Suicidal poisoning by ingestion of Taxus Baccata leaves. Case report and literature review

Abstract

A 43-year-old man was found unconscious at his home by the family members. He was transported to the local hospital where there was suspected the diagnosis of voluntary intoxication due to an unknown plant, possible Taxus baccata. He died 4 hours post admission and a medico-legal autopsy was performed, followed by histological and forensic toxicology analysis. Furthermore a botanical investigation was applied. Autopsy revealed fragments of greenish needle-like leaves in the stomach. Plant botanical investigation indicated the presence of Taxus baccata, also known as yew. The histological findings showed unspecific modifications of the internal organs, in concordance with the literature. No signs of violence could be found on the external exam or any relevant concentrations of alcohol, narcotic drugs and pharmaceuticals in the postmortem screening. Therefore, taking into account the history of the case, the clinical, paraclinical data, the autopsy findings and the ancillary examinations, the death was considered violent due to acute intoxication with Taxus baccata, this being a unique case in the activity of our Institute of Legal Medicine.

Fatal ingestion ofTaxus baccata: English yew

“…Lethal consumption of T . baccata is recognized within academic literature to be associated with toxic ingestions, both accidental and intentional [5,7,9,11,14–27]. The possibility for homicidal intent exists as a genuine risk [5,11,24].…”

Ethnobotanical and pharmacological importance of Taxus wallichiana Zucc.

“…The time from ingesting lethal dose of Taxus toxin to death usually varies between 2-5 hours with symptoms occurring between 30 minutes to 1 hour after ingestion (113). Generally, the Taxus toxins acts by generation of a block in the distal portion of the conduction system of the heart resulting in fatal arrhythmia (114). It is further reported from a study that taxine-B inhibits calcium and sodium transport in myocardial cells and interferes with heart's conducting system thereby acting as a cardiac depressant (115).…”

Clinical Toxicology of Yew Poisoning

“…A total of 26 case reports of acute yew poisoning were identified in our literature search (see Table 2). 15-40 Of the 26 cases, 9 (35%) were female and 17 (65%) male, with an average age of 30 years (range = 19 months to 55 years). Surprisingly, only 2 case reports 15,16 in our series (8%) were accidental poisonings, with the rest being deliberate ingestions.…”