Medicine, science, and the law
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Case Reports Comparative Study
A fatal case of poisoning by lidocaine overdosage--analysis of lidocaine in formalin-fixed tissues: a case report.
The death of a 76-year-old man with heart disease as a result of the injection of an excessive dose of lidocaine is presented. The patient was given 5 ml of 10% lidocaine hydrochloride (500 mg) intravenously instead of 2.5 ml of 2% lidocaine hydrochloride (50mg) in order to treat repeated paroxysmal ventricular arrhythmia. Immediately following the injection the patient had tonic clonic seizures and complete cardiopulmonary arrest followed. ⋯ In an experiment on rats we determined the concentration changes of lidocaine in formalin fixed tissues. The concentrations of lidocaine in these tissues significantly decreased to 1/3-1/4 from the original. This data shows that the cause of death was poisoning by lidocaine overdose.
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An ever-increasing demand for organs for transplantation has failed to keep pace with their availability. Social, religious and legal restrictions on the one hand and technological developments on the other have further worsened the existing shortage of organs. ⋯ However, it has certain fallacies. This paper reviews the various criteria in use to define the 'moment of death' around the world and with reference both to the Transplantation of Human Organs Act 1994 and the urgent need for organ retrieval in the present day paucity of donors.