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High cyanide level in a homicide victim burned after death: Evidence of post-mortem diffusion
Forensic Science Znternational,
Elsevier Scientific Publishers
49 (1991) 179-183 Ireland Ltd.
179
HIGH CYANIDE LEVEL IN A HOMICIDE VICTIM DEATH: EVIDENCE OF POST-MORTEM DIFFUSION
P.J. KARHUNEN, Department (Finland)
BURNED
AFTER
I. LUKKARI and E. VUORI
of Forensic
Medicine,
University
of Helsinki,
KytBsuontie
II,
SF-00300 Helsinki
(Received June llth, 1990) (Revision received August 2Oth, 1990) (Accepted January 17th, 1991)
Summary Elevated levels of carbon monoxide and cyanide serve as evidence of intravital burning in fire victims. Hydrogen cyanide is released by combustion of nitrogen-containing organic material such as plastics and wool. We present a case of a man who died of haemopneumothorax caused by a stab wound. According to several eye witnesses the body was wrapped in a plastic sheet and burned 2 days after death with the aid of gasoline. No coal pigment was observed in the mucosa of the upper airways at autopsy. The blood sample taken from the pulmonary vessels 6 days after death disclosed a level of blood carboxyhaemoglobin of 4% and of blood cyanide of 10 mgll. The low carboxyhaemoglobin level was consistent with the smoking habits of the victim. The thoracic cavity had been opened by burning of the intercostal soft tissue. This allowed hydrogen cyanide gas to enter the thoracic cavity and diffuse into the blood probably causing the high blood-cyanide level. KAYlords:
Carbon monoxide poisoning; Cyanides; Homicide; Burns; Autopsy
Introduction
In the examination of homicides involving an attempt to burn the body, it is particularly important to provide reliable data on the victims likely time of death. Detecting a high carbon monoxide level in the blood is the most commonly used method to assess that the victim was alive at the beginning of the fire [l]. However, under certain circumstances, such as low or absent carbon monoxide production due to efficient pyrolysis in high temperatures as well as in fires in open places, blood carbon monoxide determination is a poor indicator of intravital burning. In indoor fires, cyanide released from burning of plastics and wool used in furnishings may kill the victims quickly before they can inhale toxic levels of carbon monoxide. The determination of blood cyanide concentration is Correspondence
Kytosuontie
to: Pekka J. Karhunen, Department 11, SF-00300 Helsinki, Finland.
0379-0738/91/$03.50 0 1991 Elsevier Scientific Publishers Printed and Published in Ireland
Ireland Ltd.
of Forensic Medicine, University
of Helsinki,
180
thus considered a promising method to indicate that the victim was alive before the fire [1,2]. We found high levels of cyanide in the body of a man who, according to several eye witnesses statements, was killed, wrapped in a plastic sheet and burned after death. Our results suggest that care should be taken to assess the value of elevated cyanide levels in a badly burnt fire victim. Case report During a quarrel while drinking in a storage building, a 39-year-old man was stabbed with a knife which penetrated the upper lobe of the right lung. The stabbing and death of the victim was confirmed by an eye witness. The dead body, wrapped in a plastic sheet, was later seen by four other eyewitnesses. Approximately 32 h after death the body was lifted onto the back of a lorry covered with pieces of steel sheets and plastic trash, located inside the storage building. About 25-30 1 of gasoline was poured into a plastic container 45 cm x 60 cm in size and was set to fire under the vehicle to ensure complete burning. One wall of the storage building caught the fire, and a bystander immediately summoned the fire brigade. The smoke was unusually gray. The storage building and the vehicle were destroyed completely. Within 29 h, the warehouse caught fire again; 5 h later a charred body was found at the scene, and the police started to investigate the death as accidental. Nothing was suspected until the next day when the police received a phone call from one of the eye witnesses saying that the man found in the ruins was killed before being burnt. Necropsy findings The body was badly burnt, with the bones of the hands, the feet and the skull broken due to the fire (Fig. 1). The skin and soft tissues were burnt, and the thoracic cavity and peritoneal cavity had fallen open due to burning of the abdominal wall and the intercostal tissues. Even the pericardial sac had fallen open and burned. The wall of the trachea was also burnt through. A stab wound was detected between the 1st and 2nd ribs. The wound penetrated to a depth of 2-5 cm in the apex of the upper lobe of the right lung. The right lung was small and constricted, consistent with atelectasis. Coagulated blood encircled the right parietal pleura which indicated haemopneumothorax. Neither smoke pigment nor coal was detectable in the upper airways. Microscopic examination of the trachea disclosed smoke particles at the border of the burned trachea, but no signs of smoke inhalation appeared in the lower respiratory tract. Other necropsy findings included grave fatty liver (1187 g). findings The blood sample was drawn from the pulmonary vessels in this case, since no femoral blood was available due to burning. Sodium fluoride was used to preserve the sample. Samples of urine and liver were also collected as usual. The blood and urine alcohol, determined by “head space” gas chromatography,
Forensic toxicological
Fig. 1. Charred body of the victim of a homicide. Note open thoracic cavity with protruding site of the stab wound is indicated by an arrow.
