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Murder-suicide by carbon dioxide (CO2) poisoning: A family case from Berlin, Germany

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Abstract

This report demonstrates how carbon dioxide (CO2) may be a potent weapon in murder-suicide, where the death scene offers virtually no clues as to the lethal modality and the autopsy findings are nonspecific. Four bodies were discovered in an apartment in midsummer 2012 in Berlin, Germany. The bodies were those of a father (a 69-year-old business consultant), his wife (aged 26-years), and two sons (aged 3 and 6 years, respectively). The police found the wife and two sons lying in their beds and the husband in a supine position on the floor with a plastic bag over his head tied loosely around his neck with a rope. A 500 g single-use CO2 cylinder was standing on the floor. The container was almost empty and according to the label had been sold as a CO2-fertilizer for aquarium plants. Two synthetic inhalation face masks and tubing were also found, which tested positive for the DNA of all four deceased family members. It is hypothesized that the husband placed an inhalation mask over the mouths and noses of his wife and children while they were sleeping. Inhalation of pure CO2 ensured their rapid unconsciousness due to hypercapnia and severe anoxia. The rapid increase in CO2 concentration would render a victim helpless, with no time to wake and defend themselves, or others. The proximate cause of death in all cases was attributed to CO2 intoxication, based on the scene findings, the reconstructed sequence of events, the autopsy, and results of toxicological studies.

