Fatal poisoning from sodium phosphate enema. Case report and experimental study

An overdose of a common over-the-counter sodium phosphate enema solution was fatal in an infant. The marked hypernatremia, acidemia, hyperphosphatemia, and hypocalcemia observed before death were also produced in a porcine model. A study using pigs showed that the enema solution was lethal if retained in doses above 20 mL/kg, equivalent to four pediatric-sized enemas in a 2-year-old child. Even normal doses of the enema solution caused measurable changes in serum phosphorus and calcium levels.