Nikolic S, Micic J, Savic S, Uzelac-Belovski Z
Institute of Forensic Medicine, University School of Medicine, Belgrade.
Srp Arh Celok Lek. 2001 Jul-Aug;129(7-8):203-6.
Accidental deaths after parenteral use of medicaments are usually very rare. The most common cause of death is allergic reaction. In literature, the most menacing medicaments are antibiotics. Taking into account that macroscopic and microscopic autopsy findings are uncharacteristic and poor clinical features and circumstances are more or less characteristic and objective, and that the establishing of cause and mode of death could be a problem for dissectors. Later, in forensic expertise, the questions about medical malpractice could arise. In this paper the authors report on the case of a male, aged 46, a chronic psychiatric patient with schizophrenia, treated by neuroleptics, who died about half an hour after intramuscular injection of chlorpromazine. On the basis of the autopsy, microscopical and toxicological findings, clinical features and circumstances, as well as exclusion of other possible violent and morbid causes of death, it was established that the unexpected and sudden death was caused by anaphylactic allergic reaction due to injected medicament--chlorpromazine.
经肠道外用药后的意外死亡通常非常罕见。最常见的死亡原因是过敏反应。在文献中,最具威胁性的药物是抗生素。考虑到宏观和微观尸检结果不具特征性,而临床特征和情况或多或少具有特征性和客观性,并且确定死因和死亡方式可能对解剖人员来说是个问题。之后,在法医鉴定中,可能会出现关于医疗事故的问题。本文作者报告了一例46岁男性慢性精神分裂症患者的病例,该患者接受抗精神病药物治疗,在肌肉注射氯丙嗪后约半小时死亡。基于尸检、显微镜检查和毒理学结果、临床特征和情况,以及排除其他可能的暴力和病态死亡原因,确定意外猝死是由注射药物氯丙嗪引起的过敏性过敏反应所致。