Marion Pavlic

Fatal intoxication with omethoate

A case of suicide with the insecticide omethoate is reported. An 18-year-old apprentice gardener had ingested an unknown amount of omethoate. His body was found in his room lying in the storage space under his bed. The autopsy first showed multiple superficial incisions in the skin of his wrists, furthermore hemorrhagic pulmonary oedema, dilation of the right cardiac ventricle and oedema of the brain. The gastric mucosa was swollen and showed a dark brownish colour. An intensive, chemical-like smell rose from the corpse and organs. Toxicological analysis detected omethoate in cardiac blood (208xa0µg/ml), urine (225xa0µg/ml) and bile (524xa0µg/ml), in the liver (341xa0µg/ml) and kidneys (505xa0µg/ml). In the gastric content the level was 48223xa0µg/ml. The amount of the active AChE in peripheral blood serum was reduced to less than 0.2% of the normal level. To our knowledge no case of a fatal suicide by ingestion of omethoate has been reported in literature.

Fatal accident caused by isoflurane abuse.

Abstract. A fatal accident after isoflurane abuse is presented in this report. A hospital employee was found dead in the operating area with a plastic bag over his head. In his locker an almost empty bottle of isoflurane was found. Autopsy revealed signs of asphyxiation and toxicological examination revealed nordazepam and isoflurane in non-toxic concentrations in the blood. Quantification of the anaesthetic was also carried out in urine, gastric contents, liver, kidney and brain samples, and in addition, oxazepam, prothipendyl and metabolites of midazolam and prothipendyl were found in the urine. Although the drug problems of the deceased were known before, no efforts had been made to restrict access to these drugs.

Complete detachment of an aortic valve prosthesis 10 years after implantation

A 47-year-old male patient died unexpectedly 10 years after replacement of the aortic valve with a Carbomedics heart valve prosthesis required for post-endocarditic valve stenosis. The man was in regular medical attendance by his general practitioner and in hospital. Clinical data and examinations did not suggest the reoccurrence of endocarditis. Three months before his death a haemolytic anaemia of unknown genesis was diagnosed. One afternoon, while lifting a heavy object, the man suffered acute chest pain and collapsed. Resuscitation failed and the patient died in hospital. Autopsy revealed the completely detached valve prosthesis within the ascending aorta. Histological examination confirmed a chronic endocarditis at the site of the valve implantation.

Airbag contact in traffic accidents: DNA detection to determine the driver identity

A total of 34 deployed driver and passenger airbags from altogether 20 vehicles after frontal collisions were investigated. In 80% of the airbags possible biological traces could be located with an alternative light source (ALS, Polilight) at a wavelength of 450–470xa0nm. These traces were swabbed, a part of them additionally cut and subjected to DNA analysis, which led to comparable SGMplus profiles in about 60%. In the 20% of the airbags on which no possible biological traces could be located, the whole surfaces were swabbed. In these cases subsequent DNA profiling mostly led to non-interpretable results. For the evaluation and interpretation of the data, buccal swab samples provided by drivers and co-drivers were analysed. The results and conclusions from DNA analyses and the declarations from the involved passengers were always concordant. Thus, molecular biological analysis of deployed airbags can help to determine the occupants positions within a vehicle (driver or passenger status) at the time of impact.

BAK-AAK-Quotient im Konzentrationsbereich von 0,5‰ (0,25 mg/l Ausatemluft) Eine Trinkversuchserie mit dem geeichten Atemalkoholtestgerät Alcotest 7110 MK III A (Österreich-Ausführung)

ZusammenfassungZiel der vorliegenden Arbeit war es mit dem in Österreich sei 1997 zugelassenen Atemalkoholmessgerät Alcotest 7110 MK III A von Dräger, das sich technisch in einigen Punkten von dem in Deutschland zugelassenen Alcotest 7110 MK III Evidential unterscheidet, unter realitätsnahen Bedingungen Daten für eine Konversionsfaktor Atemalkoholkonzentration-Blutalkoholkonzentration (AAK-BAK) zu ermitteln und das Messverhalten dieses für Österreich spezifischen Geräts in dem Konzentrationsbereich um 0,25 mg/l Ausatemluft zu evaluieren. In 32 Trinkversuchen wurden bei 139 Probanden 30 min nach Trinkende zeitgleich AAK und BAK bestimmt. Die AAK-Werte lagen zwischen 0,05 und 0,78 mg/l Ausatemluft, die BAK-Werte zwischen 0,14 und 1,72‰ (g/l). Die daraus errechneten Konversionsfaktoren lagen zwischen minimal 1.380 und maximal 2.720 bei einem Mittelwert von 2.062. Wegen dieser großen Variationsbreite muss für die Beurteilung einer Beeinträchtigung durch Genussalkohol BAK-Werten der Vorzug gegeben werden. Sollten nur AAK-Werte vorliegen, können nach unseren Daten für die Umrechnung von AAK in BAK bei einer angebenden statistischen Wahrscheinlichkeit von 95% ein minimaler Konversionsfaktor von 1.631 und ein maximaler Konversionsfaktor von 2.493 verwendet werden.AbstractIn this study the analytical performance of the breath alcohol analyser Alcotest MK III A from Dräger was evaluated in the concentration range of 0.25 mg/l to collect data for the determination of the blood alcohol-breath alcohol (BAC-BrAC) quotient. This breath testing device has been approved for use in Austria since 1997 and differs in some technical aspects from the Alcotest 7110 MK III Evidential, which is approved for use in Germany. In 32 controlled experiments the BAC and BrAC of 139 participants were determined simultaneously 30 min after the last consumption of alcohol. The measured BAC and BrAC values ranged between 0.14 and 1.72‰ (g/l), and 0.05 and 0.78 mg/l, respectively. A conversion factor (CF) between BAC and BrAC was determined from these data pairs with a minimum of 1,380 and a maximum 2,720 and a mean value of 2,062. Due to the large variability of the CF, analysis of BAC is preferable to using conversion calculations from a forensic point of view. According to our data, if only BrAC values are available a CF ranging from 1,631 (min) and 2,493 (max) can be used to convert BrAC to BAC with a statisticl significance of 95%.

