Various Forms of Fatal Nicotine Intoxications: Three Cases Report.

Joo, Jin Woo; Kim, Minjung; Park, Min Jee; Ha, Hongil

doi:2018.42.2.71

Korean J Leg Med > Volume 42(2); 2018 > Article

Case Report

Korean Journal of Legal Medicine 2018;42(2):71-75.
DOI: https://doi.org/10.7580/kjlm.2018.42.2.71 Published online May 31, 2018.

Various Forms of Fatal Nicotine Intoxications: Three Cases Report.

Jin Woo Joo, Minjung Kim, Min Jee Park, Hongil Ha

¹Department of Pathology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
²Division of Forensic Medicine, National Forensic Service Daejeon Institute, Daejeon, Korea.
³Division of Forensic Investigation, National Forensic Service Seoul Institute, Seoul, Korea. sanchee@korea.kr

Abstract

Recently, fatal nicotine intoxications with electronic cigarette liquid have increased in Korea, but various kinds of cigarettes and smoking cessation aids may also cause fatal poisoning. We report cases of fatal nicotine intoxications involving causes other than the use of liquid nicotine. A 29-year-old woman (case 1) found dead in a hotel room with about 70 patches (21 mg dose) of nicotine on her body. Blood nicotine levels were 7.68 mg/L (heart) and 3.25 mg/L (femoral). A toxic level of zolpidem was also detected. A 28-year-old Uzbekistan man (case 2) was found dead in his uncle's room with his face covered with chewing tobacco. Blood nicotine levels were 7.3 mg/L (heart) and 4.6 mg/L (femoral). Blood alcohol level was 0.139%. A 55-year-old man (case 3) bit his tongue. As he was taken to the hospital, his wife put tobacco powders in his mouth for hemostasis, and he died of cardiac arrest. Blood nicotine levels were 2.01 mg/L (heart) and 0.96 mg/L (femoral). Nicotine-related deaths can be caused by various types of administration including transdermal and transmucosal routes, and relatively small doses may cause death, so meticulous investigation should be taken when such deaths are suspected.

Key Words: Nicotine, Tobacco use cessation products, Tobacco, Death