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Fatal poisoning by ingestion of a self-prepared oleander leaf infusion

Anna Carfora1, Raffaella Petrella2, Renata Borriello2

  • 1Department of Experimental Medicine, Forensic Toxicology Unit, University of Campania "L. Vanvitelli", Via L. Armanni, 5, 80138, Napoli, Italy. anna.carfora@unicampania.it.

Forensic Science, Medicine, and Pathology
|November 25, 2020
PubMed

Insights

This case report details a fatal oleander leaf poisoning. Toxicological analysis confirmed lethal levels of oleandrin, leading to cardiac arrhythmia and death, classified as suicide.

Area of Science:

  • Forensic Toxicology
  • Plant Poisoning
  • Cardiology

Background:

  • Oleander (Nerium oleander) contains potent cardiac glycosides.
  • Ingestion can lead to severe cardiac arrhythmias and death.
  • Extraction of active compounds for intentional poisoning is uncommon.

Observation:

  • A 71-year-old man died by suicide via ingestion of an oleander leaf infusion.
  • Paraphernalia for extracting oleandrin and other cardiac glycosides were found at the scene.
  • Toxic levels of oleandrin were detected in multiple biological samples and the infusion.

Findings:

  • LC-MS/MS confirmed toxic concentrations of oleandrin in blood, vitreous humor, urine, liver, and gastric contents.
  • Oleandrigenin was present in tissue samples; neritaloside and odoroside were found in specific samples.
  • The blood/vitreous humor ratio was calculated to estimate the time of death.

Implications:

  • This case highlights the potential lethality of self-extracted oleander compounds.
  • Accurate toxicological analysis is crucial for determining cause and manner of death in plant poisoning cases.
  • Understanding glycoside distribution in biological samples aids in post-mortem investigations.
Keywords:
Liquid chromatography-tandem mass spectrometryNerium oleander leavesOleandrin analysisOleandrin/oleandrigenin in vitreous humorPoisoning

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