Anesthesiologist suicide with atracurium

Journal of Analytical Toxicology
María A MartínezElena Almarza

Abstract

Atracurium is a nondepolarizing skeletal muscle relaxant used to facilitate endotracheal intubation and to induce skeletal muscle relaxation during surgery or mechanical ventilation. The drug undergoes a spontaneous non-enzymatic biotransformation, yielding laudanosine and an acrylate moiety. This report documents the case of a 45-year-old anesthesiologist who was found dead at the hospital where he worked. The victim was known to be depressed and undergoing treatment with venlafaxine. An empty syringe was found near the body. Toxicological analysis revealed the presence of laudanosine in the syringe, 0.6 mg/L of laudanosine in heart blood, 0.3 mg/L in urine, and 0.02 mg/L in vitreous humor. Meanwhile, concentrations of venlafaxine and O-desmethyl-venlafaxine, its active metabolite, were 0.7 and 1.1 mg/L in heart blood, 1.7 and 5.2 mg/L in urine, 0.5 and 0.7 mg/L in vitreous humor, and 400 and 20 mg in gastric content, respectively. All drugs and metabolites involved in the case were detected using gas chromatography with nitrogen-phosphorus detection (GC-NPD) and confirmed using GC-mass spectrometry in full scan mode after solid-phase extraction using Bond-Elut Certify columns. Additional high-performance liquid chromatography...Continue Reading

Citations

Jan 23, 2010·Der Anaesthesist·B Mäulen
Jul 15, 2015·Journal of Forensic and Legal Medicine·Rakesh K SewalBikash Medhi
May 18, 2016·International Journal of Legal Medicine·Jingjun XingYiwu Zhou
Oct 23, 2020·Turkish Journal of Emergency Medicine·Meenhas Oravil KunhahamedShibu C Kallivalappil
Jun 2, 2021·Anaesthesia·E PlunkettK Hawton

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