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Category Archives: Poisons & Drugs

Visine and Munchausen Syndrome By Proxy

visine-1

 

Visine is a useful medication. I use it all the time. When the Santa Ana’s blow in SoCal and the temperature rises, the humidity falls, and eyes dry out, Visine works very well. When used properly it is very safe and effective—-but, if used improperly, it can be a deadly poison.

Actually, anything can be deadly. The difference between a drug and a poison is simply a matter of dose. What can cure, can harm; what can harm, can kill. It’s really that simple.

The active, and dangerous, ingredient in Visine is tetrahydrozoline hydrochloride. If ingested in sufficient amounts, it can cause an elevation in blood pressure, a drop in heart rate, a reduction in body temperature, nausea, vomiting, shortness of breath, blurred vision, seizures, coma, and death, to name a few effects.

The case of Samantha Elizabeth Unger underlines this danger. Seems she poisoned her two children by adding the medication to their juice. And may have done so multiple times—-which could indicate that this is a case of Munchausen Syndrome By Proxy—a psychiatric disorder in which parents harm children in order to garner attention and sympathy. Odd, but not rare.

Recently on Crime and Science Radio, Jan Burke and I interviewed Beatrice Yorker, the Dean of the College of Health and Human Services at California State University, Los Angeles and a renowned expert in Munchausen Syndrome By Proxy. Take a listen and check out some of the links for more info on the fascinating topic.

 

 

Snake Venom For Treating Seizures? On Second Thought

rattlesnake

 

In the dark ages of medicine, meaning anything before 50 to 100 years ago, those afflicted with epilepsy were treated, how shall we say, less than compassionately. They were often thought to be infected by some evil miasma, or possessed by a lurking devil or witch or warlock, or were afflicted with some contagious process. They were isolated from society, feared and shunned by all, and often subjected to horrific treatments – everything from freezing water to cutting holes in the skull to let out the evil spirits (trepanning).

 

trepan

 

This is not an uncommon reaction when people are faced with things that they don’t understand. And 100 years ago the medical profession actually understood very little.

A case in point would be Philadelphia physician Dr. Ralph Spangler who suggested that rattlesnake venom, which interestingly he had been using to treat tuberculosis (go figure), might be useful in treating epilepsy. He published an article about a Texas man who had been bitten by a rattlesnake and subsequently the epileptic seizures that had plagued him suddenly ceased. In this empirical observation of a single case he jumped to the profound conclusion that snake venom cures seizures. Thankfully cooler heads prevailed and other physicians pointed out that snake venom not only didn’t, and couldn’t, help epilepsy but rather frequently caused allergic reactions as well as hemolytic destruction of the blood. Not pretty.

The history of medicine is replete with such examples.

 

Crime and Science Radio: Deadly Doctors, Killer Nurses and other Medical Miscreants

photo 2012 cas

 

Join Jan Burke and I for a lively interview with Bea Yorker. We will delve into the very odd and not all that rare Munchausen by Proxy Syndrome as well as healthcare professionals who commit serial murders.

 

BIO: Beatrice Crofts Yorker is the Dean of the College of Health and Human Services at California State University, Los Angeles where CSULA’s forensic science program is located. She is renowned for her own research into Munchausen By Proxy, her landmark study of medical serial killers, and her publications on other topics that bring law, psychology, medicine, and ethics together.

 

LISTEN: http://www.blogtalkradio.com/suspensemagazine/2014/03/09/crime-and-science-radio-with-special-guest-bea-yorker

 

LINKS:

Medicine Net: Munchausen Syndrome: http://www.medicinenet.com/munchausen_syndrome/article.htm

Munchausen Syndrome, Cleveland Clinic: http://my.clevelandclinic.org/disorders/factitious_disorders/hic_munchausen_syndrome.aspx

Munchausen By Proxy: Cleveland Clinic: http://my.clevelandclinic.org/disorders/factitious_disorders/hic_munchausen_syndrome_by_proxy.aspx

Kid’s Health: Munchausen By Proxy Syndrome: http://kidshealth.org/parent/general/sick/munchausen.html

