Accidental carbon dioxide poisoning due to dry ice during a funeral wake: An autopsy case.

• We report CO 2 poisoning due to dry ice exposure during an open-coffin funeral wake. • An experiment was conducted to confirm the concentrations of CO 2 and O 2. • The experiment revealed that the cause of death was not asphyxia but CO 2 poisoning. • Collecting detailed death-scene information is essential for proving CO 2 poisoning. • Periodic room ventilation is recommended when using dry ice. We report the autopsy case of a male in his 60 s diagnosed with carbon dioxide (CO 2) poisoning caused by dry ice for cooling in a coffin during a funeral wake. He was last seen alive, clinging to his family member's body with his head inside the coffin. The autopsy and histological findings did not indicate a specific cause of death. To confirm the concentrations of CO 2 and oxygen (O 2) in the coffin, an experiment was conducted to reconstruct the scene. Based on the experimental results, 9 h after placing dry ice, the CO 2 concentration at the estimated closest point to his head was 24%, a lethal level for CO 2 poisoning. Contrastingly, although the concentration of O 2 had fallen, it never reached a lethal concentration at any of the determination points during the experiment, thereby ruling out asphyxia as a cause of death. Based on our findings, we concluded that the cause of his death was CO 2 poisoning. Forensic pathologists tend to overlook CO 2 poisoning unless suspected, as it does not exhibit specific autopsy findings. For the diagnosis of CO 2 poisoning, it is essential to collect detailed information about the deceased and the scene of death. The toxicity of CO 2 itself is not well known, although dry ice is widely available to the public. In order to make its risk well known, it is necessary to inform people about the dangers of using dry ice. [ABSTRACT FROM AUTHOR]