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Suicide by Self-Administration of a Drug Mixture (Propofol, Midazolam, and Zolpidem) in an Anesthesiologist: The First Case Report in Italy

Authors

  • Anna Pia Colucci Ph.D.,

    1. Laboratory of Forensic Toxicology of Department of Internal Medicine and Public Health, University of Bari, Bari, Italy
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  • Roberto Gagliano-Candela Ph.D.,

    Corresponding author
    1. Chief of Laboratory of Forensic Toxicology of Department of Internal Medicine and Public Health, University of Bari, Bari, Italy
    • Laboratory of Forensic Toxicology of Department of Internal Medicine and Public Health, University of Bari, Bari, Italy
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  • Lucia Aventaggiato Ph.D.,

    1. Researcher of Laboratory of Forensic Toxicology of Department of Internal Medicine and Public Health, University of Bari, Bari, Italy
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  • Antonio De Donno M.D., Ph.D.,

    1. Department of Internal Medicine and Public Health, University of Bari, Bari, Italy
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  • Sabrina Leonardi M.D.,

    1. Department of Internal Medicine and Public Health, University of Bari, Bari, Italy
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  • Giuseppe Strisciullo H.S.D.,

    1. Laboratory of Forensic Toxicology of Department of Internal Medicine and Public Health, University of Bari, Bari, Italy
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  • Francesco Introna M.D., Ph.D.

    1. Department of Internal Medicine and Public Health, University of Bari, Bari, Italy
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  • Presented in poster form at the 63rd Annual Meeting of the American Academy of Forensic Sciences, February 21–26, 2011, in Chicago, IL.

Additional information and reprint requests:

Prof. Roberto Gagliano-Candela, Ph.D.

Laboratorio di Tossicologia Forense

Dipartimento di Medicina Interna e Medicina Pubblica

Sezione di Medicina Legale

Università di Bari

c/o Policlinico, P.zza G. Cesare 11

Bari 70124

Italia

E-mail: gagliano@tossicologia.uniba.it

Abstract

The authors report an unusual case of suicide of an anesthesiologist, in which the suicide manner and means depend upon the victim's occupation. This is the first case report published in Italy of a death involving propofol and other drugs. The anesthesiologist was found dead with an empty drip still inserted in the hand and another one near his body. Forensic and toxicological findings suggested that the cause of death was a respiratory depression due to a self-administration of a rapidly infused lethal drug mixture. Analytical drug quantification was performed by gas chromatography-mass spectrometry. Blood analysis revealed: zolpidem (0.86 μg/mL), propofol (0.30 μg/mL), midazolam (0.08 μg/mL), thiopental (0.03 μg/mL), and amitriptyline (0.07 μg/mL). Adipose tissue and hair analysis suggested a previous and repeated use of these drugs verifying the fact that in Italy recreational abuse of anesthetic and sedative agents in health care practitioners is becoming an increasing problem.

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