Asphyxiation due to dry ice in a walk-in freezer

Accidental carbon dioxide poisoning due to dry ice during a funeral wake: An autopsy case

We report the autopsy case of a male in his 60 s diagnosed with carbon dioxide (CO₂) poisoning caused by dry ice for cooling in a coffin during a funeral wake. He was last seen alive, clinging to his family member's body with his head inside the coffin. The autopsy and histological findings did not indicate a specific cause of death. To confirm the concentrations of CO₂ and oxygen (O₂) in the coffin, an experiment was conducted to reconstruct the scene. Based on the experimental results, 9 h after placing dry ice, the CO₂ concentration at the estimated closest point to his head was 24%, a lethal level for CO₂ poisoning. Contrastingly, although the concentration of O₂ had fallen, it never reached a lethal concentration at any of the determination points during the experiment, thereby ruling out asphyxia as a cause of death. Based on our findings, we concluded that the cause of his death was CO₂ poisoning. Forensic pathologists tend to overlook CO₂ poisoning unless suspected, as it does not exhibit specific autopsy findings. For the diagnosis of CO₂ poisoning, it is essential to collect detailed information about the deceased and the scene of death. The toxicity of CO₂ itself is not well known, although dry ice is widely available to the public. In order to make its risk well known, it is necessary to inform people about the dangers of using dry ice.

Lessons Learned: Asphyxiation Hazard Associated with Dry Ice

Dry ice is widely used in the chemistry research settings as an excellent coolant. Herein, we report a case study of a graduate student researcher who lost consciousness while retrieving 180 lbs of dry ice from a deep dry ice container. We share the details of the incident and the lessons learned from it to promote safer handling of dry ice in these situations.

Suicide by Gaseous Displacement of Atmospheric Oxygen With Carbon Dioxide From Dry Ice Sublimation

ABSTRACT

Deaths from gaseous substances can occur from exposure to toxic gases or from accumulation of nontoxic gases that displace oxygen. We present a 38-year-old man with no known medical history, who was found deceased in a small bathroom with blankets and towels shoved under the door from the inside.At autopsy, the decedent was found to be in a moderate state of decomposition. There was mild pulmonary congestion, with no other significant findings. Standard postmortem toxicology on femoral blood was noncontributory.A search of the decedent's cell phone revealed statements and internet searches regarding carbon dioxide (CO 2 ) and asphyxia using dry ice. A journal entry also outlined a suicide plan using large amounts of dry ice, which was enacted by placing a laundry basket of dry ice into a bathtub containing water. Based on the investigation, the cause of death was determined to be asphyxia from displacement of oxygen with CO 2 .Dry ice sublimates into gaseous CO 2 , which quickly accumulates, with concentrations of 10% or more, rapidly becoming life-threatening. There are no pathognomonic autopsy findings seen in CO 2 -related asphyxia. In these circumstances, scene investigation is the most important factor in determining cause of death.

Novel Solventless Extraction Technique to Preserve Cannabinoid and Terpenoid Profiles of Fresh Cannabis Inflorescence

Despite its use by humans for thousands of years, the technology of cannabis usage and extraction is still evolving. Given that the primary pharmacological compounds of interest are cannabinoid and terpenoids found in greatest abundance in capitate glandular trichomes of unfertilized female inflorescences, it is surprising that older techniques of hashish making have received less technological advancement. The purpose of this study was to employ organically grown cannabis and to isolate pure trichomes from freshly picked flowers via exposure to vapor from solid CO2, commonly known as "dry ice", followed by their isolation via sifting through a 150 µ screens while maintaining the cold chain. Biochemical analysis was undertaken on fresh flower, frozen-sifted flower by-products, treated trichomes (Kryo-Kief™), dried flower, dried sifted flower by-product and dried kief. The dry ice process successfully concentrated cannabinoid content as high as 60.7%, with corresponding concentration and preservation of monoterpenoids encountered in fresh flower that are usually lost during the conventional cannabis drying and curing process. The resulting dried sifted flower by-product after dry ice processing remains a usable commodity. This approach may be of interest to pharmaceutical companies and supplement producers pursuing cannabis-based medicine development with an eye toward full synergy of ingredients harnessing the entourage effect.

