Fatal human poisoning with Padan^TM: a cartap-containing pesticide

Abstract

We report a patient who ingested about 13 g of Padan SG, a cartap-containing pesticide. After ingestion, the patient developed multiple seizures and dyspnea and lost consciousness. The patient did not recover and died on the fifth hospital day despite treatment at the early stage of poisoning. The cause of death was multisystem organ failure. Results of toxicological analysis were as follows: concentrations of nereistoxin (cartap metabolite) were 10.6 microg/mL in plasma, 18.2 microg/mL in urine, and 2.6 mg/mL in gastric fluid. Results of drug screening of urine by Triage DOA Panels and using an organophosphate detection kit were negative.

An Observational Study of 11 Cases of Cartap Poisoning - A Rare Poisoning

“…The concentration of Cartap is an important determining factor of the severity of poisoning and outcome [12]. This can be explained from the fact that the maximum quantity of poison ingested in our case was approximately 15-20 mg which is more than the dose reported in Kurisaki et al case and in both cases of Kurisaki et al and Kuwahara et al, gastric lavage was also done early, but their patients died of multiorgan failure [13,14]. Percentage of Cartap in these cases was 75%; in our case all patients had consumed 50% Cartap, probably the most common formulation available, thus justifying the concentration of poison as an important determining factor of mortality.…”

“…Frequent generalized seizures responded to lorazepam followed by phenytoin sodium and if required levetiracetam. Both Kurisaki et al and Kurisaki reported death of a 36-year-old male and a 50-year-old female, respectively, on the 5 th and 6 th day of ingestion of 75% Cartap [13,14]. In both cases, patient developed MOD (multiorgan failure).…”

“…All our patients with multiorgan failure recovered. In case of death due to MOD reported by Kurisaki et al and Bunai et al, the blood concentration of Cartap was found to be 10.6 mcg/ml [13] and 11.5 mcg/m [21], respectively, whereas in Kiyota et al case, where the patient survived after ingesting 50% Cartap the blood level was estimated to be 1.14 mcg/ml [22]. Singh et al in a case study of paraquat poisoning, opined that different treatment modalities, namely, pulse therapy with cyclophosphamide and methylprednisolone, and hemoperfusion may be used to manage patient's condition.…”

Cartap poisoning: an unusual poisoning in North India

“…Although cartap is considered to be a low toxicity poison, severe fatalities have been reported. 7 The toxicity of cartap gets enhanced while the patients concomitantly consume foods or drugs of P450 inhibitor. 5 Further the toxicity is enhanced if the amount consumed is more than 75 mL of solution containing 50% cartap along with alcohol.…”

Особенности Определения 2-Диметиламино-1,3-Бис-(Фенилсульфонилтио)пропана (Бенсултапа) В Лекарственном Растительном Сырье

“…Среди пестицидов, которые могут являться нежелательными примесями в лекарственном растительном сырье, довольно значительное ме-сто занимают средства защиты растений из груп-пы производных нереистоксина [9,10,11].…”