title: An uncommon case of a suicide with inhalation of hydrogen cyanide.
abstract: An uncommon suicide by oral ingestion of potassium cyanide salts and contemporaneous inhalation of hydrogen cyanide is presented. A 48-year-old tradesman was found dead sitting in his car. A penetrating odor of bitter almonds was noticed when opening the doors. A camping stove and a cooking pot containing large amounts of dark blue crystals were found in the footwell of the car. White powder adhered to his fingers and to the area around the mouth. Furthermore bottles containing potassium ferrocyanide and different kinds of acid and leach were found in the car together with internet information about, e.g. potassium ferrocyanide and potassium cyanide. At autopsy hemorrhages and erosions of the mucosa of the respiratory tract, esophagus and stomach were found. Concentrations of cyanide were 0.2mg/l in stomach contents, 0.96mg/kg in brain tissue, 2.79mg/kg in lungs, and 5.3mg/l in blood. The white and toxic powder potassium cyanide was formed by heating of the yellow crystals of potassium ferrocyanide on the camping stove. This powder was probably ingested orally. Addition of acid converted the salt into the highly toxic gas hydrogen cyanide. Oxidation with atmospheric oxygen built the dark blue ferrous compound Prussian blue. This case report of a person who was not familiar with chemicals demonstrates the acquisition of professional information via the internet, enabling a suicide with a complex procedure.
authors.affiliation: Institute of Forensic Medicine, Stiftsplatz 12, 53111 Bonn, Germany. f.musshoff@uni-bonn.de
authors.forename: F
authors.initials: F
authors.lastname: Musshoff
authors.forename: K M
authors.initials: KM
authors.lastname: Kirschbaum
authors.forename: B
authors.initials: B
authors.lastname: Madea
mesh_terms: D001923:Brain Chemistry; D001980:Bronchi / Q000473:pathology; D002057:Burns, Chemical / Q000473:pathology; D020378:Confined Spaces; D003296:Cooking; D003486:Cyanides / Q000032:analysis; D005295:Ferrocyanides / Q000737:chemistry; D049429:Forensic Pathology; D053593:Forensic Toxicology; D005740:Gases; D005766:Gastrointestinal Contents / Q000737:chemistry; D006361:Heating; D006470:Hemorrhage / Q000473:pathology; D006801:Humans; D006856:Hydrogen Cyanide / Q000737:chemistry / Q000506:poisoning*; D008168:Lung / Q000737:chemistry; D008297:Male; D008875:Middle Aged; D011042:Poisons; D011190:Potassium Cyanide / Q000737:chemistry / Q000506:poisoning; D020545:Respiratory Mucosa / Q000473:pathology; D013405:Suicide
chemical_list: D003486:Cyanides; D005295:Ferrocyanides; D005740:Gases; D011042:Poisons; D006856:Hydrogen Cyanide; C031835:potassium ferrocyanide; D011190:Potassium Cyanide