title: Fatal bupivacaine intoxication following unusual erotic practices.
abstract: A fatal drug overdose is described which involved unusual erotic practices. A 54-year-old male was discovered supine on the floor surrounded by sexual paraphernalia, syringes, and medications including three empty bottles of bupivacaine. Acute and chronic injection sites of the external genitalia with contusions, scarring, focal necrosis, and calcification were present at autopsy. Toxicology revealed femoral blood, heart blood, and vitreous bupivacaine concentrations of 3.8, 2.8 and 1.3 mg/L, respectively. The urine bupivacaine concentration was 11.4 mg/L. The cause of death was attributed to bupivacaine intoxication and the manner of death was accidental.
authors.affiliation: New Mexico Department of Health, Scientific Laboratory Division, Toxicology Bureau, Albuquerque, NM 87196-4700, USA.
authors.forename: Janice
authors.initials: J
authors.lastname: Yazzie
authors.forename: Sean C
authors.initials: SC
authors.lastname: Kelly
authors.forename: Ross E
authors.initials: RE
authors.lastname: Zumwalt
authors.forename: Sarah
authors.initials: S
authors.lastname: Kerrigan
mesh_terms: D000779:Anesthetics, Local / Q000008:administration & dosage / Q000097:blood / Q000506:poisoning*; D002045:Bupivacaine / Q000008:administration & dosage / Q000097:blood / Q000506:poisoning*; D006801:Humans; D007269:Injections, Intra-Arterial; D008297:Male; D008875:Middle Aged; D010262:Paraphilic Disorders; D012611:Scrotum
chemical_list: D000779:Anesthetics, Local; D002045:Bupivacaine