title: Nitrous oxide determination in postmortem biological samples: a case of serial fatal poisoning in a public hospital.
abstract: In a public hospital, eight cases of fatal poisoning by nitrous oxide (N(2)O) occurred under oxygen administration, due to an erroneous swapping of the lines in the gas system. The aim of the study was to clarify the factors involved in asphyxia by characterizing gases from different lines and measuring N(2)O concentrations in postmortem biological samples from bodies exhumed. Analyses carried out on the gas system confirmed the erroneous substitution of O(2) line with N(2)O and air line with O(2). Consequently, high N(2)O amounts were revealed in several tissues and gaseous biological samples. All specimens were analyzed by headspace gas chromatography technique. A rigorous quantitative analysis was possible only in blood (11.29-2152.04 mg/L) and urine (95.11 mg/L) and in air samples from stomach and trachea (from 5.28 to 83.63 g/m(3)). This study demonstrates that N(2)O can be detected in biological samples even 1 month after death.
authors.affiliation: National Institute of Occupational Safety and Prevention Research Center at the University of Parma, via Gramsci 14, 43100 Parma, Italy. diana.poli@unipr.it
authors.forename: Diana
authors.initials: D
authors.lastname: Poli
authors.forename: Roberto
authors.initials: R
authors.lastname: Gagliano-Candela
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Strisciullo
authors.forename: Anna P
authors.initials: AP
authors.lastname: Colucci
authors.forename: Luigi
authors.initials: L
authors.lastname: Strada
authors.forename: Domenica
authors.initials: D
authors.lastname: Laviola
authors.forename: Matteo
authors.initials: M
authors.lastname: Goldoni
authors.forename: Antonio
authors.initials: A
authors.lastname: Mutti
mesh_terms: D000059:Accidents; D000368:Aged; D000369:Aged, 80 and over; D018712:Analgesics, Non-Narcotic / Q000032:analysis* / Q000506:poisoning*; D002849:Chromatography, Gas; D049249:Exhumation; D005260:Female; D053593:Forensic Toxicology; D005740:Gases; D006779:Hospitals, Public; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D019300:Medical Errors; D009609:Nitrous Oxide / Q000032:analysis* / Q000506:poisoning*; D013270:Stomach / Q000737:chemistry; D014132:Trachea / Q000737:chemistry
chemical_list: D018712:Analgesics, Non-Narcotic; D005740:Gases; D009609:Nitrous Oxide