• Leo Pazanin, Vilka Bekavac Misak, Nedjeljka Goreta, Zvonimir Mareković, and Vedrana Petrovecki.
• Department of Neuropathology, Clinical Hospital Center Zagreb, Zagreb, Croatia. leo.pazanin@zg.t-com.hr
• J. Forensic Sci. 2008 Sep 1;53(5):1185-7.

AbstractEndotracheal intubation is a simple, rapid, and safe technique that is being used as a standard procedure for airway management. However, airway injury during endotracheal intubation could be a significant source of morbidity or even mortality for patients and a source of liability for physicians as well. We report an unusual case of fatal tracheal occlusion by intraluminal blood clot complicating endotracheal intubation. The patient, a 62-year-old woman, with renovascular hypertension and incipient renal failure was scheduled for renal autotransplantation. The surgery was uneventful but the postoperative course was complicated with a lethal airway obstruction. At autopsy a linear longitudinal tracheal laceration was identified with an intraluminal blood clot obstructing the tracheal lumen. Tracheal laceration as a cause of death is a rare and potentially fatal complication of endotracheal intubation with intratracheal bleeding, clot formation, tracheal occlusion, and subsequent asphyxia.

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