Medicine Net: Munchausen By Proxy: http://www.medicinenet.com/munchausen_syndrome_by_proxy/article.htm

Angels of Death: The Doctors: Crime Library: http://www.crimelibrary.com/serial_killers/weird/doctors/index_1.html

Angels of Death: The Female Nurses: Crime Library: http://www.crimelibrary.com/notorious_murders/angels/female_nurses/index.html

Angels of Death: The Male Nurses: Crime Library: http://www.crimelibrary.com/notorious_murders/angels/male_nurses/index.html

Serial Murder By Healthcare Professionals by BC Yorker, et al: http://www.ncbi.nlm.nih.gov/pubmed/17199622

Serial Murder By Healthcare Professionals by BC Yorker, et al: As PDF File: http://www.chem.sc.edu/analytical/chem107/tox/chem107_toxarticle.pdf

Psychology Today: The Medical Murder Club: http://www.psychologytoday.com/blog/the-human-equation/201206/the-medical-murder-club

 

 

Nip, Tuck, Jump: An Anesthetic Death?

nip_tuck

 

 

Beverly Hills is famous for plastic surgery. And famous plastic surgeons. Like Dr. Brian Novak, one the surgeons to the stars. But recently, things didn’t go so well with one of his patients. Like something from the TV series Nip/Tuck, where odd happenings were common, the recent suicide of a 53 year old woman was bizarre and unexpected. Seems she and undergone a face lift, after which she recuperated at the North Camden Drive clinic. At some point she became agitated, confused, ripped off her gown, and now naked climbed to the 10th floor roof where she threatened to jump. Ultimately she did, despite the efforts of a crisis negotiation team.

 

BH Clinic

 

How and why did this happen? I would suspect her tragic behavior had to do with drugs. Not those kind. The medical kind. Anesthetics and pain meds, drugs that work on the brain, the former to induce deep sleep and the latter to reduce the perception of pain. But these drugs can also cause confusion, disorientation, and bizarre behavior. Even delusions and hallucinations. These reactions can be part of the drug’s effects or a reaction to withdrawal or “coming down” from the drugs’ effects. These reactions are often unpredictable and come on quickly, as seems to be the case here. Sad.

 

 

Pillow Talk: Post-Sex Confessions Can Sink Your Perfect Murder

Pillow talk can undo your perfect murder. Seems that folks like to confess, or at least tell secrets, after sex. Researchers blame it on Oxytocin—the “love hormone.” Funny, I don’t remember it being called that in med school. Regardless, it just might lower inhibitions and make folks gabby.

 

Pegye Bechler

Pegye Bechler

 

An example can be found in the famous 1997 Pegye Bechler murder here in Orange County, CA. Husband Eric apparently decided to kill his wife and make it look like a boating fatality. His story: he was on a bodyboard, Pegye towing him behind their boat, when a rogue wave knocked him off the board. When he surfaced, the boat was going in circles with no Pegye in sight. The wave had knocked her off the boat and she had drowned. Two problems: Pegye was an excellent swimmer and the water was dead calm that day.

 

Eric Bechler

Eric Bechler

 

Still, even though the police doubted Eric’s story, they had no witnesses, no body, and no real evidence. Eric walked. For a while anyway. He then got a new girlfriend, model and Baywatch actress, Tina New. Seems that one evening after a round of sex and a dose of Ecstasy, Eric confessed to Tina, saying he had killed Pegye with a dumbbell and dumped her body in Newport Bay. At first she dismissed his story but later decided to go to the police. A sting was arranged and she managed to record his confession. Eric was ultimately convicted and given a life sentence.

 

Crime and Science Radio: The Infancy of Toxicology: Interview with Deborah Blum, Author of The Poisoner’s Handbook

CSR 970x250

 

DP Lyle and Deborah Blum, author of the critically acclaimed book THE POISONER’S HANDBOOK, discuss poisons, old and new, and the origins of forensic toxicology. Meet Charles Norris, New York City’s first ME, and Alexander Gettler, The Father of Forensic Toxicology, and walk with them through Jazz Age New York and the birth of forensic toxicology. Learn about poisons such as carbon monoxide, chloroform, arsenic, thallium, and many others.

