Medical Findings and Toxicological Analysis in Infant Death by Balloon Gas Asphyxia: A Case Report.
In recent years, the increasing number of asphyxiation cases due to helium inhalation is remarkable. All described cases in the literature where diagnosed as suicide. In this article, however, we describe a triple infant homicide in which helium, as balloon gas, was administered to three young children after sedation causing asphyxiation and death through the medical findings and toxicological analysis. During autopsy, in addition to standard toxicological samples, gas samples from lungs as well as lung tissue itself were directly collected into headspace vials. Besides routine toxicological analysis, which revealed toxic levels of doxylamine, qualitative analysis on gas and lung samples was performed using headspace gas chromatography-mass spectrometry. As carrier gas, the commonly used helium was replaced by nitrogen. In gas samples from lungs of all three children, no helium was found. Nevertheless, lung tissue samples were found positive on helium. Therefore, sedation followed by asphyxia due to helium inhalation can strongly be assumed as the cause of death of all three children.
KU Leuven Toxicology and Pharmacology, Campus Gasthuisberg, Onderwijs en Navorsing 2, Herestraat 49, PO box 922, 3000 Leuven, Belgium.
Eva
E
Cuypers
KU Leuven Toxicology and Pharmacology, Campus Gasthuisberg, Onderwijs en Navorsing 2, Herestraat 49, PO box 922, 3000 Leuven, Belgium.
Elien
E
Rosier
KU Leuven Toxicology and Pharmacology, Campus Gasthuisberg, Onderwijs en Navorsing 2, Herestraat 49, PO box 922, 3000 Leuven, Belgium.
Sara
S
Loix
KU Leuven, Imaging and Pathology Department, Division Forensic Biomedical Sciences, University of Leuven (KU Leuven), Campus Sint-Rafaël, Kapucijnenvoer 33, 3000 Leuven, Belgium.
Wim
W
Develter
KU Leuven, Imaging and Pathology Department, Division Forensic Biomedical Sciences, University of Leuven (KU Leuven), Campus Sint-Rafaël, Kapucijnenvoer 33, 3000 Leuven, Belgium.
Wouter
W
Van Den Bogaert
KU Leuven, Imaging and Pathology Department, Division Forensic Biomedical Sciences, University of Leuven (KU Leuven), Campus Sint-Rafaël, Kapucijnenvoer 33, 3000 Leuven, Belgium.
Joke
J
Wuestenbergs
KU Leuven, Imaging and Pathology Department, Division Forensic Biomedical Sciences, University of Leuven (KU Leuven), Campus Sint-Rafaël, Kapucijnenvoer 33, 3000 Leuven, Belgium.
Wim
W
Van de Voorde
KU Leuven Toxicology and Pharmacology, Campus Gasthuisberg, Onderwijs en Navorsing 2, Herestraat 49, PO box 922, 3000 Leuven, Belgium.
Jan
J
Tytgat
D000280:Administration, Inhalation; D001237:Asphyxia / Q000175:diagnosis*; D001344:Autopsy; D004319:Doxylamine / Q000378:metabolism / Q000633:toxicity; D006371:Helium / Q000378:metabolism*; D006634:Histamine H1 Antagonists / Q000378:metabolism / Q000633:toxicity; D006708:Homicide; D006801:Humans; D007223:Infant; D066088:Infant Death
D006634:Histamine H1 Antagonists; D006371:Helium; D004319:Doxylamine