We report the death of a young female non-diabetic after self-administration of insulin which led to the trial and conviction of her partner, who was himself an insulin-dependent diabetic. This brings out particular lessons for the pathologist in view of the rarity of such deaths, emphasizes the importance of careful laboratory analysis and illustrates a number of interesting legal points.
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References
1.
ArkyR. A.VeverbrantsE.AbramsonE. A. (1968) Irreversible hypoglycemia: a complication of alcohol and insulin. JAMA206, 575–8.
2.
BirkinshawV. J.GurdM. R.RandallS. S.CurryA. S.PriceD. E.WrightP. H. (1958) Investigations in a case of murder by insulin poisoning. BMJ2, 463–8.
3.
CampbellI. W.RatcliffeJ. G. (1982) Suicidal insulin overdose managed by excision of insulin injection site. BMJ 285, 408–9.
4.
CoeJ. I. (1975) Post-mortem peripheral blood glucose and cardiopulmonary resuscitation. For. Sci. Gaz.6, 1.
5.
CritchleyJ. A. J.H.ProudfootA. T.BoydS. G.CampbellI. W.BrownN.S.GordonA. (1984) Deaths and paradoxes after intentional insulin overdose. BMJ289, 225.
6.
DerobertL.HadengueA.MartinR. (1952) Ann. Med. Leg.32, 278–9.
7.
GinH.LarmaudieB.AubertinJ. (1983) Attempted suicide by insulin injection treated with artificial pancreas. BMJ287, 249–50.
8.
GreenfieldJ. G.BlackwoodW.CorsellisJ. A. N. (1976) Greenfield's Neuropathology, third edition. London, Edward Arnold, pp. 74–6.
9.
HaibachH.DixJ. D.ShahJ. H. (1987) Homicide by insulin administration. J. For. Sci.32, 208–16.
10.
HorwitzD. L., (1989) Factitious and artificial hypoglycaemia. Endocrinol. Metab. Clinics N. Am.18, 203–10.
11.
KaminerY.RobbinsD. R. (1988) Attempted suicide by insulin overdose in insulin dependent diabetic adolescents. Paediatrics81, 526–8.
12.
LevyW. J.GardnerD.MoseleyJ.DixJ.GaedeS. E. (1985) Unusual problems for the physician in managing a hospital patient who received a malicious insulin overdose. Neurosurgery17, 992–6.
13.
PiochW. (1960) Dtsch Z ges gerichtl. Med.49, 665.
14.
Reports (1974) High court of Justiciary HM Advocate v. McTavish. Scots Law Times, 246–7.
15.
SchweisheimerW. (1963) Med. Klin.58, 1046–7.
16.
TedeschiC. G.EckertW. G.TedeschiL. G. (1977) Post mortem chemistry of blood, cerebrospinal fluid, and vitreous humor. For. Med. Vol. 2: Physical Trauma. 1033–60.
17.
TunbridgeW. M. G. (1981) Factors contributing to deaths of diabetics under fifty years of age. Lancet2, 569–72.
