Yesterday I posted about a nut job who apparently whipped up an OJ and Rubbing Alcohol cocktail and left it a Starbucks. Scary. But now it seems that TGI Fridays and other restaurants in New Jersey might have done the same thing with Scotch. Really? If this is true they are guilty of poisoning their Scotch drinking customers.
Some things make you scratch your head.
Screwdrivers can be dangerous. Not only the ones used to tighten and remove screws, which can be lethal weapons, but the ones you get at your local bar. OJ and Vodka. Nice way to get hammered and up your vitamin C intake. Multitasking.
But Ramineh Behbehanian apparently has her own recipe. OJ and alcohol. Not vodka or even ethyl alcohol (ethanol–the kind you drink), but isopropyl alcohol (isopropanol–rubbing alcohol). It seems she whipped up a couple pf bottles of this concoction and placed them in the refrigerated section of her local Starbucks. Fortunately, someone observed her doing it and called the police.
Maybe this was simply a prank. Maybe she innocently thought isopropyl alcohol and ethyl alcohol were interchangeable. No harm, no foul. Maybe. Except she’s a pharmacist. She knows the difference.
So what is isopropyl alcohol and why is it dangerous?
From HOWDUNNIT: FORENSICS
Isopropanol
Isopropanol is also an intoxicant and a CNS depressant whose effects usually appear within ten to thirty minutes after ingestion, depending upon the amount consumed and whether food or other beverages are taken as well. Fifteen to 20 percent of ingested isopropanol is converted to acetone, which produces acidosis (excess acid in the body). This greatly complicates things. The victim appears drowsy and off balance, and possesses a staggering gait, slurred speech, and poor coordination. Nausea, vomiting (sometimes bloody), abdominal pain, sweating, stupor, coma, and death from respiratory depression may follow. Hemorrhage into the bronchial tubes (breathing tubes or airways) and chest cavity may occur.
Isopropanol also absorbs through the lungs and the skin. Not infrequently, infants experience isopropanol toxicity from alcohol-and-water sponge baths used to treat childhood fevers.
As they say: Don’t try this at home.
From HOWDUNNIT: FORENSICS: When more than one person is found dead in a house or a car and there is no evidence of trauma, carbon monoxide toxicity is considered. The odds of two or more people dying from natural causes at the same time and the same place are extremely remote.
Such is the case of “Buckwild” star Shane Gandee who was found dead, along with two other men, in a vehicle partially submerged in mud. The supposition is that mud clogged the vehicle’s tail pipe and this allowed carbon monoxide (CO) to accumulate inside the passenger compartment, resulting is death from asphyxia.
When I first read the circumstances surrounding this tragedy, my first thought was CO. With no signs of trauma, little else made sense. Apparently the authorities have agreed that this was the cause of death.
Also from HOWDUNNIT: FORENSICS: CHAPTER 8: ASPHYXIA
CARBON MONOXIDE
Deaths from carbon monoxide poisoning are usually suicidal or accidental. It is an uncommon method for homicide, but it has been reported. Carbon monoxide is stealthy, treacherous, deadly, and common. A family is found dead and the cause is a faulty heater or fireplace. A suicide victim is found in his garage with the car engine running. Campers are found dead in a tent, a kerosene lantern burning in one corner. Each of these is due to carbon monoxide poisoning.
Carbon monoxide is a tasteless, odorless, colorless gas that is completely undetectable by humans. It results from the incomplete combustion of carbon-containing fuels—paper, wood, gasoline, and many other combustible products. Complete combustion of one of these fuels yields carbon dioxide (CO2). If there is a deficiency of oxygen or if the fi re is smoldering and doesn’t produce enough heat to drive the reaction to completion, incomplete combustion occurs and the result is the production of carbon monoxide.
Wood, coal, and gas are common carbon-containing fuels. Faulty stoves,heaters, and fireplaces, as well as the exhaust from a car engine, can fill the air with carbon monoxide. Carbon monoxide poisoning is a more common cause of death in fires than is the fire itself. Charcoal briquettes are particularly dangerous as they are designed to smolder rather than burst into flame and are also good sources for carbon monoxide. Using a charcoal grill in an enclosed space such as a garage or tent can lead to carbon monoxide buildup very quickly. Faulty butane and propane camp stoves and heaters can also be deadly.
Carbon monoxide’s treachery lies in its great affinity for hemoglobin, the oxygen-carrying molecule within our red blood cells (RBCs). When inhaled, CO binds to hemoglobin producing carboxyhemoglobin. It does so three hundred times more readily than does oxygen, and thus it displaces oxygen. The result is that the blood that leaves the lungs and heads toward the body is rich in carbon monoxide (carboxyhemoglobin) and poor in oxygen (oxyhemaglobin).
