A Death Too Fast - Suxamethonium Chloride Poisoning: A Case Report

Abstract

Introduction: Suxamethonium chloride (SUX) is a short acting depolarizing muscle relaxant commonly used for medical procedures to induce respiratory paralysis. The case report aims to highlight the important postmortem findings associated with SUX poisoning. Case report: A female adult health-care worker in her thirties was found dead in her bedroom at home. There were two empty ampoules of IV/IM Suxamethonium Chloride 100 mg/2 ml found next to the body. Results: The autopsy revealed an adult female with multiple needle injection marks. Gross examination of the lungs showed markedly congested lungs and froth in the airways. The liver showed foci of petechial haemorrhages and confluent haemorrhages. Other internal organs showed diffuse vascular congestion. Microscopically, significant pathological changes were seen in the lungs and kidneys with areas of pulmonary infarction and acute tubular necrosis. SUX was not detected from the toxicological analysis. Correlating the circumstantial evidence at the scene of death, autopsy and microscopic findings, the cause of death was certified as SUX poisoning.  Conclusions: We wished to demonstrate the autopsy and histopathological findings associated with acute SUX poisoning culminating in death due to respiratory paralysis.