Journal Article

Is it worth carrying out determination of n-butane in postmortem samples? A case report and a comprehensive review of the literature

Paraf, François, El Balkhi, Souleiman, Moreau, Fanny, Coutaz-Fluck, Caroline, Gaulier, Jean-Michel

2016

Overview

The aim of this article is to illustrate the importance of n -butane determination in postmortem samples through a case report and to propose actions and precautions to be taken into consideration when butane is suspected to be involved in cases of death. The case concerns a 15-year-old boy found dead after sniffing a cigarette lighter refill. Toxicological investigation revealed the presence of butane in the heart and femoral blood (1280 and 1170 μg/L, respectively), in the gastric contents (326 μg/L), and in the liver (1010 μg/kg) and lung tissues (210 μg/kg). Propane was present only in the blood samples at concentrations tenfolds lower. Butane can be involved in three kinds of fatalities: deliberate inhalations including volatile substance abuse (VSA), involuntary exposure, and homicides. A fatal outcome of butane inhalation can be caused by asphyxia and/or cardiac arrhythmia. In the context where butane exposure is evidenced by non-toxicological investigations, the usefulness of the determination of butane in postmortem samples is often questionable. However, it is admitted that butane-related deaths are generally underreported. Several difficulties including sample handling and storage, substantial variation in tissue concentrations, and lack of a lethal threshold make the interpretation of butane results challenging. In our opinion, systematic toxicological methods should be developed in order to analyze butane, at least when it concerns a typical VSA victim, even when butane is not actually suspected to be the cause of death.

• Publisher: Springer Berlin Heidelberg,Springer Nature B.V
• Subject: Adolescent / Aerosols / Blood / Blood tests / Butanes - analysis / Butanes - poisoning / Cardiac arrhythmia / Case Report / Case reports / Chromatography, Liquid / Death & dying / Death, Sudden - etiology / Deaths / Drug abuse / Forensic Medicine / Forensic Toxicology / Gases / Humans / Inhalant Abuse / Involuntary / Literature reviews / Liver / Male / Mass Spectrometry / Medical Law / Medicine & Public Health / Murders & murder attempts / Precautions / Propane / Propane - blood / Smoking / Storage / Substance abuse / Toxicology / Usefulness / VOCs / Volatile organic compounds