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... This is the most commonly reported motive in the literature [1]. In one case that involved a 69-year-old father killing his wife and his two sons by carbon dioxide poisoning, possible financial motives were mentioned in his suicide note [13]. ...
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Murder-suicides are defined as the murder of at least one person and the suicide of the offender following the murder. The intention to commit suicide must be primary. In most cases, a male offender kills a female victim after a separation. The current analysis was the first analysis of the typology of murder-suicides in Berlin. We analyzed the autopsy files of the Institute for Forensic Medicine of the Charité University Medicine Berlin and of the City Institute for Forensic Medicine Berlin. We performed descriptive and statistical analyses of cases between 2005 and 2013. We identified 17 murder-suicides. All 17 offenders were male, and 20 of the victims (90%) were female. The offenders used firearms in the majority of the cases. In seven cases, the victims and offenders were at least 80 years old. The average age of the offenders was 63 years. Disease was the motive in 6 cases involving older offenders. Our study might support the development of prevention strategies. In this regard, it is important to build a database for murder-suicides in Germany and other countries, to formulate a uniform definition of murder-suicide, to carry out nationwide interdisciplinary studies on this topic and to improve the existing health care structures, especially for older adults and people with depression.
... In August 1986, a limnic eruption at Lake Nyos in Northwestern Cameroon killed 1746 people and 3500 livestock in a matter of minutes due to release of CO 2 dissolved in the water (9). Although large quantities of CO 2 , gaseous or solid form, are rel-atively accessible to persons, very few cases of suicidal deaths from asphyxia in the setting of high concentration of CO 2 have been published (10,11). ...
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Carbon dioxide (CO 2 ) therapy is the subcutaneous or transcutaneous administration of CO 2 for therapeutic purposes. Carbon dioxide therapy is used for localized lipolysis, to treat chronic skin conditions, and is a safe treatment. Full-body CO 2 baths are offered in European spa centers, in which the clients are placed into full body bags infused with CO 2 at an optimal concentration range between 1000 and 1400 mg/L (516 000-722 500 ppm). Commercially manufactured, air-tight bags and accompanying apparatus designed to provide CO 2 baths can be purchased for home use. Few human CO 2 -related deaths have been reported. They have been mostly accidental, consisting of persons trapped in a closed environment in the presence of “dry ice” or solid CO 2 . There have been no reported deaths of a human undergoing a CO 2 therapy at home. We present a case of a middle-aged male found at home completely inside an air-sealed bag wrapped tightly around his body. The bag was connected to a working pump and a CO 2 gas tank. The pump was connected through an inflow and outflow circuit to the bag. The inflow tubing for CO 2 gas delivery was partially disrupted, while the outflow tubing was intact. The autopsy and toxicology were unremarkable. The cause of death was determined to be asphyxia by vitiated atmosphere as evident by the displacement of oxygen by CO 2 and low pressure created inside a “CO 2 therapy bath.” The manner of death was accidental.
... However, H 2 S and CO 2 poisoning have been more extensively studied in accidental or occupational fatalities, mostly occurred in confined spaces [15][16][17][18][19][20][21][22][23][24], but also in suicidal events [25][26][27][28][29][30]. Unfortunately, few reports mention the levels of toxic gases at the death scene [13,27,31,32] although it is well known that the acute toxicity of H 2 S and CO 2 is more dependent on environmental concentration than time of inhalation. ...
Article
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... Intoxication and death with gases is reported in many cases [7,11,12], either accidents or suicides. Gases such as nitrogen [13,14], carbon monoxide [6,7], carbon dioxide [15,16], helium [8][9][10][11][12], air [4], butane [17], hydrogen sulfide [18][19][20], nitrous oxide [21] were reported as cause of death. ...
Article
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... However, supporting our results are observations of inci- dents with CO 2 in humans. Survivors of CO 2 poisoning reported, besides a pungent smell and difficulty breathing, no fear, pain, or other warning signs, and unconsciousness was reached within a few seconds [71,72]. Also, a recent study comparing CO 2 , isoflurane, and pentobarbi- tal-phenytoin euthanasia in mice observed no specific behavioral signs for distress [7]. ...
Article
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... Such scenarios include closed atmospheres where oxygen is used up and carbon dioxide builds up. This has been seen in cars with catalytic converters that remove carbon monoxide, wine vat rooms with dry ice, rooms with carbon dioxide fire extinguisher mechanisms, and in some natural disasters such as volcano lake eruptions, where large amounts of carbon dioxide can be released and have resulted in multiple fatalities (20)(21)(22)(23)(24)(25)(26). In the Lake Nyos incident in Cameroon in 1986, over 1700 people were killed and there were another 5000 survivors from what was believed to be the massive release of carbon dioxide from the lake (27). ...
Article
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... KEYWORDS: forensic science, forensic pathology, silage pit, accidental death, drowning, carbon dioxide, hydrogen sulfide, infrared gas analyzer Fatalities due to gas intoxication are rare in routine forensic casework. They are mostly accidental deaths (1), but cases of suicide or homicide (2,3) have also been reported. The most common is carbon monoxide (CO) intoxication (4); Intoxication by other gases is much more rare (ammonia, methane, propane and butane, hydrogen sulfide, carbon dioxide etc.). ...
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... Während von Sautter et al. [20] ein 4 Personen betreffender erweiterter Sui-zid unter Verwendung einer CO2-Gasflasche berichtet wurde und Duncanson [6] einen "iatrogenen Homizid" durch Inhalation einer 60 %igen CO2-Narkose beschreibt, ist eine homizidale Anwendung der Noxe in Form von Trockeneis in der Literatur bisher nicht beschrieben. Demgegenüber ist der "Mordmethode" Trockeneis hingegen bereits ein Fernsehfilm der Reihe "Tatort" gewidmet und damit einem großen Publikum bekannt gemacht worden ("Tatort: Auskreuzung", Folge 811, Erstausstrahlung 25.09.2011) ...
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A cloud of carbon dioxide gas, with an estimated volume of 1 km3 was released from Lake Nyos, a volcanic crater lake in Cameroon, Africa, causing 1700 to 2000 human fatalities as well as killing thousands of livestock and wild animals. At the request of the Cameroonian Government, the Office of Foreign Disaster Assistance of the U.S. Department of State sent a multidisciplinary team which included 2 forensic pathologists to assist the Government of Cameroon in investigating this natural disaster. The medical evaluation was concentrated in 3 areas: the autopsy of human and animal fatalities, examination and interview of survivors, and examination of the scene of the disaster. Toxicologic specimens were obtained at autopsy, and numerous samples of lake water were collected. The autopsy findings were consistent with asphyxia. The results of chemical analyses excluded many volatiles but not carbon dioxide as the toxic agent. The exact source of this gas continues to be a subject of a heated geologic debate, but fermentation of organic materials in the lake water has been eliminated on the basis of C14 isotope studies. This investigation underlines the value of forensic pathologists in epidemiological studies and in the examination of living persons.
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A 44-year-old male, engaged in the transportation of dry ice, was found dead on the floor of the freezer of his refrigerator car which was parked in front of the place where he was scheduled to make a delivery. Autopsy was performed to investigate the cause of death. Apart from the signs of acute death, no other significant findings were obtained, either macro or microscopically; carbon dioxide poisoning was thus strongly suspected. We created a simulation experiment by using the refrigerator car to reproduce the events of the accident. The oxygen concentration in the freezer was 21.0% as indicated by oxygen sensors, but decreased to 17.1-17.4% when the engine was stopped. This decrease in oxygen concentration supposedly results from the production of carbon dioxide by the vaporization of dry ice. Carbon dioxide concentration in the air could be calculated from the change in the oxygen concentration in the closed space of the freezer. The concentration was assessed at 17.1-18.6%. An oxygen concentration of 17.1-17.4% does not of itself cause serious hypoxia, but a carbon dioxide concentration of 17.1-18.6% probably causes serious intoxication, because this value is beyond that of intoxication levels published in references. Therefore, we concluded that the cause of death in this case was carbon dioxide intoxication.
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The authors describe three accidental deaths resulting from occupational hazards involving environmental gas alterations. One involved the displacement of oxygen caused by leakage of liquid nitrogen during the installation of a magnetic resonance imaging system. Two involved elevated environmental carbon dioxide concentrations: dry ice sublimation in a walk-in refrigerator in a research laboratory, and activation of a carbon dioxide fire alarm-extinguisher system by a woman locked in a bank vault. The autopsy findings, scene investigations, and certifications of these deaths, as related to the mechanisms of death, are discussed.
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Carbon dioxide is a physiologically important gas, produced by the body as a result of cellular metabolism. It is widely used in the food industry in the carbonation of beverages, in fire extinguishers as an 'inerting' agent and in the chemical industry. Its main mode of action is as an asphyxiant, although it also exerts toxic effects at cellular level. At low concentrations, gaseous carbon dioxide appears to have little toxicological effect. At higher concentrations it leads to an increased respiratory rate, tachycardia, cardiac arrhythmias and impaired consciousness. Concentrations >10% may cause convulsions, coma and death. Solid carbon dioxide may cause burns following direct contact. If it is warmed rapidly, large amounts of carbon dioxide are generated, which can be dangerous, particularly within confined areas. The management of carbon dioxide poisoning requires the immediate removal of the casualty from the toxic environment, the administration of oxygen and appropriate supportive care. In severe cases, assisted ventilation may be required. Dry ice burns are treated similarly to other cryogenic burns, requiring thawing of the tissue and suitable analgesia. Healing may be delayed and surgical intervention may be required in severe cases.
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