title: Death caused by ingestion of an ethanol-based hand sanitizer.
abstract: BACKGROUND
  The use of hand sanitizer is effective in preventing the transmission of disease. Many hand sanitizers are alcohol-based, and significant intoxications have occurred, often in health care facilities, including the emergency department (ED).
  
  
  OBJECTIVE
  We present this case to highlight potential toxicity after the ingestion of an ethanol-based hand sanitizer.
  
  
  METHODS
  A 36-year-old man presented to the ED with ethanol intoxication. Ethanol breath analysis was measured at 278 mg/dL. After 4 h, the patient was less intoxicated and left the ED. Thirty minutes later, he was found apneic and pulseless in the ED waiting room bathroom after having ingested an ethanol-based hand sanitizer. Soon after a brief resuscitation, his serum ethanol was 526 mg/dL. He never regained consciousness and died 7 days later. No other cause of death was found.
  
  
  CONCLUSIONS
  The case highlights the potential for significant toxicity after the ingestion of a product found throughout health care facilities. Balancing the benefit of hand sanitizers for preventing disease transmission and their potential misuse remains a challenge.
authors.affiliation: Division of Medical Toxicology, Department of Emergency Medicine, University of California-San Diego Health System, San Diego, California 92103, USA.
authors.forename: Aaron B
authors.initials: AB
authors.lastname: Schneir
authors.forename: Richard F
authors.initials: RF
authors.lastname: Clark
mesh_terms: D000328:Adult; D000435:Alcoholic Intoxication / Q000150:complications*; D000431:Ethanol / Q000097:blood / Q000506:poisoning*; D017809:Fatal Outcome; D064548:Hand Sanitizers / Q000506:poisoning*; D006801:Humans; D008297:Male
chemical_list: D064548:Hand Sanitizers; D000431:Ethanol
keywords: alcohol; death; ethanol; hand sanitizer