title: 2-Methyl-4-chlorophenoxyacetic acid and bromoxynil herbicide death.
abstract: METHODS
  We report a fatal case of a 37 year old gentleman who ingested a MCPA/bromoxynil co-formulation herbicide. Although clinically well on initial examination, our patient declined dramatically over his 18 h admission with increasing CO2 production, hyperthermia and metabolic derangement to eventually die from cardiac asystole 20 h post ingestion. Two hours after ingestion the MCPA concentration was 83.9 μg/mL and bromoxynil concentration was 137 μg/mL.
  
  
  CONCLUSIONS
  The patients' mechanism of death appeared to be uncoupling of oxidative phosphorylation, excess CO2 production and hyperthermia. There is limited knowledge on the acute toxicity of these herbicides, in particular bromoxynil, and this case highlights the relentless progression of severe toxicity in humans.
authors: School of Medicine and Public Health, University of Newcastle , Newcastle, NSW , Australia.
authors: Ingrid
authors: I
authors: Berling
authors: Nicholas A
authors: NA
authors: Buckley
authors: Ahmed
authors: A
authors: Mostafa
authors: Michael A
authors: MA
authors: Downes
authors: Jeffrey
authors: J
authors: Grice
authors: Gregory
authors: G
authors: Medley
authors: Michael S
authors: MS
authors: Roberts
authors: Geoffrey K
authors: GK
authors: Isbister
mesh_terms: D008456:2-Methyl-4-chlorophenoxyacetic Acid / Q000506:poisoning*; D000328:Adult; D002245:Carbon Dioxide / Q000378:metabolism; D018450:Disease Progression; D017809:Fatal Outcome; D005334:Fever / Q000139:chemically induced / Q000503:physiopathology; D006323:Heart Arrest / Q000139:chemically induced / Q000503:physiopathology; D006540:Herbicides / Q000506:poisoning*; D006801:Humans; D000860:Hypoxia / Q000139:chemically induced / Q000378:metabolism; D008297:Male; D009570:Nitriles / Q000506:poisoning*; D010085:Oxidative Phosphorylation / Q000187:drug effects; D011041:Poisoning / Q000175:diagnosis / Q000209:etiology* / Q000378:metabolism / Q000503:physiopathology; D013997:Time Factors
chemical_list: D006540:Herbicides; D009570:Nitriles; D002245:Carbon Dioxide; D008456:2-Methyl-4-chlorophenoxyacetic Acid; C006826:bromoxynil
keywords: 2-Methyl-4-chlorophenoxyacetic Acid; Herbicides; Overdose, Poisoning, Uncoupling agents, Analysis, Bromoxynil, Death