On May 8, 2021, a 27-year-old university student was seen in the outpatient’s department of one of the renowned private hospitals within the city and was attended to by a team of clinicians led by a physician (a doctor with a master’s degree in Internal Medicine).
The patient complained of abdominal pain that had lasted for one week. The pain was burning in nature and most pronounced in the mid-upper part of the abdomen. The pain that did not respond to the painkillers that the patient had taken, was associated with loss of appetite, body weakness, nausea, vomiting and diarrhoea.
The day he was admitted, the pain had gotten progressively worse. On further probing, the patient disclosed a history of excessive drinking of alcohol the week leading to his admission.The doctors noted that the patient was obese; his weight was 105kg and his height was 167 cm.
The patient’s breathing was rather fast and his pulse rate was also high. The abdominal pain was quite evident when he was examined. His blood sugar was found to be quite high. The patient’s blood pressure was abnormal. A diagnosis of acute pancreatitis (inflammation of the pancreases of recent onset) with an elevated blood sugar was made.
The doctors also noted that patient could also have developed diabetes, as there was also a history of diabetes and high blood pressure in the family.
The diagnosis of pancreatitis was confirmed by special laboratory examination tests. These tests are known as enzyme markers for the pancreatitis and they were all elevated.
The patient dies
The patient’s condition deteriorated a day after admission. His blood pressure dropped below normal and he became restless. His breathing was compromised. He was transferred to the intensive care unit (ICU). He was screened for Covid-19 and the results came back positive.
On the fourth day of admission, the patient’s kidneys failed to form adequate amounts of urine and he was diagnosed with kidney failure. On May 13, the patient went into coma and the following day, he spiked very high fevers.
The patient died on May 15 and the cause of death was stated as acute pancreatitis. Other conditions associated with the patient’s death were stated as diabetes and Covid-19 infection.The patient was buried on May 18, 2021, but a postmortem examination was not carried out before the burial.
The father of the deceased was not satisfied with the cause of death as disclosed by the hospital and through the police, a court order was obtained for the exhumation of and postmortem examination of the body. These were carried out on July 30, 2021, but no cause of death was established.
Samples were removed for toxicology analysis and these included stomach contents of the deceased, bile, scalp tissue with some hair, the toe nails and parts of liver and kidney. The results of the toxicology tests, dated April 12, 2022 indicated that the stomach contents and parts of liver and kidney quantitatively contained Carbofuran, a very poisonous substance in the class of Carbamates.
The toxicology report described the chemical as an agriculture pesticide and that human exposure to the chemical can result in a range of toxicological effects, which include blurred vision, excessive salivation, nausea, vomiting, convulsions and death. The World Health Organisation classifies the chemical as highly hazardous.
Contention
The postmortem report stated that the possible sources of the chemical are contaminated food and crops that are intentionally or accidentally ingested or when the chemical is exposed to the skin. The postmortem report also noted that Carbofuran poisoning causes death within a very short time.
The authors of the report were hesitant to conclude that the death of the patient was due to Carbofuran poisoning, but recommended that a quantitative test be performed to determine the actual chemical concentration level in the submitted poisons and whether it was a lethal dose.
The authors of the report further recommended that the samples be submitted for further analysis to a different laboratory and another opinion obtained.
Carbofuran is a Carbamate and is classified as extremely toxic. These chemicals are used as insecticides and share a number of properties with other pesticides known as organophosphates.
These chemicals, when ingested by human beings or when human beings are exposed to them cause excessive secretion of saliva, sweating, abdominal cramps and pain, diarrhea, general weakness, difficulty in breathing, headaches, twitching of the muscles, excessive constriction of the pupils of the eyes and later on convulsions and death. These signs and symptoms of Carbofuran poisoning occur within a few hours after exposure to the poison.
The patient certainly did not have some of the cardinal signs and symptoms of Carbofuran poisoning such as excessive secretion of saliva and constriction of the pupils. He is reported to have started feeling unwell and complained of abdominal pain nearly two months after his elder brother was seen giving him some drink.
He was also noted to be taking too much water which in reality is a symptom of someone with diabetes. And when the patient was alive in hospital nobody raised any complaint of poisoning.
It is also important to note that once poisons enter the body, they are absorbed in the blood stream and would be broken down and the evidence of such poisons would be by finding the breakdown products of that poison in the tissues of the body and urine.
It is absurd and bizarre that a poison that was administered to a patient on March 14, 2021 would only manifest in the first week of May 2021 and would still be found intact in the stomach of the deceased on July 30, 2021 and the doctors would not find any signs and symptoms of the poison during the one week the patient was admitted in hospital. Two people, including the elder brother of the deceased were arrested, taken to court, charged and tried for the murder of the deceased.
Chemical
Highly hazardous
Toxicology tests dated on April 12, 2022 indicated that the stomach contents and parts of liver and kidney quantitatively contained Carbofurantoxicology. The report described the chemical as an agriculture pesticide and that human exposure to the chemical can result in a range of toxicological effects, which include blurred vision, excessive salivation, nausea, vomiting, convulsions and death.
To be continued