[The role of alcohol and/or benzodiazepines in occupational accidents compared to accidents due to other causes].

SummaryAll patients who were admitted within one year to the Department of Traumatology of the Innsbruck University Hospital as a result of an accident were included in this epidemiological study: a total of 1611 patients. 18.9% (n = 304) of these patients were injured as a result of a work-related accident and the remaining 81.2% (n = 1307) were involved in accidents due to other causes. Within the group of patients involved in work-related accidents, alcohol consumption was more frequent in males (13.3%) than in females (1.8%) (p = 0.016) and clearly lower than in patients injured by accidents due to other causes. In work-related accidents we found a correlation between the educational standard of patients and the frequency of alcohol consumption. The mean blood alcohol concentration was lower in patients involved in work-related accidents (0.76 ± 0.58 g/l) than in those involved in other injuries (1.63 g/l ± 0.74 g/l). No correlations were found concerning benzodiazepine use and demographic variables and all measured benzodiazepine plasma levels were within the therapeutic range.ZusammenfassungIn die Untersuchung wurden all jene Patienten, die innerhalb eines Jahres aufgrund ihrer Verletzungen im Rahmen eines Unfalles an der Unfallchirurgischen Ambulanz untersucht und anschließend stationär aufgenommen wurden, eingeschlossen. 304 (18,9 %) Personen verletzten sich im Rahmen eines Arbeitsunfalls, 1307 (81,2 %) Patienten erlitten Verletzungen durch Unfälle anderer Genese. Allen Patienten wurde eine Blutprobe entnommen, um einen eventuellen Alkohol- und/oder Benzodiazepinkonsum nachzuweisen. Zum Unfallzeitpunkt wiesen deutlich mehr männliche (13,3 %) als weibliche Patienten (1,8 %) positive Blutalkoholspiegel auf (p = 0,016). Der größte Anteil von alkoholisierten Patienten (17 %) fand sich in der Gruppe der un- und angelernten Arbeitskräfte, während Akademiker und Facharbeiter sowie Pensionisten eine niedrigere Alkoholisierungshäufigkeit aufwiesen (9,4 %, 6,7 %). Alle drei Gruppen waren bezüglich der gemessenen Blutalkoholkonzentrationen (BAC s) vergleichbar (0,76 ± 0,56 g/l, 0,66 ± 0,62 g/l, 0,83 ± 0,65 g/l). Auch die durchschnittliche Blutalkoholkonzentration (BAC) war bei Patienten mit Arbeitsunfällen deutlich niedriger als in der Vergleichsgruppe. Benzodiazepinkonsum korrelierte mit keiner der untersuchten demographischen Variablen. Blutplasmakonzentrationen bewegten sich im therapeutischen bzw. subtherapeutischen Bereich. Alkoholkonsum zeigte keinen Einfluss auf die Ausprägung der erlittenen Verletzung, bei den Benzodiazepinen hingegen zeigte sich ein Trend in Richtung eines Zusammenhanges zwischen Benzodiazepinkonsum und höherem Verletzungsgrad.

Forensische Alkohologie – Österreichische Gegebenheiten

In diesem Abschnitt werden osterreichische Besonderheiten bei der forensischen Alkohologie, insbesondere wichtige gesetzliche Regelungen, dargestellt. Augenmerk wird vor allem auch auf rechtlich festgelegte Verpflichtungen fur klinisch tatige Arzte im Zusammenhang mit Alkoholdelikten gelegt, um das korrekte Vorgehen in der Praxis zu erleichtern. Das Kapitel ist als Erganzung zum bisher Ausgefuhrten zu sehen, auf das an dieser Stelle verwiesen wird.