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A Fire Extinguisher Death: The Macklin Effect
Ryan Blumenthal1, Brigitte Hänert-van der Zee
1From the Department of Forensic Medicine, School of Medicine, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa.
Abstract:
We present the case of an adult white man found dead in a psychiatric institution with fine white powder (monoammonium phosphate) deposited over the entire face after he insufflated the contents of a dry chemical fire extinguisher. Fine white powder was present within the mouth and sinuses and lined the upper airways. On opening the thoracic cavity, approximately 500 g of fine white powder was present within the right thoracic cavity. The esophagus was ruptured. Traumatic emphysema of the posterior sternum wall was present (pneumomediastinum). The ethmoid bones were fractured by the barotrauma. On polarization of the lung tissue, birefringent material was noted deposited along the bronchovascular sheaths and in a subpleural distribution. Death was probably due to a combination of barotrauma and asphyxia.This case study provides strong evidence in support of the etiology and pathophysiology of the Macklin effect. It also provides for the first visual evidence of the phenomenon.
Insights
A man died after inhaling fire extinguisher powder, leading to lung injury and esophageal rupture. This case provides visual evidence of the Macklin effect, a rare phenomenon of air spreading into the chest cavity.
Area of Science:
- Forensic Pathology
- Toxicology
- Pulmonary Medicine
Background:
- Accidental or intentional self-harm involving inhalation of foreign substances can lead to severe respiratory complications.
- Dry chemical fire extinguishers contain monoammonium phosphate, which can cause significant tissue damage upon inhalation.
Observation:
- A case study of an adult male found deceased with extensive facial deposition of monoammonium phosphate powder.
- Internal examination revealed powder in the airways, a ruptured esophagus, pneumomediastinum, fractured ethmoid bones, and powder within the thoracic cavity.
- Lung tissue analysis showed birefringent material consistent with monoammonium phosphate along bronchovascular sheaths and in a subpleural distribution.
Findings:
- Inhalation of dry chemical fire extinguisher contents resulted in barotrauma and asphyxia.
- Evidence of esophageal rupture and traumatic emphysema (pneumomediastinum) was observed.
- Microscopic examination confirmed the presence of monoammonium phosphate within the lung tissue.
Implications:
- This case provides strong evidence supporting the etiology and pathophysiology of the Macklin effect.
- It offers the first visual documentation of the Macklin effect, enhancing understanding of its occurrence.
- Highlights the severe and potentially fatal consequences of inhaling fire extinguisher contents.
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