Case of cardiac arrest due to carbon dioxide poisoning following an explosion of a carbon dioxide tank

Carbon dioxide is widely used for a variety of purposes. As it is a normal constituent of air, the public generally regards it as safe. Although low concentrations of carbon dioxide are not harmful to human beings, high concentrations are toxic, and can cause serious harm, including cardiac arrest. Only a limited number of cases of carbon dioxide intoxication have been reported in Korea, and they have all been mild, with no cases of cardiac arrest following acute exposure to high concentrations of carbon dioxide, reported previously. We describe a case of carbon dioxide poisoning following an explosion of a carbon dioxide tank, which led to cardiac arrest in a 66-year-old patient. This cardiac arrest could have been avoided if the patient was fully aware of the hazardous effects and serious consequences of exposure to high concentrations of carbon dioxide.

Lethal physiological effects of carbon dioxide exposure at high concentration in rats

The acute toxicity of high concentrations of carbon dioxide (CO₂) was investigated in anesthetized rats using physiological parameters. At an oxygen concentration of 21%, the survival time decreased in a concentration-dependent manner from ≥7.3 h at 20% CO₂ to 1.0 h at 50% CO₂. The animals were divided into groups that were exposed to 40% CO₂ and 21% O₂ balanced with nitrogen (CO₂ group), 40% CO₂ and 12.6% O₂ (CO₂-Hypoxia group), 0% CO₂ and 12.6% O₂ (Hypoxia group), and 0% CO₂ and 21% O₂ (Control group) for 3 h. In the CO₂ group, mean blood pressure (MBP) increased temporarily in the first 60 min followed by a gradual decrease, while breathing rate (BR) decreased immediately up to 3 h and the concentration of serum indicators reflecting organ damage increased. Most of these effects progressed in the CO₂-Hypoxia group. The Hypoxia group showed a contrasting response to the CO₂ groups in MBP and BR, and a slight partial increase in the serum indicators. Histological changes were not observed in any primary organs of any group, except for eosinophilic or necrosis of pyramidal cells in the hippocampal CA1 region of the CO₂ group. These results indicate that high concentrations of CO₂ inhalation are toxic, likely due to BR suppression, and that hypoxia produced under a high CO₂ environment, while showing little effect on its own, enhances the toxic effects of CO₂.

Death in a Carbon Dioxide Therapy Bath: A Case Report and Review of the Literature

Carbon dioxide (CO₂) therapy is the subcutaneous or transcutaneous administration of CO₂ for therapeutic purposes. Carbon dioxide therapy is used for localized lipolysis, to treat chronic skin conditions, and is a safe treatment. Full-body CO₂ baths are offered in European spa centers, in which the clients are placed into full body bags infused with CO₂ at an optimal concentration range between 1000 and 1400 mg/L (516 000-722 500 ppm). Commercially manufactured, air-tight bags and accompanying apparatus designed to provide CO₂ baths can be purchased for home use. Few human CO₂-related deaths have been reported. They have been mostly accidental, consisting of persons trapped in a closed environment in the presence of "dry ice" or solid CO₂. There have been no reported deaths of a human undergoing a CO₂ therapy at home. We present a case of a middle-aged male found at home completely inside an air-sealed bag wrapped tightly around his body. The bag was connected to a working pump and a CO₂ gas tank. The pump was connected through an inflow and outflow circuit to the bag. The inflow tubing for CO₂ gas delivery was partially disrupted, while the outflow tubing was intact. The autopsy and toxicology were unremarkable. The cause of death was determined to be asphyxia by vitiated atmosphere as evident by the displacement of oxygen by CO₂ and low pressure created inside a "CO₂ therapy bath." The manner of death was accidental.

