Fatal Poisoning by Ammonium-Containing Fluoride Compounds: An Autopsy Case

In the forensic literature, reports of acute fatal poisoning caused by ammoniumcontaining fluoride compounds are rare. We report a case of fluoride poisoning in a 46-year-old man who was found dead, with oral bleeding, beside his vehicle. At autopsy, notable findings included brown discoloration of the iris, as well as the gastric and proximal intestinal mucosa, with increased stiffness of the affected intestinal tissues. Toxicological analysis identified fluoride and ammonium ions in an aqueous solution that was recovered from the vehicle. Quantitative analysis of postmortem specimens revealed fluoride concentrations of 55.3 and 37.7 mg/L in cardiac and femoral blood samples, respectively. From the investigation scene, autopsy findings, and toxicological results, the cause of death was determined to be acute fluoride intoxication. This case highlights the importance of scene-derived evidence in guiding targeted toxicological analysis, particularly for substances that are not routinely included in standard screening, and demonstrates characteristic autopsy findings that may enable a diagnosis of acute intoxication by ammoniumcontaining fluoride compounds.