title: Three homicides with darts tainted with succinylcholine: autopsy and toxicology.
abstract: In emergency departments, intoxication with the muscle relaxant succinylcholine (SUX) often leads to a potentially lethal respiratory paralysis or other deleterious side effects. However, homicide cases with SUX poisoning are very rare because the toxic or lethal concentration ranges of SUX have not yet been determined. We described three uncommon homicide cases due to acute poisoning by darts contaminated with SUX. All the victims died quickly (less than 30 min) after being shot by an especially designed dart gun. Succinylmonocholine (SMC), a metabolite of SUX, was used as a marker to detect the latter. HPLC-MS/MS analysis demonstrated the presence of SUX in the droplet residues of the darts and SMC in the blood and urine in all cases. SMC concentrations of 0.45, 14.0, and 17.9 ng/ml were detected in the victims' blood and 259.0 ng/ml in the urine from the third case. The main pathological changes consisted of hemorrhage of the injured soft tissues, visceral congestion, severe pulmonary edema, and multifocal petechial hemorrhage of the heart and lungs. Taken together, the findings supported a diagnosis of fatal SUX poisoning. Futhermore, our study provided a reference for the lethal concentrations of SUX poisoning.
authors.affiliation: Department of Forensic Medicine, Tongji Medical College, Huazhong University of Science and Technology, No. 13 Hangkong Road, Wuhan, Hubei, 430030, China.|Medical School, Ningbo University, Ningbo, Zhejiang, 315211, China.
authors.forename: Jingjun
authors.initials: J
authors.lastname: Xing
authors.affiliation: Department of Forensic Medicine, Tongji Medical College, Huazhong University of Science and Technology, No. 13 Hangkong Road, Wuhan, Hubei, 430030, China.
authors.forename: Wenhe
authors.initials: W
authors.lastname: Li
authors.affiliation: Department of Forensic Medicine, Tongji Medical College, Huazhong University of Science and Technology, No. 13 Hangkong Road, Wuhan, Hubei, 430030, China.
authors.forename: Fang
authors.initials: F
authors.lastname: Tong
authors.affiliation: Department of Forensic Medicine, Tongji Medical College, Huazhong University of Science and Technology, No. 13 Hangkong Road, Wuhan, Hubei, 430030, China.
authors.forename: Yue
authors.initials: Y
authors.lastname: Liang
authors.affiliation: Institute of Forensic Science, Ministry of Public Security People's Republic of China, No. 17 Nanli Mulidi, Beijing, 100038, China. guanglong_he@163.com.
authors.forename: Guanglong
authors.initials: G
authors.lastname: He
authors.affiliation: Department of Forensic Medicine, Tongji Medical College, Huazhong University of Science and Technology, No. 13 Hangkong Road, Wuhan, Hubei, 430030, China. zhouyiwu@outlook.com.
authors.forename: Yiwu
authors.initials: Y
authors.lastname: Zhou
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood / Q000652:urine; D002851:Chromatography, High Pressure Liquid; D006708:Homicide; D006801:Humans; D008297:Male; D013058:Mass Spectrometry; D008875:Middle Aged; D009467:Neuromuscular Depolarizing Agents / Q000032:analysis / Q000506:poisoning*; D013390:Succinylcholine / Q000031:analogs & derivatives / Q000032:analysis / Q000097:blood / Q000506:poisoning* / Q000652:urine; D014951:Wounds, Stab
chemical_list: D015415:Biomarkers; D009467:Neuromuscular Depolarizing Agents; C035798:succinylmonocholine; D013390:Succinylcholine
keywords: Darts shooting; Fatal poisoning; Homicide; Muscle relaxant; Succinylcholine