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From Wikipedia, the free encyclopedia. For other uses, see Overdose disambiguation. From National Center for Health Statistics.
Open the dashboard dropdown menu and pick "U. From the menus on the right pick all races, all ages, and both sexes. Medicines Talk , Winter Available at "Archived copy". Archived from the original on Retrieved Goldfrank's toxicologic emergencies. Live Strong. Archived from the original on 18 April Retrieved 17 May Subst Use Misuse.
Centers for Disease Control and Prevention. December June Pain Medicine. Journal of Urban Health. April Huffington Post. Oxford Handbook of Clinical Medicine. United Kingdom: Oxford. And Archived at the Wayback Machine. By National Institute on Drug Abuse. The New York Times. Archived at Archive.
DEATH, DRUGS, AND MUSCLE
January 1, article. Drug Overdose. CDC Injury Center. Click on "Rising Rates" tab. Nelson, Lewis H. Lewin Olson, Kent C. Also required was an explanation of the availability of rocuronium in hospitals as well as a demonstration of how rocuronium is administered.
Testimony by REJ in this case was particularly difficult because family members and friends of the victim sat in the courtroom facing the witness stand and reacted emotionally to descriptions of muscle paralysis while awake, air hunger, and the probable sequence of death.
Because the precise dose of rocuronium administered or site of administration was not known, onset times had to be given in ranges, with the disclaimer that effects depended on the actual dose. For example, intramuscular administration of 1. The wife of an anesthesiologist died suddenly and unexpectedly. Although the initial death certificate did not list homicide as the cause of death, the father of the wife suspected foul play, and an investigation was launched.
One of us RLK reviewing information about this case learned that the anesthesiologist had previously been tried for murder and was found not guilty. This previous trial followed the sudden and unexpected death of the husband of a woman with whom he had allegedly been having an affair. With the help of RLK, the district attorney theorized that the anesthesiologist had injected succinylcholine into the buttocks of the first victim while he slept.
The body was exhumed and detailed examination revealed a fractured hyoid bone. It was then speculated that an injected dose of succinylcholine produced apnea but had begun to wear off before death, so the first victim was strangled. A second autopsy of the deceased wife found a high concentration of choline in her buttocks. Choline concentrations in plasma reflect those of succinylcholine.
by John Cross
A yr-old pharmacist who worked in a large city crime laboratory was convicted of murdering her husband with fentanyl. She called after claiming to have discovered her husband unconscious and apneic in their apartment when she returned from an afternoon of shopping.
She reported finding him lying in bed with their wedding picture and rose petals. When paramedics arrived at the apartment, the woman was performing cardiopulmonary resuscitation on her husband. The paramedics took over resuscitation at the scene and in the ambulance but soon after arrival at the emergency department of the nearest hospital the husband was pronounced dead.
Initial analysis of blood and gastric fluid samples found no barbiturates, benzodiazepines, or other drugs commonly taken for suicide. The discovery that fentanyl fentanyl patches, crystalline fentanyl, and vials of the opioid was missing from the woman's place of employment triggered a reanalysis of the husband's blood and gastric fluid samples for the presence of fentanyl. The minimum effective blood concentration of fentanyl administered intravenously during patient-controlled analgesia is 0. At the trial the prosecuting attorney presented evidence that the pharmacist stole fentanyl from her place of employment and fed her husband soup laced with the drug.
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The prosecutor claimed that as the woman's husband became somnolent from the soup she was feeding him, she placed numerous fentanyl patches on his chest and arms. These patches were not on his body when the paramedics arrived but there was some evidence the patches had been previously applied.
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Finally, the attorney showed that the woman purchased roses using her own credit card a few hours before she called The motive for the murder was that her husband would not agree to a divorce that she wanted in order to continue an affair with another pharmacist at her place of employment. Her husband had also threatened if she pursued a divorce to reveal to her employer that she was a methamphetamine addict, which could have resulted in the loss of her job.
Testimony in this case by THS involved confirming that the fentanyl blood concentration was high enough to produce apnea and death that could have resulted from the consumption of fentanyl-laced soup and fentanyl patches applied to the husband's body. The woman was sentenced to life in prison.
A yr-old physician, general practitioner, called from a hotel room in a small agricultural community. The victim was a yr-old, lb, 6-ftin mentally challenged former patient whom the physician had befriended after caring for him in the emergency department of a large-city general hospital several months earlier.
The victim had suffered respiratory arrest after multiple intramuscular and intravenous injections of fentanyl and midazolam. The physician was performing cardiopulmonary resuscitation on the victim when the paramedics arrived. The paramedics took over resuscitation at the scene and in the ambulance, but the victim was dead on arrival at the hospital.
Most of the film in the camera and approximately 25 other videos showed the victim lying supine and breathing quite slowly while deeply sedated with the physician applying oils and creams on the abdomen, genitals, and upper legs of the victim. Blood samples of the victim taken in the emergency department demonstrated high concentrations of both fentanyl and midazolam. Testimony in this case by THS involved confirming that the fentanyl and midazolam blood concentrations were sufficiently high to produce apnea, especially when considering that the two drugs can act synergistically in decreasing respiratory function.
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The physician was sentenced to 10—20 yr in prison. Hospital personnel noted that several patients of a particular anesthesiologist had suddenly become apneic in the postanesthesia care unit after having seemingly recovered from their anesthetics. Because administration of neostigmine restored ventilation in these patients, respiratory depression was diagnosed due to nondepolarizing muscle relaxants.
Death, Drugs, & Muscle
Although a rebound effect of intraoperative muscle relaxants was initially suspected, one of the patients had not received muscle relaxants during surgery. A nurse reported that in one case she had seen a surgeon who had not operated on the patient at bedside shortly before he stopped breathing. That surgeon and the anesthesiologist for the apneic patients had been engaged in a bitter work dispute.