Is old stuff back? A fatal case of ethyl chloride sniffing

Jennifer P Pascali,Paolo Fais,Guido Viel,Giovanni Cecchetto,Massimo Montisci

doi:10.1186/s41935-019-0136-4

Jennifer P Pascali, Paolo Fais + Show 3 more

Open Access

https://doi.org/10.1186/s41935-019-0136-4

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Abstract

BackgroundEthyl chloride (EC) or chloroethane is a colourless halogenated hydrocarbon gas regularly employed as a topical anaesthetic spray for pain-related injuries and muscle spasm in athletes. However, EC became also popular as a street drug in the 1980s. Brief inhalations of EC vapour can result in dizziness, euphoria, confusion, incoordination, hallucinosis, impairment of short-term memory and narcosis. Inhalation of higher doses, usually employed to “get high”, may be related to severe depression of the central nervous system. Indeed, toxicity and deaths have been reported so far.Case presentationA 40-year-old man was found unresponsive after EC inhalation. EC determination was performed by dynamic headspace gas chromatography coupled to mass spectrometry. EC was detected in the peripheral blood (0.156 g/L), central blood concentration (0.203 g/L) and the lung and brain (19 and 25 mg/kg). EC in the vitreous humour showed a sensitively lower respect to blood (0.018 vs 0.203 g/L).ConclusionsConsidering the results of toxicological analyses of investigations on the death scene besides the absence of any signs of trauma, death was attributed to inhalation of ethyl chloride.

Highlights

Ethyl chloride (EC) or chloroethane is a colourless halogenated hydrocarbon gas regularly employed as a topical anaesthetic spray for pain-related injuries and muscle spasm in athletes
We describe a case of fatal intoxication due to EC sniffing, providing medico-legal considerations and toxicological findings on different tissues, contributing to the casuistic over the inhalant intoxications, which determination may be difficult if some precautions on sample collection and storage at the crime scene are missing
Literature on EC fatal exposures is scarce, and this interpretation of toxicological results is supported exclusively by the case reported by Broussard et al Loss of ethyl chloride from collected samples was prevented by using tight-seal headspace vials; no important differences were observed between the results of blood collected at the crime scene (0.165 g/L) and at the autopsy (0.156 g/L) because autopsy was promptly performed during the following day

Summary

Conclusions

The death scene investigation immediately suggested to examine ethyl chloride’s role in causing the death, confirming the importance of a correct and comprehensive crime scene investigation (Fais et al 2017). The class of the inhalants is reported to be abused for recreational purposes by young male adults, and a review of cases has been proposed by Senussi and colleagues (Senussi and Chalise 2015). This case reminds the importance of a comprehensive investigation on the death scene, bearing in mind toxicological issues. A proper toxicological sampling and collection both on the crime scene and at the autopsy is mandatory especially in cases of fatal volatile intoxications in order to avoid volatile dispersion. Quali-quantitative toxicological analyses seemed mandatory on non-biological samples retrieved along the death scene investigation.

Background

Results

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