title: Death due to anaphylactic shock secondary to intravenous self-injection of Toradol: a case report and review of the literature.
abstract: A fatality due to the intravenous self-injection of Ketorolac (Toradol) is reported. Ketorolac is a nonsteroidal anti-inflammatory drug (NSAID) with marked analgesic activity. There is limited information of fatalities attributed to ketorolac toxicity. Here we report the case of a 53-year-old woman with a medical history of depression that was found deceased at home with no evidence of trauma or injuries. Near the body, a syringe and three empty vials (30 mg) of Toradol were found. A fresh needle mark on the right arm was noticed. Toxicological analyses were performed using a gas chromatography-mass spectrometry (GC/MS) technique. The estimated ketorolac concentration in the blood was 8 mug/ml; urine and gastric content were negative for this compound. Based on the autopsy, histologic findings and toxicological results of anaphylactic shock associated with ketorolac self-administration was assumed to be the underlying pathophysiological mechanism of death and the manner, suicide.
authors.affiliation: Institute of Forensic Medicine, Catholic University, School of Medicine, Rome, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Oliva
authors.forename: Fabio
authors.initials: F
authors.lastname: De Giorgio
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Arena
authors.forename: Nadia
authors.initials: N
authors.lastname: Fucci
authors.forename: Vincenzo L
authors.initials: VL
authors.lastname: Pascali
authors.forename: Pierluigi
authors.initials: P
authors.lastname: Navarra
mesh_terms: D000707:Anaphylaxis / Q000139:chemically induced* / Q000175:diagnosis*; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage / Q000097:blood / Q000506:poisoning*; D003937:Diagnosis, Differential; D017809:Fatal Outcome; D005260:Female; D008401:Gas Chromatography-Mass Spectrometry; D006801:Humans; D007275:Injections, Intravenous; D020911:Ketorolac Tromethamine / Q000008:administration & dosage / Q000097:blood / Q000506:poisoning*; D008875:Middle Aged; D011180:Postmortem Changes; D013405:Suicide
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D020911:Ketorolac Tromethamine