ribs caused by burning of the intercostal
soft tissues. The
182
resulted in figures of 2.3%, and 3.4%0 (g/l), respectively. Drug screening performed using an enzyme-digested liver sample by means of thin layer chromatography and capillary gas chromatography gave a negative result. The blood carboxyhaemoglobin concentration was determined by the method of Sakata et al. [3] and was found to be 4%. The method described by Bonnichsen and Maehly [4] was used to determine blood cyanide concentration. This method consists of microdiffusion of cyanides as hydrogen cyanide and spectrophotometric determination of the concentration; cyanide concentration was 10 mgll. Discussion Hydrogen cyanide is one of the most toxic gases. Interest in the role of cyanides in fire accidents was initiated by aircraft accidents in the U.S.A. during the 1960s [5]. Toxic fumes from pyrolysis of plastic material in the cabins caused several dozen passengers with insignificant physical injury to perish [5,6]. Cyanide has been found in association with high carboxyhaemoglobin levels in victims of indoor fires [l]. It has also been reported that in several cases victims have died of cyanide poisoning linked with relatively low carboxyhaemoglobin levels [1,2,6]. Low carboxyhaemoglobin levels and high cyanide levels may be expected especially in those fires involving mainly nitrogen-containing material such as wool, nylon, silk, asphalt, X-ray films, polyacrylonitrile and polyurethane. Hydrogen cyanide may kill the victim through early cardiovascular and respiratory center depression [5]. Cyanide is normally present in low amounts in the plasma and can be produced by decomposing tissue [5,7]. In 3-month-old blood samples, cyanide levels of up to 0.1 mg/l have been found [8]. In this case, the blood sample was taken only 6 days after death, and thus post-mortem production of 10 mg/l of hydrogen cyanide seems less likely. Ballantyne and Marrs [7] have discussed the postmortem diagnosis of lethal cyanide poisoning thoroughly. According to their view the transformation of cyanide is a more probable phenomenon than is postmortem formation, and hence a prompt autopsy and rapid analysis is recommended by them. Cyanide-level in an organ depends on erythrocyte concentration [5]. Thus, considering the high temperature during the fire as well as the opening of the thoracic cavity, drying and haemoconcentration may probably play a role in this case. The levels of hydrogen cyanide in victims of fire-related deaths have usually ranged from 0.17 to 2.62 mg/l [1,9], whereas high values up to 11-60 mg/l have been detected in air-accident victims [6]. In this case, the 10 mg/l level thus falls within the limits reported but, compared with cyanide values reported in other indoor fires, is unusually high. A low carboxyhaemoglobin level is not infrequently found in victims of house fires. However, in this case, the presence of a low (4%) carboxyhaemoglobin level is consistent with the known smoking habits of the victim.
