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Death attributed to amobarbital and levomepromazine intoxication
1Department of Forensic Medicine, Faculty of Medicine, Kyushu University, Fukuoka 812-8582, Japan.
Legal Medicine (Tokyo, Japan)
|August 26, 2003
Summary
This case study details the fatal intoxication of a patient due to high levels of amobarbital and levomepromazine. Autopsy revealed severe lung edema and liver necrosis, indicating drug overdose as the cause of death.
Area of Science:
- Forensic Toxicology
- Clinical Pathology
- Pharmacology
Background:
- A 29-year-old male patient, potentially with schizophrenia, died 9 hours after hospital admission.
- Autopsy showed generalized organ congestion, severe pulmonary edema, and centrilobular liver necrosis without other significant findings.
Purpose of the Study:
- To determine the concentrations of amobarbital and levomepromazine in biological samples.
- To establish the cause of death in a patient with suspected drug intoxication.
Main Methods:
- Drug screening for amobarbital and levomepromazine.
- Quantitative analysis of drug concentrations in body fluids and tissues using gas chromatography-mass spectrometry (GC-MS).
Main Results:
- Whole blood concentrations were 9.02 µg/mL for amobarbital and 231 ng/mL for levomepromazine.
- These levels exceeded therapeutic ranges but were not considered acutely toxic on their own.
- Histopathological findings of severe lung edema and liver necrosis were noted.
Conclusions:
- The combined effects of amobarbital and levomepromazine, supported by toxicological and pathological findings, were determined to be the cause of death.
- This case highlights the potential for intoxication even when drug levels are not definitively fatal.
- The study underscores the importance of comprehensive toxicological analysis in unexplained deaths.