Forensic Medical Expert Opining in Cases Linked with Corhydron

• NCJ Number: 226717
• Journal: Problems of Forensic Sciences Volume: 70 Dated: 2007 Pages: 154-160
• Author(s): Maciej Barzdo; Leszek Zydek; Waldemar Machala; Jaroslaw Berent
• Date Published: 2007
• Length: 7 pages
• Publication Format: Article
• Publication Type: Report (Study/Research); Case Study
• Language: English
• Country: Poland

Annotation

This paper reports on four cases in which it was necessary for forensic medical experts in Poland to determine whether deaths and physical symptoms of persons who had ingested Corhydron, a medicine marketed as containing hydrocortisone, might have actually mistakenly contained succinylcholine, a medicine that relaxes skeletal muscles and may cause death due to the relaxation of respiratory muscles when accidentally administered.

Abstract

The key question in the four cases examined in this paper was whether the Corhydron received by any of the four patients might have mistakenly contained succinylcholine at the time of manufacture rather than the required hydrocortisone. In order to answer this question, it was necessary in each case to assess whether the patient had symptoms characteristic of the action of succinylcholine after administration of the Corhydron. In the cases presented in this paper, the possibility of the administration of a relaxant drug, namely succinylcholine, mistakenly contained in Corhydron instead of hydrocortisone was ruled out. Of key significance in making this determination was the lack of a time link between administration of Corhydron and the occurrence of symptoms suggestive of consumption of a relaxant drug. This determination was critical because the action of succinylcholine is sufficiently quick that symptoms of the drug’s action occur almost immediately after administration; however, the assessment of every patient who has possibly been exposed to the action of a relaxant drug should be treated individually. This is because symptoms that occur after ingesting succinylcholine, i.e., contractions of particular muscle groups, are only distinct when they occur in persons of average or strong musculature. In emaciated, weakened, and obese persons, the characteristic muscle cramps associated with succinylcholine may not be clearly visible or may not occur at all. 3 references