Forensic Features of Pharmacobezoars

Three cases of pharmacobezoars are reported to demonstrate typical autopsy findings and potential lethal mechanisms: (i) A 32‐year‐old woman died following an overdose of prescription medications. A gelatinous pharmacobezoar was found forming a cast of her bronchial tree. (ii) A 24‐year‐old woman al...

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Bibliographic Details
Published in:Journal of forensic sciences 2015-03, Vol.60 (2), p.341-345
Main Authors: England, Georgina, Heath, Karen J., Gilbert, John D., Byard, Roger W.
Format: Article
Language:English
Subjects:
Adult
Aged
airway obstruction
Airway Obstruction - etiology
asphyxia
Asphyxia - etiology
aspiration
Autopsies
Bezoars - pathology
Bronchi
Drug Overdose
Drug-Related Side Effects and Adverse Reactions
Esophagus
Female
Forensic Pathology
forensic science
Forensic sciences
Forensic Toxicology
Humans
Larynx
Male
pharmacobezoars
Prescription drugs
reflux
sudden death
Tablets
Young Adult
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Summary:Three cases of pharmacobezoars are reported to demonstrate typical autopsy findings and potential lethal mechanisms: (i) A 32‐year‐old woman died following an overdose of prescription medications. A gelatinous pharmacobezoar was found forming a cast of her bronchial tree. (ii) A 24‐year‐old woman also died following an overdose of prescription medications. At autopsy, two pharmacobezoars were present, one within the larynx and another occluding the right main bronchus. Deaths in both cases were attributed to airway occlusion by pharmacobezoars complicating mixed drug toxicity. (iii) A 79‐year‐old man was found dead in a car. Death was attributed to the combined effects of carbon monoxide and drug toxicity with a large pharmacobezoar lodged within the esophagus. Pharmacobezoars are specific types of bezoars that occur when pharmaceutical materials, such as tablets, suspensions, and/or drug delivery devices, aggregate and contribute to death by occluding airways with tenacious material or by eluting drugs.
ISSN:0022-1198
1556-4029
DOI:10.1111/1556-4029.12679