title: Fatal hepatic failure following accidental tramadol overdose.
abstract: A case of fatal overdose of tramadol is described, occurring in a 67-year-old man with painful rib fractures who accidentally ingested more than the recommended daily dose. The mode of death was acute liver failure due to fulminant hepatic necrosis. Post-mortem toxicology was negative apart from revealing a blood tramadol concentration well above the normal therapeutic range. This is the first report of fatal tramadol ingestion occurring in a therapeutic setting and also the first tramadol-related death where the mechanism was liver failure.
authors.affiliation: Department of Pathology, Belfast City Hospital, Lisburn Road, BT9 7AD Belfast, UK.
authors.forename: M B
authors.initials: MB
authors.lastname: Loughrey
authors.forename: C M
authors.initials: CM
authors.lastname: Loughrey
authors.forename: S
authors.initials: S
authors.lastname: Johnston
authors.forename: D
authors.initials: D
authors.lastname: O'Rourke
mesh_terms: D000059:Accidents; D000368:Aged; D000701:Analgesics, Opioid / Q000506:poisoning*; D062787:Drug Overdose; D017809:Fatal Outcome; D006801:Humans; D017114:Liver Failure, Acute / Q000139:chemically induced*; D008297:Male; D014147:Tramadol / Q000506:poisoning*
chemical_list: D000701:Analgesics, Opioid; D014147:Tramadol