LISTEN: http://www.blogtalkradio.com/suspensemagazine/2013/09/17/crime-and-science-radio–the-infancy-of-toxicology

LINKS:

Deborah Blum: http://deborahblum.com

Ethanol: http://en.wikipedia.org/wiki/Ethanol

Methanol: http://en.wikipedia.org/wiki/Methanol

Carbon Monoxide (CO): http://en.wikipedia.org/wiki/Carbon_monoxide

Arsenic: http://en.wikipedia.org/wiki/Arsenic

5 Classic Poisons and the People Who Used Them:

http://mentalfloss.com/article/23174/5-classic-poisons-and-people-who-used-them

Famous Poisonings, Real and Fictional: http://en.wikipedia.org/wiki/List_of_poisonings

Deadliest Poisons in History: http://io9.com/5942161/the-deadliest-poisons-in-history-and-why-people-stopped-using-them

Forensic Toxicology: http://en.wikipedia.org/wiki/Forensic_toxicology

Crime Library: Forensic Toxicology: http://www.trutv.com/library/crime/criminal_mind/forensics/toxicology/index.html

Poison and Progress: WSJ: http://online.wsj.com/article/SB10001424052748703699204575016971709814644.html?mod=WSJ_latestheadlines

Thallium Poisoning: http://en.wikipedia.org/wiki/Thallium_poisoning

Facts About Thallium Poisoning: http://www.medicinenet.com/script/main/art.asp?articlekey=79810

Mathieu Joseph Bonaventure Orfila, The Original Father of Toxicology: http://www.nlm.nih.gov/visibleproofs/galleries/biographies/orfila.html

Dancing With Black Widow Spiders: http://www.nytimes.com/2013/09/17/science/dancing-with-black-widows.html?_r=0

 

 

Q and A: Can My Villain “Force Feed” Pills To a Dead Woman?

Q: My hero, an investigative journalist, is looking into the death of a woman at an acid house/rave party in the early 1990’s. The novel is set in the present day and so the hero has no access to the body, just autopsy reports, coroners reports, the transcript of the inquest, etc. The woman was a light user of Ecstasy but the autopsy discovered that she had 70 ecstasy pills in her stomach. The scenario I want to create is that the hero discovers that while the woman took some of the pills willingly, she was then force fed others, and then after she died she was force fed yet more. In order for this scenario to work I’m wondering the following:

1) For how long after death does stomach acid continue to operate?

2) For how long after death would the digestive system continue to break down the ecstasy and would the ecstasy continue to be absorbed into the bloodstream?

3) Is it likely/possible that a sizeable amount of pills would remain undigested in her stomach, bearing in mind that the body was not found for a number of hours?

4) What injuries/signs on the body would there be of someone force feeding her the pills?

5) Is it possible to force feed somebody pills after death, how would they get the corpse to “swallow” and what injuries might be caused to the body as a result?

James, St Albans, UK.

 

PIlls

 

 

A: At death, all metabolic processes cease immediately since there is no longer blood flow to keep these processes going or even to keep the tissues and cells responsible for these activities alive. This includes the digestive processes. Sure there could still be a small amount of acid effect but this would only be from the acid in the stomach at the time of death and this would be quickly neutralized by the materials the acid was combining with. The bottom line is that all digestive processes cease immediately on death, more or less freezing the stomach contents in time. This is also true for the level of most toxins in the blood and urine, which offers the medical examiner a tool for determining the cause and time of death.

At death, the stomach would no longer move or churn or secrete acids and digestive enzymes so the ecstasy would remain intact as it was at the time of death. Yes there could conceivably be residual whole pills and in fact this is not uncommon in overdoses of all kinds. Some dissolve and are absorbed prior to death and others do not and these remnants can then be tested to determine what they are. All the stomach contents would remain intact until the decay process destroyed them, so if the body was found in a reasonable period of time, the stomach contents could be analyzed for their chemical characteristics, which would include the presence of any drugs or alcohol.

