Homicidal Paraquat Poisoning Following Ligature Strangulation

Abstract

We report a case of homicidal paraquat poisoning preceded by attempted manual strangulation. The poison had been forcibly ingested when the victim was unconscious due to pressure on the neck. The victim survived for ten days and died due to development of fibrosing alveolitis. The autopsy showed classic features of proliferative stages of paraquat poisoning and healing signs of ligature strangulation.

A Forensic Case of Suicide Ingestion of Paraquat Herbicide

“…Another manner of absorption is via inhalation of droplets or nebulized dust, causing damage to the nasal and pharyngeal mucous membranes, epistaxis, pharyngodynia, asthma, vomiting, and headache; frequently, ocular damage is associated with exfoliation of the corneal and conjunctival epithelia, corneal edema, eye pain, photophobia, and decreased visual acuity. Oral ingestion is the most fatal modality, 26 and the estimated minimum lethal dose for men is approximately 35 mg/kg of body weight, although a smaller amount can still be lethal without timely treatment 12 . In particular, the ingestion of liquid formulations containing 20% of PQ, such as Gramoxone and Dextrone, are associated with a mortality of approximately 60% with a minimum lethal dose that has been estimated to be 10 mL 27 …”

“…International literature attributes 14% to 20% of total suicides to agricultural pesticide poisoning, 1 making them one of the main contributors to the global suicide burden 2 . Among all agricultural pesticides, Paraquat (PQ) is one of the most widely used herbicides in the world, and poisoning is generally associated with accidental events, 3,4 suicides, 5–7 or homicides 8–13 . Accidental occurrences 14,15 are usually detectable a few hours after exposure and occur mainly among agricultural operators.…”

“…Because these actions are planned, administration of multiple low doses of pesticide are often observed 19 in which the burning taste of PQ can be masked by mixing it with hot liquids, spicy foods, or alcohol 8 . In some cases, preliminary stunning of the victims by asphyxiation is reported in literature with the purpose of forcing the ingestion of PQ by pouring the substance directly into the throat 12 . It is therefore evident that, in a forensic context, it is far from unusual to come across scenarios in which PQ is in various ways involved as a possible cause of death of a subject.…”

“…2 Among all agricultural pesticides, Paraquat (PQ) is one of the most widely used herbicides in the world, and poisoning is generally associated with accidental events, 3,4 suicides, [5][6][7] or homicides. [8][9][10][11][12][13] Accidental occurrences 14,15 are usually detectable a few hours after exposure and occur mainly among agricultural operators. They are due to noncompliance with the precautions of use of PQ or negligence in its custody or handling.…”

“…8 In some cases, preliminary stunning of the victims by asphyxiation is reported in literature with the purpose of forcing the ingestion of PQ by pouring the substance directly into the throat. 12 It is therefore evident that, in a forensic context, it is far from unusual to come across scenarios in which PQ is in various ways involved as a possible cause of death of a subject. Depending on the type of exposure and the amount of herbicide ingested, the spectrum of resulting biological signs can vary greatly in severity and lethality.…”