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A Fatal Case of CO2 Intoxication in a Fermentation Tank

Authors

  • Mattias Kettner M.D.,

    Corresponding author
    1. Department of Experimental Forensic Medicine, Institute of Forensic Medicine, University of Saarland Medical School, Homburg/Saarland, Germany
    • Departments of Forensic Medicine, Forensic Toxicology, and Forensic Molecular Biology, Institute of Forensic Medicine, Goethe-University Frankfurt/M., Frankfurt/M, Germany
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  • Frank Ramsthaler M.D.,

    1. Departments of Forensic Medicine, Forensic Toxicology, and Forensic Molecular Biology, Institute of Forensic Medicine, Goethe-University Frankfurt/M., Frankfurt/M, Germany
    2. Department of Experimental Forensic Medicine, Institute of Forensic Medicine, University of Saarland Medical School, Homburg/Saarland, Germany
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  • Christian Juhnke Dipl.Ing.,

    1. Department of Low Temperature and Vacuume Technology, University of Applied Sciences, Frankfurt/M, Germany
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  • Roman Bux M.D.,

    1. Departments of Forensic Medicine, Forensic Toxicology, and Forensic Molecular Biology, Institute of Forensic Medicine, Goethe-University Frankfurt/M., Frankfurt/M, Germany
    2. Departments of Forensic Medicine, Forensic Toxicology, and Forensic Molecular Biology, Institute of Forensic Medicine, University of Heidelberg Medical School, Heidelberg, Germany
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  • Peter Schmidt M.D.

    1. Departments of Forensic Medicine, Forensic Toxicology, and Forensic Molecular Biology, Institute of Forensic Medicine, Goethe-University Frankfurt/M., Frankfurt/M, Germany
    2. Department of Experimental Forensic Medicine, Institute of Forensic Medicine, University of Saarland Medical School, Homburg/Saarland, Germany
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Additional information and reprint requests:

Mattias Kettner, M.D.

Department of Experimental Forensic Medicine

Institute of Forensic Medicine

University of Saarland Medical School

Building 42

66421 Homburg/Saarland

Germany

E-mail: Mattias.Kettner@uniklinikum-saarland.de

Abstract

Carbon dioxide (CO2) is an odorless constituent of air. Higher concentrations can be detected in geothermal and automotive emissions, fermentation, and sublimation of dry ice. An unskilled worker entered a fermentation tank to clean it, which had not been done for about 5 months allowing for high concentrations of CO2 to build up. A second worker entered the tank to rescue the first one. Shortly after both were found the first worker was rescued directly whereas the tank had to be rotated to pull the second worker out. Cardiopulmonary resuscitation was successful only for the first worker. Medico-legal autopsy showed bruises, hematoma, myocardial hemorrhage, and edema of the lungs. The right lung was vacuum degassed in an argon atmosphere and quadrupole-mass-spectrometry showed an elevated CO2 content in lung gases. Thus, CO2 intoxication/asphyxia in a vitiated atmosphere due to fermentation of wine mash was established as the cause of death.

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