This strong affinity of hemoglobin for carbon monoxide means that very high blood levels can occur by breathing air that contains only small amounts of carbon monoxide. For example, breathing air that contains a carbon monoxide level as low as 0.2 percent may lead to blood carbon monoxide saturations greater than 60 percent after only thirty to forty-five minutes. So, a faulty heater or smoldering fi re that produces only a small amount of carbon monoxide becomes increasingly deadly with each passing minute.
This powerful attraction for hemoglobin explains how certain individuals succumb to carbon monoxide poisoning in open areas. Most people believe that carbon monoxide is only toxic if it is in an enclosed area, but this is not true. There have been cases of individuals dying while working on their cars in an open area, such as a driveway. Typically the victim is found lying near the car’s exhaust. Similarly, the newly recognized problem of carbon monoxide poisoning in swimmers and water skiers who loiter near a dive platform on the back of a powerboat with an idling engine.
The degree of exposure to carbon monoxide is typically measured by determining the percent of the hemoglobin that is carboxyhemoglobin. The signs and symptoms of carbon monoxide toxicity correlate with these levels. The normal level is 1 to 3 percent, but may be as high as 7 to 10 percent in smokers. At levels of 10 to 20 percent, headache and a poor ability to concentrate on complex tasks occur. Between 30 and 40 percent, headaches become severe and throbbing, and nausea, vomiting, faintness, and lethargy appear. Pulse and breathing rates increase noticeably. Between 40 and 60 percent the victim becomes confused, disoriented, and weak, and displays extremely poor coordination. Above 60 percent, coma and death are likely. These are general ranges since the actual effect of rising carbon monoxide levels varies from person to person. In the elderly and those with heart or lung disease, levels as low as 20 percent may be lethal. Victims of car exhaust suicide or those who die from fire in an enclosed room may reach 90 percent.
A running car engine in an enclosed garage is a common method for suicide, but it could also be used for homicide. If the killer subdues the victim by force or by way of intoxication, he could place the victim in his car and let the carbon monoxide actually do him in. When determining the manner of death, the ME looks for evidence of trauma to the victim as well as performs a toxicology screen. Finding trauma, such as evidence of a blow to the head, might change the manner of death from suicide to homicide, but finding drugs may not. Some people use multiple suicide methods to assure success and a drug overdose combined with carbon monoxide inhalation is not rare.
When more than one person is found dead in a house or a car and there is no evidence of trauma, carbon monoxide toxicity is considered. The odds of two or more people dying from natural causes at the same time and the same place are extremely remote.
Carboxyhemoglobin is bright red in color and imparts this hue to the blood. When the ME performs an autopsy and sees bright cherry-red blood, he suspects carbon monoxide poisoning as the cause of death. This finding is not absolutely conclusive since cyanide inhalation or ingestion can also result in bright cherry-red blood and tissues. Also, individuals dying from cold exposure or corpses exposed to very low temperatures may show bright red blood.
Livor mortis in these situations may also be red or pink rather than the usual blue-gray color (see Chapter Five: Time of Death, “Livor Mortis”).
At autopsy, the internal organs in victims of carbon monoxide intoxication are also bright red. Interestingly, this color does not fade with embalming or when samples taken by the ME are fixed in formaldehyde as part of the preparation of microscopic slides. At times the presence of carbon monoxide can be found in the blood as long as six months after death.
Individuals who survive carbon monoxide intoxication may have serious long-term health problems. The brain is particularly vulnerable since it is extremely sensitive to lack of oxygen. Symptoms and signs of brain injury can begin immediately or be delayed for several days or weeks. The most common aftereffects include chronic headaches, memory loss, blindness, confusion, disorientation, poor coordination, and hallucinations. The ME may be asked to evaluate a living victim in this situation if the exposure was due to a criminal act or if a civil lawsuit is involved.
Q: I am currently doing research for a historical novel, one of my main characters, a prosperous middle aged male, was an arsenic-eater who used this drug regularly for some time, at least two years probably longer, he became addicted to it and took increasingly large doses. He eventually died from an overdose of arsenic, possibly intentionally (as in suicide). Could you give me some information about what type of physical as well as psychological symptoms he may have had both as a habitual user as well as dying from n overdose of this drug?
