Self-administrated propofol – a case report of a physician suicide - 03/05/18

Doi : 10.1016/j.toxac.2018.03.002

Silviya Stoykova ^a,^b,^⁎ , Teodora Kiryakova ^c, Dimitar Nikolov ^c, Ahmed Nedzhib ^d, Ivayla Pantcheva ^a, Vasil Atanasov ^a,^b
^a Sofia University “St. Kliment Ohridski”, Faculty of Chemistry and Pharmacy, Analytical Chemistry Department, Laboratory of Biocoordination and Bioanalytical Chemistry, 1, J.-Bourchier boulevard, 1164 Sofia, Bulgaria
^b Military Medical Academy, Disaster Medicine and Toxicology Department, Analytical Toxicology Laboratory, 3, St. Georgi Sofiiski street, 1606 Sofia, Bulgaria
^c Medical University, Medical Faculty, Forensic Medicine and Deontology Department, 1, St. Georgi Sofiiski street, 1606 Sofia, Bulgaria
^d Military Medical Academy, Disaster Medicine and Toxicology Department, Research Laboratory of Military Toxicology, 3, St. Georgi Sofiiski street, 1606 Sofia, Bulgaria

^⁎Corresponding author. Sofia University “St. Kliment Ohridski”, Faculty of Chemistry and Pharmacy, Analytical Chemistry Department, Laboratory of Biocoordination and Bioanalytical Chemistry, 1, J.-Bourchier boulevard, 1164 Sofia, Bulgaria.Sofia University “St. Kliment Ohridski”, Faculty of Chemistry and Pharmacy, Analytical Chemistry Department, Laboratory of Biocoordination and Bioanalytical Chemistry, 1, J.-Bourchier boulevard, 1164 Sofia, Bulgaria.

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Summary

Fatal self-administrated propofol intoxication of a 29-years old anesthesiologist, found dead in his home, is reported. The toxicological screening, performed using gas chromatography-mass spectrometry of blood and urine samples, evidenced only the presence of propofol and lidocaine despite the numerous empty packages of various drugs found at the crime scene. Propofol was quantitated in all available biological specimens (blood, urine, vitreous humor, liver and brain tissue) using high performance liquid chromatography–diode array/fluorescent detector. The obtained results for drug concentration were as follows: blood – 0.90μg/mL (free) and 1.00μg/mL (after enzymatic hydrolysis); urine<0.05μg/mL; vitreous humor – 0.08μg/mL; liver – 5.70mg/kg and brain – 1.13mg/kg. Both toxicological results and autopsy findings confirmed that death was caused by respiratory failure due to propofol overdose, administered within short time period. Crucial factor for data interpretation was the postmortem redistribution of propofol, characterized with rapid drug accumulation in tissues.

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Keywords : Forensic toxicology, Propofol, Suicide, Homicidal poisoning, Postmortem redistribution

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Vol 30 - N° 2

P. 142-148 - juin 2018 Retour au numéro

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Self-administrated propofol – a case report of a physician suicide - 03/05/18

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