Controversy over fatal monointoxication with flunitrazepam

摘要

abstract_textpThe case of a 56-year-old man who died after suicidal monointoxication with rohypnol tablets (flunitrazepam) is presented. Toxicological analysis revealed a recent intoxication with flunitrazepam, which the victim survived only for a brief period. Illicit drugs, other medication or alcohol could not be detected. Autopsy revealed disseminated whitish foci in the inferior lobe of the right lung suspicious for a tumor or pneumonia. The first presumption was that this finding was an immediate consequence of limited consciousness caused by the flunitrazepam intoxication. However, histological analysis of this area demonstrated an extensive, recent, but at least 2 to 3-day-old bronchopneumonia. Furthermore, the lungs showed signs of acute and chronic stasis with local fibrosis as well as emphysema, consistent with further pre-existing lung diseases. This case is an example of a fatal monointoxication with a benzodiazepine caused by a combination of pre-existing disease (bronchopneumonia) and side effects of the medication (depression of respiration). It underlines once more that determination of monointoxication with benzodiazepines alone as the cause of death necessitates very careful and exhaustive measures with all investigative techniques to confirm this assumption./p/abstract_text