PMID: 10605076Dec 22, 1999Paper

Importance of storing emergency serum samples for uncovering murder with insulin

Forensic Science International : Synergy
P J KoskinenJ S Viikari

Abstract

A case of a previously healthy 48-year-old man murdered by exogenous insulin administration is reported. The patient was delivered unconscious to the emergency unit. Initially, treatment with hyperbaric oxygen was commenced because decompression sickness was suspected. However, the treatment was aborted as the patient was found to be hypoglycaemic (nadir serum glucose 0.3 mmol/l) and treatment and diagnostics of hypoglycaemia commenced. Brain damage due to hypoglycaemia was severe, and the patient remained in a vegetative state for 2 months before he died of multiorgan failure. Serum samples drawn at admittance were stored frozen, whereby it was possible to show retrospectively, that while the concentration of insulin in serum was high (75 mU/l, increasing further to over 240 mU/l in the next few hours) concentration of C-peptide was low (below detection limit of 0.1 nmol/l) at the hypoglycaemic stage. It was concluded that the patient had received exogenous insulin somehow, and the police was informed. Circumstantial evidence obtained during ensuing criminal investigation was considered by the court to prove the patient's wife (a nurse) guilty of murder. The availability of stored frozen serum samples drawn at the early stage ...Continue Reading

References

Jan 1, 1983·Journal - Forensic Science Society·S M Fletcher
Oct 1, 1995·Diabetic Medicine : a Journal of the British Diabetic Association·V Marks
Aug 23, 1958·British Medical Journal·V J BIRKINSHAWP H WRIGHT

Related Concepts

Blood Glucose
C-Peptide
Legal Medicine Discipline
Wrongful Death
Reactive Hypoglycemia
Insulin B Chain

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