title: Unusual way of suicide by carbon monoxide. Case Report.
abstract: OBJECTIVE
  Authors discuss the case of a suicide of a 29-year-old man caused by carbon monoxide (CO) intoxication. What the authors found interesting was the unusual way of committing suicide that required good technical skills and expert knowledge.
  
  
  METHODS
  The level of carboxyhemoglobin (COHb) in the blood of the deceased man was routinely determined by the modified method by Blackmoore (1970), using gas chromatography/thermal conductivity detection. The level of saturation of the hemoglobin by CO in the collected blood sample is determined relatively to the same sample saturated to 100%.
  
  
  RESULTS
  In the blood sample of the deceased man the lethal concentration of COHb of 76.5% was determined. Within the following examinations the blood alcohol concentration of 0.05 g.kg(-1) was determined. Further analysis revealed traces of sertraline, its metabolite N-desmethylsertraline, omeprazole and caffeine in the liver tissue, traces of N-desmethylsertraline, ibuprofen and caffeine in urine sample, and only traces of caffeine in the stomach content and blood samples were proved. To commit suicide the man used a sophisticated double container-system equipped with a timer for controlled generation of CO based on the chemical reaction of concentrated sulphuric acid and formic acid. The used timer was set by an electromechanical timer switch that triggered the fatal reaction of the acids while the man was sleeping.
  
  
  CONCLUSIONS
  The authors discuss an unusual case of suicide by CO intoxication rarely seen in the area of forensic medicine and toxicology that is specific due to its sophisticated way of execution.
authors.affiliation: Institute of Forensic Medicine, St. Anne's University Hospital Brno and Masaryk University, Faculty of Medicine, Brno, Czech Republic.
authors.forename: Michal
authors.initials: M
authors.lastname: Zelený
authors.affiliation: Institute of Forensic Medicine, St. Anne's University Hospital Brno and Masaryk University, Faculty of Medicine, Brno, Czech Republic.
authors.forename: Jan
authors.initials: J
authors.lastname: Pivnička
authors.affiliation: Institute of Forensic Medicine, St. Anne's University Hospital Brno and Masaryk University, Faculty of Medicine, Brno, Czech Republic.
authors.forename: Martin
authors.initials: M
authors.lastname: Šindler
authors.affiliation: Fire Rescue Service of the South Moravian Region, Department Tišnov, Czech Republic.
authors.forename: Pavel
authors.initials: P
authors.lastname: Kukleta
mesh_terms: D000328:Adult; D002248:Carbon Monoxide / Q000138:chemical synthesis*; D002249:Carbon Monoxide Poisoning; D002263:Carboxyhemoglobin / Q000032:analysis; D053593:Forensic Toxicology; D005561:Formates / Q000737:chemistry; D006801:Humans; D008297:Male; D013405:Suicide; D013464:Sulfuric Acids / Q000737:chemistry
chemical_list: D005561:Formates; D013464:Sulfuric Acids; C030544:formic acid; D002248:Carbon Monoxide; D002263:Carboxyhemoglobin; C033158:sulfuric acid