183
The most probable explanation in this case would be that toxic fumes containing hydrogen cyanide may have entered the open thoracic cavity following burning of the intercostal soft tissues. The wall of the trachea had also been burned. It thus seems possible that high smoke-gas pressures in these circumstances had caused hydrogen cyanide to diffuse into tissues, producing false positive elevated blood levels. Thus, care should be taken when interpreting positive cyanide levels as a sign of intravital burning. References P. Lundquist, L. Rammer and B. Sorbo, The role of hydrogen cyanide and carbon monoxide in fire casualties: a prospective study. Forensic Sci. Znt., 43 (1989) 9-14. M. Okae, K. Yamamoto, Y. Yamamoto and Y. Fukui, Cyanide carboxyhemoglobin and blood acid-base state in animals exposed to combustion products of various combinations of acrylic fibre and gauze. Forensic Sci. Znt., 42 (1989) 33-41. M. Sakata, A. Yoshida and M. Haga, Simple determination of carboxyhemoglobin by double wavelength spectrophotometry of absorbance difference and the comparison with gas chromatographic method. Forensic Sci. Znt., 21 (1983) 187-195. R. Bonnichsen and A.C. Maehly, Poisoning by volatile compounds. III Hydrocyanic acid. J. Forensic Sci. Sot., 11 (1966) 516-528. T.T. Noguchi, J.J. Eng and E.C. Klatt, Significance of cyanide in medicolegal investigations involving fires. Am. J. Forensic Med. Pathol., 9 (1988) 304-309. J. Zamecnik and J. Tam, Cyanide in blood by gas chromatography with NP detector and acetonitrile as internal standard. Application on air accident fire victims. J. Anal. Tozieol., 11 (1987) 47-48. B. Ballantyne and T.C. Marrs, Post-mortem features and criteria for the diagnosis of acute lethal cyanide poisoning. In B. Ballantyne and T.C. Marrs (eds.), Clinical and Experimental Z’osicology of Cyanides, Wright, Bristol, 1987, pp. 217-247. A. Curry, Toxicology: general considerations. In: Poison Detection in Human Organs, 3rd edn., Charles C Thomas, Springfield IL, 1976, pp. 18-19 and 26-27. H.R Wetherall, The occurrence of cyanide in the blood of fire victims. J. Forensic Sci., ll(l966) 167-173.
Elsevier Scientific Publishers
49 (1991) 179-183 Ireland Ltd.
179
HIGH CYANIDE LEVEL IN A HOMICIDE VICTIM DEATH: EVIDENCE OF POST-MORTEM DIFFUSION
P.J. KARHUNEN, Department (Finland)
BURNED
AFTER
I. LUKKARI and E. VUORI
of Forensic
Medicine,
University
of Helsinki,
KytBsuontie
II,
SF-00300 Helsinki
(Received June llth, 1990) (Revision received August 2Oth, 1990) (Accepted January 17th, 1991)
Summary Elevated levels of carbon monoxide and cyanide serve as evidence of intravital burning in fire victims. Hydrogen cyanide is released by combustion of nitrogen-containing organic material such as plastics and wool. We present a case of a man who died of haemopneumothorax caused by a stab wound. According to several eye witnesses the body was wrapped in a plastic sheet and burned 2 days after death with the aid of gasoline. No coal pigment was observed in the mucosa of the upper airways at autopsy. The blood sample taken from the pulmonary vessels 6 days after death disclosed a level of blood carboxyhaemoglobin of 4% and of blood cyanide of 10 mgll. The low carboxyhaemoglobin level was consistent with the smoking habits of the victim. The thoracic cavity had been opened by burning of the intercostal soft tissue. This allowed hydrogen cyanide gas to enter the thoracic cavity and diffuse into the blood probably causing the high blood-cyanide level. KAYlords:
Carbon monoxide poisoning; Cyanides; Homicide; Burns; Autopsy
Introduction
In the examination of homicides involving an attempt to burn the body, it is particularly important to provide reliable data on the victims likely time of death. Detecting a high carbon monoxide level in the blood is the most commonly used method to assess that the victim was alive at the beginning of the fire [l]. However, under certain circumstances, such as low or absent carbon monoxide production due to efficient pyrolysis in high temperatures as well as in fires in open places, blood carbon monoxide determination is a poor indicator of intravital burning. In indoor fires, cyanide released from burning of plastics and wool used in furnishings may kill the victims quickly before they can inhale toxic levels of carbon monoxide. The determination of blood cyanide concentration is Correspondence
Kytosuontie
to: Pekka J. Karhunen, Department 11, SF-00300 Helsinki, Finland.