It is very difficult to force-feed a living person pills and so doing could lead to trauma around the mouth and face as the pills were shoved into the victim’s mouth and his mouth and nose held close until he swallowed. Or there could be no trauma and in which case there would be no way of knowing this. But evidence of trauma might suggest a force-feeding. It would be a best guess but an experienced medical examiner can usually make this determination. Since all processes and movement by the deceased stop at death, swallowing cannot occur and force-feeding a corpse is impossible. The pills would simply collect in the mouth and throat.

In your victim there could easily be undigested pills and toxicological testing of these, and of course blood and urine, would reveal what chemicals were in the victim’s stomach and system. Since your body is found several hours later there would be essentially no decay and therefore everything in the bloodstream and in the stomach would remain intact more or less as it was at the time of death. With facial trauma the ME might consider that the OD was forced, and in the absence of such evidence might simply think it was an intentional or accidental OD.

Also this ARTICLE on my website might help.

 

Crime and Science Radio: Drugs, Poisons, Toxins, and Death

CSR 970x250

 

 

DP Lyle, MD discusses several famous cases that involve the use of drugs and poisons and reveals the toxicological principles behind each case. Kristen Rossum and the American Beauty Murder, Stella Nickell’s product tampering, and the complex issues surrounding Kurt Cobain’s death are some of the topics to be discussed.

LISTEN: http://www.blogtalkradio.com/suspensemagazine/2013/09/07/crime-and-science-radio–drugs-poisons-toxins-and-death

LINKS:

Forensic Toxicology.net

http://www.forensictoxicology.net

Forensic Toxicology: Wikipedia

http://en.wikipedia.org/wiki/Forensic_toxicology

WSJ: Poison and Progress

http://online.wsj.com/article/SB10001424052748703699204575016971709814644.html?mod=WSJ_latestheadlines

Toxipedia: Toxicology Timeline

http://toxipedia.org/display/toxipedia/Toxicology+Timeline

Kristin Rossum: Wikipedia

http://en.wikipedia.org/wiki/Kristin_Rossum

Murderpedia: Kristin Rossum

http://murderpedia.org/female.R/r/rossum-kristin.htm

CBS 48 Hours: American Beauty (2009)

http://www.cbsnews.com/8301-18559_162-505815.html

Stella Nickell: Wikipedia

http://en.wikipedia.org/wiki/Stella_Nickell

Murderpedia: Stella Nickell

http://murderpedia.org/female.N/n/nickell-stella.htm

People: Killing Her Husband Wasn’t Enough for Stella Nickell; to Make Her Point, She Poisoned a Stranger

http://www.people.com/people/archive/article/0,,20099360,00.html

CBS 48 Hours: Bitter Pill: A Wife on Trial

http://www.cbsnews.com/8301-18559_162-294700.html

Find-em: Stella M. Nickell Case

http://www.find-em.com/stella/index.html

Kurt Cobain: Wikipedia

http://en.wikipedia.org/wiki/Kurt_Cobain

Death of Kurt Cobain: Wikipedia

http://en.wikipedia.org/wiki/Death_of_Kurt_Cobain

Unsolved.com: Kurt Cobain

http://www.unsolved.com/ajaxfiles/leg_kurt_cobain.htm

Justice For Kurt

http://www.justiceforkurt.com

Everyjoe.com: Kurt Cobain: Murder or Suicide? The Truth About the Nirvana Enigma

http://www.everyjoe.com/2013/07/30/entertainment/kurt-cobain-murder-suicide-nirvana/

Youtube: Kurt Cobain: Death Conspiracy

http://www.youtube.com/watch?v=mSGZL0QPjsQ

Youtube: Nirvana Kurt Cobain’s Death Documentary

http://www.youtube.com/watch?v=34otpYSCG8A

Ryder Salmen Dies From Drug-laced Mother’s Milk:

http://www.foxnews.com/health/2013/09/05/baby-boy-dies-after-ingesting-mother-drug-laced-breast-milk/

 

 
 

Joseph Rivera: The New Andrew Luster?

