title: A series of hospital homicides.
abstract: Patient deaths in hospitals due to medical staff are very rare. In the autumn of 2006, preliminary proceedings were initiated against a nurse on account of an overdose of medication leading to death, administered during her care of the patient. In the course of these proceedings, exhibits relating to the deaths of a total of 13 patients who had died due to chemical-toxicological causes were reviewed. Nine of them were exhumed. On average, death had occurred 22 months prior to exhumation (range of 1-34 months). The average age of the deceased was 76 years (range of 65-92 years). In five of the cases, analysis results and an evaluation of the medical records confirmed that a final, undocumented dose of sodium nitroprusside or midazolam was administered. After administration of sodium nitroprusside, the active agent rapidly releases nitrogen monoxide, itself undetectable. Another indicator that can be detected, however, is the cyanide that is also released. In one of the exhumed patients, cyanide could still be detected 18 months after death. The nurse stated that her motive was sympathy towards seriously ill patients. She was sentenced res judicata to life imprisonment on five counts of causing the death of a patient.
authors.affiliation: State Institute of Legal and Social Medicine, Turmstrasse 21, Haus L, 10559 Berlin, Germany. edwin.ehrlich@germed.berlin.de
authors.forename: Edwin
authors.initials: E
authors.lastname: Ehrlich
authors.forename: Benno
authors.initials: B
authors.lastname: Riesselmann
authors.forename: Michael
authors.initials: M
authors.lastname: Tsokos
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003486:Cyanides / Q000097:blood; D049249:Exhumation; D005260:Female; D005554:Forensic Medicine; D053593:Forensic Toxicology; D005858:Germany; D006708:Homicide; D006801:Humans; D006993:Hypnotics and Sedatives / Q000097:blood / Q000506:poisoning; D008297:Male; D008874:Midazolam / Q000097:blood / Q000506:poisoning; D009042:Motivation; D009599:Nitroprusside / Q000008:administration & dosage / Q000506:poisoning; D009741:Nursing Staff, Hospital; D014665:Vasodilator Agents / Q000008:administration & dosage / Q000506:poisoning
chemical_list: D003486:Cyanides; D006993:Hypnotics and Sedatives; D014665:Vasodilator Agents; D009599:Nitroprusside; D008874:Midazolam