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Published on: August 4, 2010
Fatal intravenous injection of potassium in hospitalized patients
Angela R Wetherton1, Tracey S Corey, John J Buchino
1Department of Pathology and Laboratory Medicine, University of Louisville School of Medicine, Kentucy, USA.
Insights
Fatal intravenous potassium injections can be subtle and easily missed. Forensic pathologists should consider this cause in unexpected hospital deaths.
Area of Science:
- Forensic Pathology
- Toxicology
- Clinical Medicine
Background:
- Intravenous administration of potassium chloride (KCl) is a common medical procedure.
- Hyperkalemia, or elevated serum potassium, can lead to fatal cardiac arrhythmias.
- Accidental or intentional overdose of potassium can occur in healthcare settings.
Observation:
- This report details four cases of fatalities resulting from intravenous potassium injection within a hospital environment.
- The clinical and autopsy findings in these cases were subtle, potentially leading to misdiagnosis.
- The deaths were sudden and unexpected in hospitalized patients.
Findings:
- Autopsy and toxicological analyses confirmed lethal levels of potassium in the deceased.
- The subtle nature of the findings highlights the challenges in identifying potassium injection as the cause of death.
- The route of administration was confirmed as intravenous in all cases.
Implications:
- These cases underscore the importance of considering iatrogenic or intentional potassium overdose in the differential diagnosis of sudden, unexpected deaths in hospitals.
- Forensic pathologists must maintain a high index of suspicion for potassium-related fatalities.
- Improved vigilance and diagnostic protocols may be necessary to prevent such occurrences.
Abstract:
We describe 4 cases of fatal intravenous injection of potassium in the hospital setting. These cases illustrate the subtlety of findings in such deaths and remind the forensic pathologist to consider this type of event in sudden, unexpected death of hospitalized patients.
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