NCJ Number
221682
Journal
Journal of Forensic Sciences Volume: 52 Issue: 6 Dated: November 2007 Pages: 1408-1410
Date Published
November 2007
Length
3 pages
Annotation
This report presents what the authors believe to be the first case in which the sole cause of death was sevoflurane, which has been used as an inhaled anesthetic since 1985 and is a colorless, nonflammable, nonirritant, fluorinated methyl isopropyl ether chemically related to desflurane and isoflurane.
Abstract
A 31-year-old White male anesthetist was found dead in the break room of the surgery area. He was lying prone in bed holding an uncapped empty bottle labeled Utane. The body had lividity in the face, neck, and chest consistent with the subject's position when he was found. He had a history of gastritis/heartburn which had been treated with antacids. The family medical history included heart disease. In the postmortem examination, no drug was detected by enzyme immunoassays or gas chromatography-mass spectrometry or flame ionization detection. At room temperature, the sevoflurane concentration in the gas phase was 0.0155 percent, 0.404 percent, and 0.223 percent for the blood, brain, and lung specimens, respectively. Using specified calculations, the gas phase concentrations at 37 degrees C were 0.3 percent (blood) and 1.5 percent (brain and lung) or by weight 15 mg/ml in blood and 130 mg/kg in brain and lung. The autopsy revealed pulmonary edema and frothing in the lung. It also found atherosclerotic coronary artery disease with 50-percent occlusion of the left main coronary artery. The remainder of the external and internal examination revealed a healthy individual. The cause of death was ruled as sevoflurane toxicity, and the manner of death was ruled accidental. The subject probably died because his breathing became obstructed, leading to asphyxiation; or his cardio-respiratory system became depressed to the point of apnea and/or cardiovascular collapse. 14 references