title: [Fatal sodium chloride intoxication--case report and review of the literature].
abstract: The authors describe the case of a 63-year-old, female nursing home inhabitant suffering from trisomy 21, who accidentally ingested the anti-epileptic medication of another nursing home inhabitant. After telephone instructions from a specialist in internal medicine, caregivers forced the woman to vomit by means of saline solution and digital manipulation. This caused not only substantial hypernatriaemia but also aspiration pneumonia, from which the woman died after short hospitalization. The potential toxicity by major electrolyte shifts in terms of hypernatriaemia following administration of sodium chloride solution is well known; this measure is medically contraindicated for the induction of vomiting. The mechanisms leading to death in this case are presented, differentiated and discussed against the background of the literature.
authors.affiliation: Institut für Rechtsmedizin der Charité, Universitätsmedizin Berlin.
authors.forename: Claas T
authors.initials: CT
authors.lastname: Buschmann
authors.forename: Frank
authors.initials: F
authors.lastname: Lange
authors.forename: Michael
authors.initials: M
authors.lastname: Tsokos
mesh_terms: D000927:Anticonvulsants / Q000008:administration & dosage*; D001921:Brain / Q000473:pathology; D004314:Down Syndrome / Q000473:pathology*; D017809:Fatal Outcome; D005260:Female; D005858:Germany; D006801:Humans; D006955:Hypernatremia / Q000473:pathology*; D008168:Lung / Q000473:pathology; D008297:Male; D008318:Malpractice / Q000331:legislation & jurisprudence; D008508:Medication Errors / Q000331:legislation & jurisprudence*; D008875:Middle Aged; D011015:Pneumonia, Aspiration / Q000473:pathology*; D012462:Saline Solution, Hypertonic / Q000008:administration & dosage / Q000633:toxicity*; D014132:Trachea / Q000473:pathology
chemical_list: D000927:Anticonvulsants; D012462:Saline Solution, Hypertonic