Deaths from Environmental Hypoxia and Raised Carbon Dioxide

This paper reviews deaths in which there is an environment that is low in oxygen and/or has elevated levels of carbon dioxide. These deaths present problems to autopsy pathologists, as the autopsy is typically negative and postmortem toxicology cannot be used to detect the effects of hypoxia and raised levels of carbon dioxide. Deaths from hypoxia and raised carbon dioxide may be encountered in work-and nonwork-related environments. Typically these are accidents, but suicides may be encountered and criminal charges may follow these events. Environments that have been associated with these events include mines, tunnels, sewers, and pits. Transportation incidents may also be associated with hypoxic events, particularly aircraft and submarines. When an atmosphere low in oxygen is entered, collapse can be rapid, or immediate if the environmental oxygen is below 6%. Environments rich in carbon dioxide can also cause death, even with a high oxygen concentration. Such environments may be encountered in industrial settings, but also occur in natural disasters such as the Lake Nyos disaster. The identification of these deaths typically requires a coordinated investigation with safety inspectors and other experts in industrial- and work-related deaths.

Murder-suicide by carbon dioxide (CO2) poisoning: a family case from Berlin, Germany

This report demonstrates how carbon dioxide (CO(2)) may be a potent weapon in murder-suicide, where the death scene offers virtually no clues as to the lethal modality and the autopsy findings are nonspecific. Four bodies were discovered in an apartment in midsummer 2012 in Berlin, Germany. The bodies were those of a father (a 69-year-old business consultant), his wife (aged 26-years), and two sons (aged 3 and 6 years, respectively). The police found the wife and two sons lying in their beds and the husband in a supine position on the floor with a plastic bag over his head tied loosely around his neck with a rope. A 500 g single-use CO(2) cylinder was standing on the floor. The container was almost empty and according to the label had been sold as a CO(2)-fertilizer for aquarium plants. Two synthetic inhalation face masks and tubing were also found, which tested positive for the DNA of all four deceased family members. It is hypothesized that the husband placed an inhalation mask over the mouths and noses of his wife and children while they were sleeping. Inhalation of pure CO(2) ensured their rapid unconsciousness due to hypercapnia and severe anoxia. The rapid increase in CO(2) concentration would render a victim helpless, with no time to wake and defend themselves, or others. The proximate cause of death in all cases was attributed to CO(2) intoxication, based on the scene findings, the reconstructed sequence of events, the autopsy, and results of toxicological studies.

Suicide by carbon dioxide

Suicides by self-poisoning are common in all parts of the world. Among these intoxications, gases are rarely used, especially carbon dioxide (CO2). Very few cases of self-inflicted and deliberate carbon dioxide poisonings have been reported. This paper presents two uncommon suicides by carbon dioxide intoxication. In one case, a 53-year-old man tightly sealed a small bathroom and locked himself in it likely with dry ice. Warning notices were tagged to the door. In another case, a 48-year-old man working in a restaurant committed suicide by closing himself in a walk-in refrigerator and opening the stored carbon dioxide containers intended for the beverage dispensing equipment. The limited possibilities of proving lethal CO2 intoxications post-mortem necessitate a close cooperation of the involved parties during investigation. Only the synopsis of all findings permits a sound assessment regarding the manner and cause of death.

A fatal case of CO(2) intoxication in a fermentation tank

Carbon dioxide (CO2 ) is an odorless constituent of air. Higher concentrations can be detected in geothermal and automotive emissions, fermentation, and sublimation of dry ice. An unskilled worker entered a fermentation tank to clean it, which had not been done for about 5 months allowing for high concentrations of CO2 to build up. A second worker entered the tank to rescue the first one. Shortly after both were found the first worker was rescued directly whereas the tank had to be rotated to pull the second worker out. Cardiopulmonary resuscitation was successful only for the first worker. Medico-legal autopsy showed bruises, hematoma, myocardial hemorrhage, and edema of the lungs. The right lung was vacuum degassed in an argon atmosphere and quadrupole-mass-spectrometry showed an elevated CO2 content in lung gases. Thus, CO2 intoxication/asphyxia in a vitiated atmosphere due to fermentation of wine mash was established as the cause of death.