The authors recently reported about the complex suicide of a former veterinarian who injected xylazine and levomethadone together with T61, which is normally used for the euthanasia of domestic and laboratory animals (1). Furthermore, various analgesics were detected in biological samples, probably taken as painkillers for an existing cancer disease. The quaternary ammonium compound mebezonium iodide, an acetylcholine inhibitor, is an active ingredient of T61, in addition to embutramide and tetracaine (2). Embutramide has narcotic properties and induces deep anesthesia and an inhibition of the respiratory center located in the brainstem. Tetracaine is a local anaesthetic substance and decreases painful reactions at injection sites. A recent report by the authors summarized cases of suicides or homicides involving the use of T61 (1). However, in most cases, embutramide, which is exclusively used in T61, was the only substance analyzed because of analytical difficulties when analyzing quarternary ammonium compounds like mebezonium. Before this report, mebezonium was only analyzed in two cases, once by thin-layer chromatography followed by ultraviolet spectrophotometry after elution from silica gel (3), and later by liquid-chromatography –mass spectrometry with quantification by a specific ion, m/z 294 (4). Because there are relatively few authentic cases reported in the literature, the distribution and concentration of all three ingredients of T61 in the body of a new case appears worthwhile to communicate. A 40-year-old male was found dead in the gateway of his home. In a garage 15 m away, opened bottles of wine, sherry and rum were found, as were a depleted 20 mL syringe, an opened pharmaceutical vial of T61 (50 mL with a rest of 5 mL) and a suicide note. Three years ago, T61 had been used for euthanasia of the Saint Bernard dog of the family and the veterinary surgeon had forgotten the rest of the drug, which was stored in the cellar. Autopsy findings The body weight was 84.1 kg and body height was 174.5 cm. No signs of external violence were observed. An injection mark was found over the back of the left hand with edema of the subcutaneous tissues. Another skin injection mark was noted on the palm of the left wrist, also with edema of the subcutaneous tissues. The subcutaneous tissues of both injection sites were dark black with discoloration. Edematous swelling of the subcutaneous tissues of the left forearm was observed, as were extreme congestion of internal organs, cerebral and pulmonary edema, acute pulmonary emphysema and advanced coronary atherosclerosis.