination marbling of the skin was found, suggesting septicemia. In persons found dead with a history of dog exposition and with no other obvious cause of death, examination for DF-2 should be performed.     

Death and injury caused by land mines in Burma

One hundred and eighty-eight Burmese refugees in Thailand were interviewed. One hundred and five of those interviewed had knowledge of a total of 313 persons who had been exposed to land mine explosions. Twenty-three of the interviewed were land mine survivors. They were all male, aged between eight and 68 years, and all except one had been injured between 1986 and 1997. Fifteen of the 23 were civilians, eight were guerilla soldiers who were injured either in battle or while deploying or disarming land mines. Those who had stepped on land mines were all crus or femur amputated and had several scars on the lower limbs, abdomen and some also on the forearms. Those who had handled a land mine had lost either fingers or hands and one also lost both eyes. This study shows that the frequency of land mine accidents in Burma has been underestimated and that the mortality is high. The study also supports the general impression that many victims are civilians.     

Homicide due to intravenous metallic mercury injection followed by sodium cyanide injection

We report a case of homicide due to intravenous mercury injection followed by meperidine and sodium cyanide injection. A 35-year-old woman was found dead in bed at home by her husband. Reportedly, she had been sick for more than 5 months. Initial death investigation revealed no evidence of foul play. Her death was believed to be natural. Therefore, her body was buried without an autopsy. Two months after death, her family requested an autopsy because they suspected her physician husband killed her. Her body was exhumed, and an autopsy was performed. Postmortem examination revealed numerous metallic mercury globules in the pulmonary arteries. Toxicological analysis revealed a high concentration of mercury in the tissue samples of the lungs, liver, heart, and kidney. In addition, cyanide and meperidine were also found in the heart and liver. The detailed case history and postmortem examination findings are described.