Tissue distribution of lidocaine after fatal accidental injection

J Forensic Sci. 1984 Oct;29(4):1229-36.

Abstract

The accidental death of a 64-year-old heart patient as a result of the injection of an incorrect dose of lidocaine is presented. The attending nurse inadvertently administered an intravenous bolus of 10 mL of 20% lidocaine (2g). The patient should have received 5 mL of 2% lidocaine (0.1 g). Such iatrogenic overdoses of lidocaine arise from confusion between prepackaged dosage forms. Lidocaine concentrations (mg/L or mg/kg were: blood, 30; brain, 135; heart, 106; kidney, 204; lung, 89; spleen, 115; skeletal muscle, 20; and adipose, 1.3. The results indicate that even during cardiopulmonary resuscitation as much as 38% of the administered dose of lidocaine may be found in poorly perfused tissue such as skeletal muscle and adipose.

Publication types

  • Case Reports

MeSH terms

  • Accidents
  • Forensic Medicine
  • Humans
  • Injections, Intravenous
  • Lidocaine / poisoning*
  • Male
  • Medication Errors*
  • Middle Aged
  • Tissue Distribution

Substances

  • Lidocaine