[Carbon monoxide as an external cause of fatality]

Carbon monoxide intoxications mainly occur as a result of fires in houses and failures of heating systems. Case of fatal accident involving a charcoal factory worker is described in this paper.

Authors based on a medico-legal autopsy protocol and material collected in prosecutor files. Medico-legal autopsy of a 46 year old male was performed in the forensic medicine department. Interlocutory proceedings indicated that the immediate cause of death was a head-crush caused by a hydraulic cover. Previously self-ignition in the factory was noted.

Autopsy revealed crushes of cervical spine involving the medulla. Where there were no sings of carbon monoxide intoxication. Due to unusual circumstances of the accident (self-ignition was detected by a carbon monoxide sensor and was treated by steam) additional toxicological test of autopsy material was performed. Twenty percent of carboxyhemoglobin was detected in blood collected from the heart cavity. In our opinion carbon monoxide may have been responsible for the accident.

Relatively low carboxyhemoglobin concentration in the blood is known to be an important cause of central nervous system abnormalities. Exposure to carbon monoxide may also result in an impaired response to danger. Sometimes carbon monoxide exposure does not lead to fatal intoxication, but may lead to a fatal accident. Regardless of a well noted immediate cause of death, a specific toxicological test must be involved in each medico-legal procedure, if exposition to various chemical substances is suspected.