Fatal ingestion of Taxus brevifolia (Pacific yew): a case report.

Taxus brevifolia, the Pacific yew, is an evergreen shrub that is common to the Pacific Northwest of North America. The Taxus spp. are often seen in decorative hedging and topiary, though historically have been referred to as the "death tree" for its known toxicity. The yew contains cardiotoxic alkaloids including taxine A and B, which are present in all parts of the plant except the red arils. Deliberate ingestions can result in life threatening effects including cardiac dysrhythmias, hemodynamic instability, and death without intervention. Serious toxicity following accidental ingestion is rare. A 38 year old woman was assessed on scene after ingesting yew needles in a suicide attempt. Shortly after Emergency Medical Services (EMS) arrival, she became unresponsive and pulseless. A wide complex ventricular tachycardia followed by bradycardia was reported. She received epinephrine, atropine, amiodarone, and several cardiac defibrillations but ultimately expired in the field thirty minutes later. Postmortem serum samples confirmed the presence of taxine B and isotaxine B. This case highlights the severe and rapid characteristics of taxine poisoning, despite being generally considered less toxic than other Taxus spp. Patients require aggressive and immediate medical care following intentional ingestions. [ABSTRACT FROM AUTHOR]