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To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.forsciint.2006.04.003 Byline: F. Papin (a), F. Clarot (b), C. Vicomte (b), J.M. Gaulier (c), C. Daubin (d), F. Chapon (e), E. Vaz (b), B. Proust (b) Keywords: Rodenticide; Chlorophacinone; Poisoning; Anticoagulant; Cerebral vein thrombosis Abstract: Superwarfarin exposure is a growing health problem, described in many countries. The authors report a case of suspicious chlorophacinone poisoning with a problematic diagnosis. They review the literature and discuss particularities of anticoagulant rodenticide intoxication, as well as the apparent contradiction between anticoagulant intoxication and lethal thrombosis. Author Affiliation: (a) Forensic Department, Caen University Hospital, Caen, France (b) Medical Forensic Institute, Rouen University Hospital, Charles Nicolle, Rouen, France (c) Pharmacokinetic and Toxicology Laboratory, Limoges University Hospital, Limoges, France (d) Intensive Care Unit, Caen University Hospital, Caen, France (e) Neuropathology Department, Caen University Hospital, Caen, France Article History: Received 9 February 2006; Revised 4 April 2006; Accepted 9 April 2006

Lethal occurrence is exceptional after disopyramide or mianserin poisoning. A case of intentional lethal intoxication with these drugs was reported, as well as a review of the literature. Pre- and postmortem blood concentrations of disopyramide or mianserin were assessed in a woman who died from acute cardiac failure after ingestion. The premortem blood concentration of disopyramide alone was considered lethal, and a toxic premortem concentration of mianserin was observed that may have increased cardiovascular failure induced by disopyramide because the metabolism of both drugs is mediated via cytochrome P450. Moreover, it was shown that the postmortem redistribution of disopyramide was limited, as pre- and postmortem concentrations were 48 and 65 mg/L, respectively. As regards mianserin, redistribution was observed after death with pre- and portmortem concentrations at 0.23 and 0.79 mg/L, respectively. This case illustrates that if postmortem blood concentration of disopyramide is known, the premortem concentration can be deduced., (© 2014 American Academy of Forensic Sciences.)

First synthesized in 1970, propafenone is a frequently used 1C antiarrhythmic drug metabolized into two major metabolites, 5-hydroxypropafenone and norpropafenone. Paradoxically, fatal intoxication is rarely described, and only six cases have been reported in the literature. We report our experience with two patients found dead of self-inflicted poisoning where the propafenone blood concentration was very high (one concentration to our knowledge is one of the highest reported in the literature). At autopsy, no evidence of significant pathological disease were found. Propafenone was detected in blood by gas chromatography-mass spectrometry and by high-performance liquid chromatography using a diode-array detector, respectively, as propafenone artifact and propafenone. Blood propafenone concentrations were 4180 ng/mL and 9123 ng/mL. The literature regarding propafenone pharmacokinetic and intoxication is reviewed, and we discuss the low death rate attributed to this drug in contrast to its frequent use.

We report a fatal head injury caused by a tear-gas cartridge and point out the underestimated potential injury of this type of weapon. Gas pressure wounds and the death mechanisms are also described. A review of the literature and forensic considerations of head injury without projectile are presented.

A 29-year-old woman presented with dilated epidural veins and incapacitating headache after undergoing a lumbar puncture. Two months later, the results of follow-up MR imaging were normal. These findings suggest that temporary dilation of the epidural vein may occur in association with post-lumbar puncture intracranial hypotension syndrome. In these cases, it seems useful to confirm whether the patient has recently undergone a lumbar puncture.