Death due to anaphylactic shock secondary to intravenous self-injection of Toradol: a case report and review of the literature.
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.
Oliva
Antonio
A
Institute of Forensic Medicine, Catholic University, School of Medicine, Rome, Italy.
De Giorgio
Fabio
F
Arena
Vincenzo
V
Fucci
Nadia
N
Pascali
Vincenzo L
VL
Navarra
Pierluigi
P
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
D000894:Anti-Inflammatory Agents, Non-Steroidal; D020911:Ketorolac Tromethamine