0379-0738/91/$03.50 0 1991 Elsevier Scientific Publishers Printed and Published in Ireland
Ireland Ltd.
of Forensic Medicine, University
of Helsinki,
180
thus considered a promising method to indicate that the victim was alive before the fire [1,2]. We found high levels of cyanide in the body of a man who, according to several eye witnesses statements, was killed, wrapped in a plastic sheet and burned after death. Our results suggest that care should be taken to assess the value of elevated cyanide levels in a badly burnt fire victim. Case report During a quarrel while drinking in a storage building, a 39-year-old man was stabbed with a knife which penetrated the upper lobe of the right lung. The stabbing and death of the victim was confirmed by an eye witness. The dead body, wrapped in a plastic sheet, was later seen by four other eyewitnesses. Approximately 32 h after death the body was lifted onto the back of a lorry covered with pieces of steel sheets and plastic trash, located inside the storage building. About 25-30 1 of gasoline was poured into a plastic container 45 cm x 60 cm in size and was set to fire under the vehicle to ensure complete burning. One wall of the storage building caught the fire, and a bystander immediately summoned the fire brigade. The smoke was unusually gray. The storage building and the vehicle were destroyed completely. Within 29 h, the warehouse caught fire again; 5 h later a charred body was found at the scene, and the police started to investigate the death as accidental. Nothing was suspected until the next day when the police received a phone call from one of the eye witnesses saying that the man found in the ruins was killed before being burnt. Necropsy findings The body was badly burnt, with the bones of the hands, the feet and the skull broken due to the fire (Fig. 1). The skin and soft tissues were burnt, and the thoracic cavity and peritoneal cavity had fallen open due to burning of the abdominal wall and the intercostal tissues. Even the pericardial sac had fallen open and burned. The wall of the trachea was also burnt through. A stab wound was detected between the 1st and 2nd ribs. The wound penetrated to a depth of 2-5 cm in the apex of the upper lobe of the right lung. The right lung was small and constricted, consistent with atelectasis. Coagulated blood encircled the right parietal pleura which indicated haemopneumothorax. Neither smoke pigment nor coal was detectable in the upper airways. Microscopic examination of the trachea disclosed smoke particles at the border of the burned trachea, but no signs of smoke inhalation appeared in the lower respiratory tract. Other necropsy findings included grave fatty liver (1187 g). findings The blood sample was drawn from the pulmonary vessels in this case, since no femoral blood was available due to burning. Sodium fluoride was used to preserve the sample. Samples of urine and liver were also collected as usual. The blood and urine alcohol, determined by “head space” gas chromatography,
Forensic toxicological
Fig. 1. Charred body of the victim of a homicide. Note open thoracic cavity with protruding site of the stab wound is indicated by an arrow.
