Non-accidental carbon monoxide poisoning from burning charcoal in attempted combined homicide-suicide.

ABSTRACT

OBJECTIVE: To describe an emerging form of serious child abuse in combined homicide-suicide in Hong Kong. METHOD: This is a retrospective hospital chart review in a regional hospital in Hong Kong from January to December 2000. RESULTS: Eight children, with a mean age of 7.8 years (range 0.5-11 years), from four families were admitted to hospital because of non-accidental exposure to carbon monoxide when their parents attempted suicide by burning charcoal. A 7-year-old boy died on arrival. His 5.6-year-old sister and another 6-month-old boy had cerebral hypoxia on admission. Hyperbaric oxygen therapy was used in both cases, with rapid improvement, although there were persistent neurological deficits in the girl. The other children in the present study were asymptomatic and none had delayed neurological sequelae. Concomitant use of sedatives was also detected in three of the surviving patients. CONCLUSIONS: Non-accidental poisoning with carbon monoxide appears to be a new means of child abuse with potentially serious consequences. Concomitant intoxication with psychotropic drugs is common in such cases. The reason for parents killing their own children under such circumstances was unclear, but a desire to exact revenge on an estranged partner was suggested.