title: A motor vehicle accident fatality involving the inhalation of 1,1-difluoroethane.
abstract: A 24-year-old female driver with a history of substance abuse was pronounced dead following a single car motor vehicle accident. A surviving front seat passenger witnessed the decedent inhaling "Dust Off" cleaner just prior to losing control of the vehicle. The propellant compound used in this product is the halogenated hydrocarbon 1,1-difluoroethane (DFE). Sealed autopsy specimens were examined for the presence and subsequent quantitation of DFE utilizing an Agilent 6850 gas chromatograph (GC)-flame-ionization detector. The levels of DFE obtained were as follows: 29.8 mg/L in femoral blood, 40.3 mg/L in pulmonary arterial blood, 85.6 mg/L in aortic blood, 79.9 mg/L in chest cavity blood, 21.2 mg/L in vitreous, 11.7 mg/kg in brain, 27.9 mg/kg in liver, 71.0 mg/L in urine, and 51.8 mg/total gastric contents. The presence of DFE was confirmed in the decedent's urine by injection on an Agilent 6890/5973 GC-mass spectrometer in full scan mode. This case presents a uniquely witnessed observation of the apparent impairing effects and consequences of the acute inhalation of halogenated hydrocarbons such as DFE and the operation of a motor vehicle. The proximity of time of death to inhalant use may also provide insight to postmortem distribution patterns of DFE in relation to normal physiologic blood flow. With further investigations, estimating the time of final use of an inhalant prior to death may be deciphered from such patterns, although a degree of caution should be applied in deaths resulting from severe trauma in which normal tissue structure is compromised because postmortem redistribution may result.
authors.affiliation: Department of Forensic Toxicology, Division of Medical-Legal and Forensic Investigations, Suffolk County, Hauppage, New York, USA. timothy.hahn@suffolkcountyny.gov
authors.forename: Timothy
authors.initials: T
authors.lastname: Hahn
authors.forename: Joseph
authors.initials: J
authors.lastname: Avella
authors.forename: Michael
authors.initials: M
authors.lastname: Lehrer
mesh_terms: D000063:Accidents, Traffic / Q000401:mortality; D000328:Adult; D000336:Aerosols; D017809:Fatal Outcome; D005260:Female; D053593:Forensic Toxicology / Q000379:methods*; D008401:Gas Chromatography-Mass Spectrometry; D006801:Humans; D006845:Hydrocarbons, Fluorinated / Q000009:adverse effects* / Q000493:pharmacokinetics; D019570:Inhalation Exposure; D011605:Psychoses, Substance-Induced / Q000175:diagnosis / Q000209:etiology / Q000378:metabolism; D012997:Solvents / Q000009:adverse effects* / Q000493:pharmacokinetics; D015813:Substance Abuse Detection / Q000379:methods; D019966:Substance-Related Disorders / Q000175:diagnosis / Q000209:etiology* / Q000378:metabolism
chemical_list: D000336:Aerosols; D006845:Hydrocarbons, Fluorinated; D012997:Solvents; C059268:1,1-difluoroethane