ribs caused by burning of the intercostal
soft tissues. The
182
resulted in figures of 2.3%, and 3.4%0 (g/l), respectively. Drug screening performed using an enzyme-digested liver sample by means of thin layer chromatography and capillary gas chromatography gave a negative result. The blood carboxyhaemoglobin concentration was determined by the method of Sakata et al. [3] and was found to be 4%. The method described by Bonnichsen and Maehly [4] was used to determine blood cyanide concentration. This method consists of microdiffusion of cyanides as hydrogen cyanide and spectrophotometric determination of the concentration; cyanide concentration was 10 mgll. Discussion Hydrogen cyanide is one of the most toxic gases. Interest in the role of cyanides in fire accidents was initiated by aircraft accidents in the U.S.A. during the 1960s [5]. Toxic fumes from pyrolysis of plastic material in the cabins caused several dozen passengers with insignificant physical injury to perish [5,6]. Cyanide has been found in association with high carboxyhaemoglobin levels in victims of indoor fires [l]. It has also been reported that in several cases victims have died of cyanide poisoning linked with relatively low carboxyhaemoglobin levels [1,2,6]. Low carboxyhaemoglobin levels and high cyanide levels may be expected especially in those fires involving mainly nitrogen-containing material such as wool, nylon, silk, asphalt, X-ray films, polyacrylonitrile and polyurethane. Hydrogen cyanide may kill the victim through early cardiovascular and respiratory center depression [5]. Cyanide is normally present in low amounts in the plasma and can be produced by decomposing tissue [5,7]. In 3-month-old blood samples, cyanide levels of up to 0.1 mg/l have been found [8]. In this case, the blood sample was taken only 6 days after death, and thus post-mortem production of 10 mg/l of hydrogen cyanide seems less likely. Ballantyne and Marrs [7] have discussed the postmortem diagnosis of lethal cyanide poisoning thoroughly. According to their view the transformation of cyanide is a more probable phenomenon than is postmortem formation, and hence a prompt autopsy and rapid analysis is recommended by them. Cyanide-level in an organ depends on erythrocyte concentration [5]. Thus, considering the high temperature during the fire as well as the opening of the thoracic cavity, drying and haemoconcentration may probably play a role in this case. The levels of hydrogen cyanide in victims of fire-related deaths have usually ranged from 0.17 to 2.62 mg/l [1,9], whereas high values up to 11-60 mg/l have been detected in air-accident victims [6]. In this case, the 10 mg/l level thus falls within the limits reported but, compared with cyanide values reported in other indoor fires, is unusually high. A low carboxyhaemoglobin level is not infrequently found in victims of house fires. However, in this case, the presence of a low (4%) carboxyhaemoglobin level is consistent with the known smoking habits of the victim.
183
The most probable explanation in this case would be that toxic fumes containing hydrogen cyanide may have entered the open thoracic cavity following burning of the intercostal soft tissues. The wall of the trachea had also been burned. It thus seems possible that high smoke-gas pressures in these circumstances had caused hydrogen cyanide to diffuse into tissues, producing false positive elevated blood levels. Thus, care should be taken when interpreting positive cyanide levels as a sign of intravital burning. References P. Lundquist, L. Rammer and B. Sorbo, The role of hydrogen cyanide and carbon monoxide in fire casualties: a prospective study. Forensic Sci. Znt., 43 (1989) 9-14. M. Okae, K. Yamamoto, Y. Yamamoto and Y. Fukui, Cyanide carboxyhemoglobin and blood acid-base state in animals exposed to combustion products of various combinations of acrylic fibre and gauze. Forensic Sci. Znt., 42 (1989) 33-41. M. Sakata, A. Yoshida and M. Haga, Simple determination of carboxyhemoglobin by double wavelength spectrophotometry of absorbance difference and the comparison with gas chromatographic method. Forensic Sci. Znt., 21 (1983) 187-195. R. Bonnichsen and A.C. Maehly, Poisoning by volatile compounds. III Hydrocyanic acid. J. Forensic Sci. Sot., 11 (1966) 516-528. T.T. Noguchi, J.J. Eng and E.C. Klatt, Significance of cyanide in medicolegal investigations involving fires. Am. J. Forensic Med. Pathol., 9 (1988) 304-309. J. Zamecnik and J. Tam, Cyanide in blood by gas chromatography with NP detector and acetonitrile as internal standard. Application on air accident fire victims. J. Anal. Tozieol., 11 (1987) 47-48. B. Ballantyne and T.C. Marrs, Post-mortem features and criteria for the diagnosis of acute lethal cyanide poisoning. In B. Ballantyne and T.C. Marrs (eds.), Clinical and Experimental Z’osicology of Cyanides, Wright, Bristol, 1987, pp. 217-247. A. Curry, Toxicology: general considerations. In: Poison Detection in Human Organs, 3rd edn., Charles C Thomas, Springfield IL, 1976, pp. 18-19 and 26-27. H.R Wetherall, The occurrence of cyanide in the blood of fire victims. J. Forensic Sci., ll(l966) 167-173.