Brandy Purdy, author of The Boleyn Wife, The Tudor Throne, and The Queen’s Pleasure
http://brandypurdy.blogspot.com
A: Arsenic (AS) can cause both chronic and acute poisoning and it was indeed used in the past by many people as a folk remedy for almost anything. So was strychnine. Though chronic users can tolerate increasing doses there is still a tipping point because AS builds in the system over time until it becomes lethal—even if repeated small doses are taken. This can take weeks or months depending on dose. And if the dose is very small, one that matches the elimination of the AS from the body, then this can go on for decades. But if the intake is above the elimination rate, it will accumulate and eventually kill the taker. For your story you don’t have to worry about the math just have your character use it for however long you want and the readers will assume the dose was too small to kill. And then when it accumulated to the point of death–or until someone either tampers with his dose or gives him an excess—have him become acutely ill and die and the readers will buy that also.
You used the word addiction here but that is not correct. AS is not addicting as would be a narcotic. It is not even habituating as are some sedatives and sleeping pills. If he stopped using it he would have no withdrawal and in fact would feel better as the effects of the AS faded.
The symptoms of AS toxicity are predominantly GI and neurological. Symptoms include nausea, vomiting, weight loss, diarrhea, abdominal pain, headaches, irritability, insomnia, poor balance, numbness and tingling of the extremities, and a few other symptoms. Your victim could have these in any combination and in any severity. His symptoms could be mostly GI, mostly neurological, or any combination of the two. They can be constant, progressive, or wax and wane. And if he used very small amounts, he might have no symptoms at all.
With acute poisoning these symptoms can be very severe and appear quickly and violently. His vomiting and diarrhea would be bloody and his abdominal pain severe. With an acute poisoning, death can take many hours and is not pleasant. He could take the AS for many months or years and feel fine and then begin to develop the above symptoms, mild at first, but they would progress in severity until he died. This progression could be over a few days, weeks, or months. Anything is possible. And, if someone gave him a large dose on top of this progression in toxicity, he could die within hours.
FOLLOW UP Q: Thank you very much, that does help but I am confused about something. Is a psychological addiction or dependency possible? In his diaries this man writes about taking larger doses and feeling stronger and being in terrible pain and headaches, vomiting, and coldness or numbness in his hands and feet, when something prevents him from having his regular doses. That’s why I used the word addiction, I assumed this was withdrawal, but I didn’t realize this was not a part of arsenic use.
FOLLOW UP A: Yes that’s possible. It’s called the placebo effect–means that if someone believes that something helps them then it will. Health food stores have made a living off this for years. If he felt that the AS made him stronger and when he couldn’t get it he would be weaker then he could easily feel that way. The truth is the exact opposite, since AS toxicity actually makes one weaker not stronger. But reality is perception. This would be a form of “psychological addiction” for lack of a more accurate term. So go with it since whatever he believes is true is true to him and that’s really all that counts in his world.
News Flash: Illicit drug manufacturers are not chemists. They do not have BS, MA, or PhD degrees. They do not work for Johnson & Johnson or Pfizer or even your local pharmacy. What they do is mix up unknown substances in a used cat box in a dingy garage and sell it to kids.
Case is point: Spice or K2. These are synthetic cannabinoid compounds—basically fake pot. Sure they get you high. Sure they turn a frat party into a psychedelic funhouse, but they can also land you in a dialysis unit. Not that sounds like fun, doesn’t it?
As Jimi would say: “Purple Haze all in my brain.”
Of course, sadly, Jimi is dead.
Criminals are for the most part not all that bright but sometimes their creativity is amazing. Drug traffickers notoriously go to great lengths to slip their product past inspectors and detection devices at airports and border crossings. Last year I posted about diamond and drug smugglers swallowing their booty in an often misguided attempt to avoid detection. Condoms filled with cocaine are one trick that can result in death if one of the condoms breaks.
X-ray of swallowed cocaine-filled balloons
Now two other clever methods have popped up:
A Panamanian woman was recently arrested in Barcelona, Spain as she attempted to smuggle 3 pounds of cocaine secreted inside her breast implants. I wonder if she got the idea from watching re-runs of NIP/TUCK, where this was one of the story lines in the quirky series.
Breast Implants
The other is a very unique pneumatic-powered canon that fires barrels packed with marijuana over the border near Yuma, AZ. It didn’t work, at least this time, but you have to give them an A for creativity.
Barrels of marijuana scattered like unexploded mortar shells
Q: I have been reading Forensics and Fiction and have decided my killer’s weapon will be injections of botox. Would a full syringe of botox given as a muscle injection be enough to kill a grown man (or woman) in 2 minutes or less? Could a smaller amount be used to get the same result? How would a non-medical person be able to get access to enough botox to kill several people?
JM – Memphis, TN
A: The botulinum toxin is one of the most lethal substances known. Very small amounts can kill. The LD50 is about 50 nanograms—a nanogram is one billionth of a gram and there are 30 grams in an ounce. LD 50 means Lethal Dose 50%—the dose that will kill 50% of those exposed to it. Here the 50 billionths of a gram needed to kill most people is a very small amount.
