Fatal self administration of tramadol and propofol: a case report

J Forensic Leg Med. 2013 Aug;20(6):715-9. doi: 10.1016/j.jflm.2013.04.003. Epub 2013 May 20.

Abstract

We describe a case of unintentional intoxication due to tramadol and propofol self administration, occurred in a middle aged man, healthcare provider, deceased despite advanced medical assistance an hour later the onset of severe and increasing dyspnea. Toxicological analysis performed with gas chromatography-mass spectrometry in blood sample, evidenced a lethal tramadol concentration and therapeutic level of Propofol. Quantitative determination was also performed in other specimens such as bile, tissues (liver, spleen, kidney) and pubic hair, to assess chronic exposure. Toxicological results and autopsy findings, supported by clinical and hematochemical data, suggested a myocardial damage, associated with respiratory failure.

Keywords: Cardiac arrest; GC–MS; Propofol; Toxicological; Tramadol.

Publication types

  • Case Reports

MeSH terms

  • Analgesics, Opioid / administration & dosage
  • Analgesics, Opioid / analysis
  • Analgesics, Opioid / poisoning*
  • Drug Overdose
  • Forensic Toxicology
  • Gas Chromatography-Mass Spectrometry
  • Hair / chemistry
  • Health Personnel
  • Heart Arrest / chemically induced
  • Humans
  • Hypnotics and Sedatives / administration & dosage*
  • Hypnotics and Sedatives / analysis
  • Limit of Detection
  • Liver / chemistry
  • Male
  • Middle Aged
  • Propofol / administration & dosage*
  • Propofol / analysis
  • Respiratory Insufficiency / chemically induced
  • Self Administration
  • Substance-Related Disorders / diagnosis*
  • Tramadol / administration & dosage
  • Tramadol / analysis
  • Tramadol / poisoning*

Substances

  • Analgesics, Opioid
  • Hypnotics and Sedatives
  • Tramadol
  • Propofol