Another case of diethyl ether intoxication?: a case report focusing on toxicological analysis.

Diethyl ether was widely used as an anesthetic agent in many countries in the second half of the 19th century and the first half of the 20th century. For this reason the majority of lethal cases involving diethyl ether reported during this period were associated with anesthesia. We present a case of asphyxial death by plastic-bag suffocation with additional detection of diethyl ether in autopsy specimens. Autopsy initially failed to reveal the cause of death. Macroscopic and microscopic findings as well as subsequent toxicological examination procedures and results are pointed out in the present case report. Headspace gas chromatography with flame ionization detection (HS-GC-FID) coupled with gas chromatography/mass spectrometry (GC-MS) proved to be the method of choice for fast and reliable analysis of unknown highly volatile substances (other than blood alcohol). In this case the detection of diethyl ether in autopsy specimens led to further investigations by the police at the death scene. During these investigations a bottle bearing a diethyl ether label was found and confiscated, which proved the insufficiency of prior death scene investigation. In order to evaluate the case from every possible angle, in such cases, especially when plastic-bag suffocation is suspected, we strongly recommend the collection of postmortem specimens in gas-tight vessels as well as the presence of a forensic expert at the death scene.

Distribution of ether in two postmortem cases.

Diethyl ether (ether) is a volatile liquid that was used in the 1800s as an anesthetic agent; however, it is no longer used for this purpose, partly because of its odor and flammability. Two postmortem cases in which ether was detected are presented. The first case was an 18-year-old male found hanging from a basement ceiling brace in a semi-sitting position with a gas mask covering his face. A container of Prestone starting fluid and a bong were found on the floor close to the body. The second case was a 20-year-old male found unresponsive in his dormitory room with two black plastic trash bags secured over his head. Two saturated rags and a resealable bag containing a clear liquid were contained within these trash bags. An almost empty can of Tradco starting fluid was also found at the scene. Ether concentrations were determined by headspace gas chromatography-mass spectrometry in the selective ion monitoring mode. In case #1, the medical examiner ruled that the cause of death was asphyxia due to hanging; the manner of death was undetermined. In case #2, the medical examiner ruled that the cause of death was asphyxia and the manner of death was suicide.

Ether: stability in preserved blood samples and a case of ether-assisted suicide.

Ethyl ether was detected in the blood of a deceased individual who had inhaled it from a mask while hanging himself. This case led to an investigation into the stability of ether in stored blood samples as described herein. Ether was spiked, at three concentrations, into batches of porcine blood. The blood was apportioned into grey-stoppered collection tubes and stored refrigerated until analysis. The concentration of ether in the blood was assessed at intervals over a two-month period. Analysis was performed by headspace gas chromatography. This study has shown, for a concentration range of 0.1 to 5.0 mg/mL, ether is stable in preserved, refrigerated blood for at least two months.

[Phenomenology of ether administration. With a review of the literature]. / Zur Phänomenologie bei Etherapplikation. Mit einer Literaturübersicht.

A 45-year-old man was found dead lying on a sofa in his house. He had pulled a plastic bag over his head, the bag containing a pad of cotton-wool soaked with diethylether. Different aspects are discussed in this paper including a review of the literature: anamnesis, scene of death, utensils used for inhalation and autopsy findings. There are especially pointed out the results of chemical-toxicological analyses in many body compartments. Furthermore are interpreted the manners and the relations of the distribution of ether as well as possible effects on the consciousness. In consideration of other published cases, the analytical results concerning ether are discussed with regard to the presumed cause of death (e.g. asphyxia) and other potential competitive mechanisms.

Near fatal respiratory distress following massive ether intravenous injection.

To the best of our knowledge, no case of ether-induced acute respiratory distress syndrome (ARDS) has been published as yet. A 36-year-old female developed pneumonitis which showed all the characteristics of a chemical-associated ARDS due to intravenous self-administration of ether: the hemodynamic investigation demonstrated a normal blood flow pattern with low left-heart filling pressure while the anteroposterior roentgenogram evidenced disseminated bilateral lung edema. Advanced symptomatic respiratory support including inhaled nitric oxide and steroidal anti-inflammatory use was the treatment of choice.

Diethyl ether, a chemical asphyxiant used as a prelude to homicide: a report of three cases.

Homicides in which the victims are first subdued with a chemical asphyxiant rare unusual and quite rare. We report three cases in which victims were first overcome by ether containing compounds and then killed by other means of asphyxiation. The ether containing compounds used in these three cases were readily available commercial products. In two cases, the distinctive spectra of the volatile compounds in the decedents' blood, from the gas chromatograph and from the gas chromatograph/mass spectrometer, were compared with suspect ether containing products recovered during the scene investigations. In one case, an identical match was obtained. In the other case, the chromatographic spectra differed slightly from the compounds found at the scene, but the difference was explainable by metabolic breakdown of the compounds in vivo.