Botox is a very diluted solution of botulinum toxin. How much solution must be injected depends on the actual concentration of the toxin in that particular solution and this varies greatly. For fiction, I wouldn’t worry about the math. Simply have the victim injected and have him die. The reader will assume that whatever the dose was it was enough.
Botox is not all that difficult to come by. It can be purchased from a pharmaceutical supply house, stolen from a pharmacy or a doctor’s office, purchased on the black market, or easily gotten in Mexico. They even have Botox parties at people’s homes where a doc will show up and inject everyone while they drink wine and chat. It’s so LA. Someone could simply steal a bottle when he wasn’t looking.
People eat some fairly odd things. There’s even a medical term for some of these foreign-substance ingestions: Pica. Some people eat their own hair (hair pica) and rarely this leads to hair ball formation–just like your cat. People eat coins, starch, paint flecks, and even dirt. In the South there is a long tradition of chalk pica and clay pica (the eating of the red clay dirt that is so common in that region). The belief, passed down generation to generation, is that the red clay offers minerals that the body needs. It doesn’t. In truth, the clay can bind iron and remove it from the body and lead to iron deficiency anemia.
In two odd cases the ingestion of foreign substances has lead to serious health consequences and even death.
Apparently a new fad is to drink cocktails that contain Liquid Nitrogen (N). Sounds delicious I know but the problem is that Liquid N hovers between -196 degrees F. (its boiling point–the temp at which it converts to its gaseous form) and -346 degrees F. (its freezing point–the temp at which it becomes solid). This can literally freeze the stomach and lead to tissue death.
This is what happened to Gaby Scanlon. She ingested the drink as part of her 18th birthday celebration at a local bar only to end up in the hospital with her stomach surgically removed after it perforated. Not the best of birthdays, I imagine, and definitely not what she expected. Her story should be a cautionary tale for others.
Then there is 32-year-old Edward Archbold. He entered a “roach and worm” eating contest run by a local pet store. The grand prize? A python. Afterwards he became ill (you think?), vomited, and died.
It is unclear what exactly killed him. Was it a toxin in the roaches and worms? Was it a rip or rupture of the esophagus from his vomiting? Tearing of the esophagus with vomiting is called Mallory-Weiss Syndrome while esophageal rupture in this circumstance is termed Boerhaave’s Syndrome. Hopefully the medical examiner’s determination will sort this out.
The recent murder of an elderly woman and the possible suicide of actor Johnny Lewis (Sons of Anarchy) smacked of mental illness, drug abuse, or more likely both. Lewis apparently beat his landlady, 82-year-old Catherine Davis, to death, attacked a neighbor, and then fell or jumped from a roof to his own death. The insanity and violence of attacks such as this always raises the possibility of drugs and mental illness.
On first look it seemed to be classic for PCP (Phencyclidine or Angel Dust) or Methamphetamine. Both if these drugs can cause acute psychotic breaks and violent behavior. But maybe something else was involved. Something fairly new.
Smiles can be gotten as a white powder or compressed into pills
Sound so innocent doesn’t it. It is actually 2C-1, a form of hallucinogenic amphetamine that can be very destructive. Another gift from the infamous Alexander Shulgin.
Why the cute name? To attract young users of course.
Q: Under what circumstances can poppers (Amyl nitrite) kill a victim so it looks like natural death? If this is not possible in reality, could you provide a pseudo-medical explanation?
L. Mitana, Slovakia
A: Amyl Nitrite is what we call a vasodilator–meaning it opens up all the blood vessels in the body. Too much can lead to an immediate and profound drop in blood pressure (BP) and this can cause death directly from shock or indirectly by generating a cardiac arrhythmia due to poor blood flow to the coronary arteries. If the victim has coronary artery disease (CAD), this drop in BP can cause a heart attack (myocardial Infarction or MI). So, too much Amyl can definitely be lethal and do so in several ways.
At autopsy the coroner would see nothing unless the victim had CAD. Either way he might write the death off as a cardiac arrhythmia. If he did test for amyl nitrite he might find it or not–it is destroyed very quickly by the body’s enzyme systems but some might remain after death–or not. But he would not test for this unless he had some evidence that Amyl Nitrite might be involved in the death.
This same vasodilatory effect is why Viagra should not be taken with long-acting nitrates. Some people who suffer from CAD are prescribed long-acting nitrates to help relieve angina—chest pain due to poor blood supply to the heart muscle. Like Amyl, these nitrates and Viagra are vasodilators and when taken in combination can cause a dramatic decline in BP and death can follow.
