TY - JOUR ID - 19928 TI - Overcoming the Challenges in Deaths by Intravenous Potassium Chloride: A Case Report JO - Asia Pacific Journal of Medical Toxicology JA - APJMT LA - en SN - 2322-2611 AU - Barwa, Jyoti AU - Singh, Rattan AU - Pradhan, Monisha AD - 1Department of Forensic Medicine & Toxicology, AIIMS Bathinda, Punjab – 151001, India AD - 2Department of Forensic Medicine & Toxicology, AIIMS Bathinda, Punjab -151001, India. AD - 3Department of Forensic Medicine & Toxicology, Vardhman Mahaveer Medical College & Safdarjung Hospital, New Delhi -110029, India. Y1 - 2022 PY - 2022 VL - 11 IS - 1 SP - 33 EP - 36 KW - Suicide KW - injection KW - Post mortem examination DO - 10.22038/apjmt.2022.19928 N2 - Introduction: Potassium chloride is extensively used as a potassium supplement, both by physicians as a therapeutic modality and by the general public, mostly in the form of salt substitute. In the oral formulation, the overdose of potassium is not frequently encountered as homeostasis is maintained by daily consumption and renal excretion mechanisms. Lethal injection of potassium chloride (KCl) is yet used either for suicide or homicide, particularly by the healthcare professionals.Case Report: We report a case of a medical professional, found dead in a hotel’s bathroom with intravenous drip set connected to an intravenous cannula, present in situ. The autopsy did not reveal any significant finding except hypo-calcemic tetany in both hands and multiple horizontally placed incised wounds on front of both forearms suggestive of suicidal tendency.Discussion: Fatal intravenous injection of potassium produces subtle or no specific anatomic changes at all thereby posing a challenge to the autopsy surgeon to unpack the cause and manner of death. Since, it is only the extracellular potassium that can be measured in the laboratory, attributing death due to potassium poisoning becomes difficult.Conclusion: In such cases when the post-mortem biological tests are unable to differentiate endogenous from exogenous substances, decisions can only be substantiated by history and circumstantial evidence.   UR - https://apjmt.mums.ac.ir/article_19928.html L1 - https://apjmt.mums.ac.ir/article_19928_ce820343cad02b7d79e167db15edbe43.pdf ER -