Joseph Rivera

Joseph Rivera

 

In a case that seems to echo that of Andrew Luster, Joseph Rivera has been arrested and charged with multiple sexual assaults involving the use of sedative drugs. Exactly like Andrew. Andrew’s drug of choice was GHB and that might also be what Rivera used. No details yet, but it wouldn’t be surprising if that’s the answer.

 

Andrew Luster

Andrew Luster

 

GHB is one of the so-called Date Rape Drugs. Their treachery lies in that, unlike true intoxicants such as alcohol and the various narcotic and sedative drugs out there, the victim appears more or less normal. Maybe a little giddy but certainly not sloppy drunk. But the victim becomes very complaint and suggestable and has no memory of what happens while under the drug’s influence. Scary stuff.

 
 

Q and A: Can My ME Uncover Drugs in a Charred Corpse?

Q: I have two characters who are found dead in their house, having been at the center of a fire that turned into a wildfire. Before the fire, a hitman gave them some type of medication that he believed would not be detected in an autopsy to cause them to go unconscious or unable to move while he set the fire around them and escaped. The idea is that I want it to look — on the outside, at least — as though they accidentally caused the wildfire, starting in their home in the forest. Then, it’s discovered that they were, technically, murdered by someone giving them a strong sedative (or something) and they were burned in the fire.

When the medical examiner does the autopsy, what is he likely to be able to notice? I read that bodies are usually not burned completely in a fire, but what would the ME find? What kinds of things would he notice and talk about in the report?

Is there a drug that would have a sedative effect on the characters that would NOT show up in an autopsy? Or something that might show up with a particular test and what reasons could an ME have to run that test?

Kari Wolfe, Colorado Springs, CO

 

Iraqi Convoy Bombed During Persian Gulf War

 

A: You are correct that fires rarely destroy a body completely. The fire simply does not burn hot enough or long enough to completely destroy the body in most structure and automobile fires. The same would hold for wildfires. The body would likely be charged severely on the outside and for several inches down but deep inside most tissues would remain intact. This would allow the medical examiner to test the muscles, brain tissue, liver, blood, bone marrow, urine, and the vitreous humor inside the eyes for various drugs.

Almost any narcotic or sedative would work for your purposes but most of these are easily found with even simple toxicological screening and for sure by more sophisticated toxicological testing using gas chromatography and mass spectroscopy.

More sophisticated drugs are not revealed by a routine drug screen and therefore more difficult to find. Add to this the fact that the medical examiner might have no reason to go to the time and expense of looking for more esoteric toxins if all evidence pointed to the victim having died in the fire.

But what if the victim didn’t die in the fire? What if the victim was already dead before the fire started? This would change everything since in that case the medical examiner could not say that the cause of death was asphyxia from the fire but rather that something else must have killed the victim. In the absence of overt trauma or another obvious cause of death, the ME would likely do more complete toxicological testing.

 

How would the ME determine that the victim was dead before the fire? One clue would be the carbon monoxide level in the blood. If this is low, the victim was not breathing while the fire was consuming him. If the carbon monoxide level was high it would indicate that he was breathing and had inhaled carbon monoxide, which comes from the burning of wood and almost any other product. The normal carbon monoxide level is less than 5% but in victims of fire it can be 60 to 90%.

Also, if the victim was still breathing during the fire he would inhale soot and heat. The heat would damage the throat and airways and soot and other fire debris would be inhaled deeply into the lungs. Finding these would indicate the victim was alive while the fire burned and not finding them would suggest a prior death. This latter situation could launch a more complete toxicological analysis of the remains and ultimately lead to the lethal drug. Such testing could take many weeks, even months, so that you can delay the discovery of the true cause of death for almost as long as you need for story purposes.

Rare toxins you might consider would be succinylcholine, PSP (paralytic shellfish poisons), Rohypnol, GHB, and a few others.

 
 
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