Was a case report:
A 47-year-old laboratory assistantingested approximately 9 g of
sodium azide powder and died 4 h later at a hospital. A high-
performance liquid chromatographic method using diode-array
detection has been developed for the determination of an azide
benzoyl derivative in blood (after a simple deproteinization) and in
several tissues (after homogenization in a neutral buffer and
deproteinization of the supernatant). The blood concentration in
this case was lower than those previously published. The highest
azide concentration was found in lung tissue. A complete
toxicological screening revealed the presence of cyanide in blood,
which has been previously reported twice, but for the first time, it
was confirmed by massspectrometry. Whether the production of
cyanide in the presence of azide took place in vivo or postmortem
remains unknown; the nature of the metabolic pathway involved
also remains unknown
A 47-year-old male laboratory technician intentionally in-
gested approximately 9 g of sodium azide powder at 8 p.m. He
was found several minutes later, vomiting and confused. He
had written a suicide note. When he arrived at the hospital
emergency department at 9:30 p.m., he showed no other clin-
ical signs. A gastric lavage was immediately performed, and
cardiac and blood pressure monitoring were established. The
patient quickly fell into a coma, and he showed signs of
laryngeal dyspnea. At 10:15 p.m., bradycardia and a drop in
blood pressure necessitated treatment with atropine and
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Journal of Analytical Toxicology, Vol. 20, March/April 1996
ephedrine. The patient was then intubated and mechanically
ventilated. A few minutes later, electrical shocks and vaso-
pressive drugs (adrenaline and isoprenaline) had to be admin-
istered because of cardiac arrest. A continuous supraventricular
arrhythmia followed for some minutes, and there were elec-
trocardiographic signs of myocardial ischemia. A second heart
arrest then occurred; resuscitation was ineffective. Death was
declared at 11:45 p.m.
The autopsy was performed on the following day. A deep
cyanosis of the face and the fingers and purple and bluish
lividities on the body were noted. The lungs were congested,
and pleura, like epicardium, presented petechia. The liver bled
when sectioned. Meninges were congested, and the brain was
very pale. Gastric contents and bile, kidney, liver, and brain
samples were collected for toxicological analysis. Blood sam-
pled during the sectioning of the thoracic wall, which probably
came from congested intercostal veins (called thoracic blood),
and from the suprahepatic veins (suprahepatic b
