Self-administrated propofol -Â a case report of a physician suicide

Fatal self-administrated propofol intoxication of a 29-years old anesthesiologist, found dead in his home, is reported. The toxicological screening, performed using gas chromatography-mass spectrometry of blood and urine samples, evidenced only the presence of propofol and lidocaine despite the numerous empty packages of various drugs found at the crime scene. Propofol was quantitated in all available biological specimens (blood, urine, vitreous humor, liver and brain tissue) using high performance liquid chromatography-diode array/fluorescent detector. The obtained results for drug concentration were as follows: blood - 0.90 μg/mL (free) and 1.00 μg/mL (after enzymatic hydrolysis); urine < 0.05 μg/mL; vitreous humor - 0.08 μg/mL; liver - 5.70 mg/kg and brain - 1.13 mg/kg. Both toxicological results and autopsy findings confirmed that death was caused by respiratory failure due to propofol overdose, administered within short time period. Crucial factor for data interpretation was the postmortem redistribution of propofol, characterized with rapid drug accumulation in tissues.