Problems of Forensic Sciences 2005 Vol. 64 (LXIV) 417-424
THE INFLUENCE OF PHARMACOLOGICAL TREATMENT DIRECTLY PRIOR TO DEATH ON THE FORMATION OF ENDOGENOUS ETHYL ALCOHOL
Krzysztof MAKSYMOWICZ1, Maria KAŁA2, Ewa JAŹWIŃSKA-TARNAWSKA3, Magdalena HURKACZ3
1Chair and Department of Forensic Medicine, Medical University, Wrocław
2Institute of Forensic Research, Cracow
3Chair and Department of Clinical Pharmacology, Medical University, Wrocław
Streszczenie
Analysis of blood and urine samples collected during the autopsy of a 14-year-old girl, treated for 12 hours after a road accident at the Intensive Care Unit, showed the presence of 0.9‰ ethyl alcohol in blood, but none in urine. Moreover, the possibility of the child consuming alcohol before death was practically excluded during an investigation of the accident circumstances. A blood sample was collected 24 hours after death, the body having been stored under refrigeration during this time, which protected against post-mortem changes. The result, indicating the presence of ethyl alcohol in blood, had legal consequences in the settlement of who had caused the accident, and hence who had civil responsibility. In this paper, the authors analysed the treatment of the young female patient immediately before death with the aim of establishing the mechanism of formation of ethyl alcohol in the blood of the deceased child. The results of the case analysis and performed experiments showed that most probably the presence of ethyl alcohol in the blood of the deceased was caused by post-mortem decomposition changes of one of the pharmacological substances used in the treatment – hydroxyethyl starch (HES). This is a preparation substituting for blood plasma (serum) in intensive treatment, “topping up” the volume of the vascular bed.
Słowa kluczowe
Pharmacological treatment; Hydroxyethyl starch; Endogenous ethyl alcohol.