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Establishment of the methods for diagnosing cause of death following drug administration

Research Project

Project/Area Number 13670427
Research Category

Grant-in-Aid for Scientific Research (C)

Allocation TypeSingle-year Grants
Section一般
Research Field Legal medicine
Research InstitutionKyushu University

Principal Investigator

KUDO Keiko  Graduate School of Medical Sciences, Lecturer, 大学院・医学研究院, 講師 (10186405)

Co-Investigator(Kenkyū-buntansha) TSUJI Akiko  Graduate School of Medical Sciences, Assistant, 大学院・医学研究院, 助手 (10171993)
NISHIDA Naoki  Akita University, School of Meicine, Lecturer, 医学部, 講師 (10315088)
IKEDA Noriaki  Graduate School of Medical Sciences, Professor, 大学院・医学研究院, 教授 (60176097)
Project Period (FY) 2001 – 2002
Project Status Completed (Fiscal Year 2002)
Budget Amount *help
¥3,400,000 (Direct Cost: ¥3,400,000)
Fiscal Year 2002: ¥1,300,000 (Direct Cost: ¥1,300,000)
Fiscal Year 2001: ¥2,100,000 (Direct Cost: ¥2,100,000)
Keywordsmedical accident / local anesthesia / antipsychotics / sudden death / high spinal anesthesia / disinfectant / 刺激伝導系 / 医療事故の鑑定 / テトラカイン / クロルヘキシジン / 麻酔薬
Research Abstract

We have experienced a case where a patient died during spinal anesthesia induced by tetracaine, and the cause of death was supposed to be high spinal anesthesia. In order to prove high spinal anesthesia, we first establish the sensitive method to determine tetracaine and its metabolite using GC/MS, and measured the tissue levels of tetracaine and its metabolite in the case and blood levels following normal spinal anesthesia. Distribution of tetracaine and its metabolite in rabbits after high versus normal spinal anesthesia was also measured, and we could establish the method to diagnose high spinal anesthesia. Using this method, the cause of death of the case was proved to be high spinal anesthesia.
Chlorthexidine is an effective antibacterial agent and has been widely used in hospital as an antiseptic agent and as a disinfectant. Because chlorhexidine gluconate solution can be found in many places in a hispital, accidental intravenous injection of this fluid into a patient is possible. We have established a simple and reliable HPLC method using a polymer-coated ODS column and determined the serum levels of a patient who died after a suspected intravenous injection of chlorhexidine gluconate.
Sudden unexpected death is occasionally seen in psychiatric patients, and various cuases of death including cardiovascular insufficiency have been reported. We found microscopic cardiopulmonary abnormalities in 2 cases of sudden death in obese psychiatric patients whose blood levels of psychiatric drugs were not high enough. Therefore, these abnormalities may be significant findings in obese psychiatric patients and may help in investigations into the manner of death.

Report

(3 results)
  • 2002 Annual Research Report   Final Research Report Summary
  • 2001 Annual Research Report
  • Research Products

    (12 results)

All Other

All Publications (12 results)

  • [Publications] Kudo K, Hino Y, Ikeda N et al.: "Blood concentrations of tetracaine and its metabolite following spinal anesthesia"Forensic Sci Int. 116. 9-14 (2001)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      2002 Final Research Report Summary
  • [Publications] Hino Y, Inoue H, Kudo K et al.: "Distribution of tetracaine and its metabolite in rabbits after high versus normal spinal anesthesia"Forensic Sci Int. 124. 130-136 (2001)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      2002 Final Research Report Summary
  • [Publications] Hino Y, Kudo K, Kiyoshima A et al.: "A sudden death following tetracaine-induced spinal anesthesia"Legal Med. 4. 55-59 (2002)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      2002 Final Research Report Summary
  • [Publications] Kudo K, Ikeda N, Kiyoshima A et al.: "Toxicological analysis of chiorhexidine in human serum using HPLC on a polymer coated ODS column"J Anal Toxicol. 26. 119-122 (2002)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      2002 Final Research Report Summary
  • [Publications] Kudo K, Hino Y, Ikeda N et al.: "Blood concentrations of tetracaine and its metabolite following spinal anesthesia"Forensic Sci Int. 116. 9-14 (2001)

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      2002 Final Research Report Summary
  • [Publications] Hino Y, Inoue H, Kudo K et al.: "Distribution of tetracaine and its metabolite in rabbits after high versus normal spinal anesthesia"Forensic Sci Int. 124. 130-136 (2001)

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      2002 Final Research Report Summary
  • [Publications] Hino Y, Kudo K, Kiyoshima A et al.: "A sudden death following tetracaine-induced spinal anesthesia"Legal Med. 4. 55-59 (2002)

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      2002 Final Research Report Summary
  • [Publications] Kudo K, Ikeda N, Kiyoshima A et al.: "Toxicological analysis of chlorhexidine in human serum using HPLC on a polymer coated ODS column"J Anal Toxicol. 26. 119-122 (2002)

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      2002 Final Research Report Summary
  • [Publications] Kudo K, Hino Y, Ikeda N et al.: "Blood concentrations of tetracaine and its metabolite following spinal anesthesia"Forensic Sci Int. 116. 9-14 (2001)

    • Related Report
      2001 Annual Research Report
  • [Publications] Hino Y, Inoue H, Kudo K et al.: "Distribution of tetracaine and its metabolite in rabbits after high versus normal spinal anesthesia"Forensic Sci Int. (in press).

    • Related Report
      2001 Annual Research Report
  • [Publications] Hino Y, Kudo K, Kiyoshima A et al.: "A sudden death following tetracaine-induced spinal anesthesia"Legal Med. (in press).

    • Related Report
      2001 Annual Research Report
  • [Publications] Kudo K, Ikeda N, Kiyoshima A et al.: "Toxicological analysis of chlorhexidine in human serum using HPLC on a Polymer coated ODS column"J Anal Toxicol. (in press).

    • Related Report
      2001 Annual Research Report

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Published: 2001-04-01   Modified: 2016-04-21  

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