Key result
Beta-2 agonist inhalation linked to fatal cardiac arrhythmia and secondary cervical spine injury.
Why the study?
The cause of sudden unexpected death with unusual cervical spine lesions was unclear and required detailed postmortem and biomechanical investigation.
Case Report (n=1)
This case report highlights the utility of combining postmortem imaging, histology, and biomechanical finite element analysis to determine the sequence of events in sudden unexpected death.
Alerts clinicians to rare beta-2 agonist arrhythmia risk; extends forensic multimodal analysis for sudden-death investigation.
A naked man died under peculiar circumstances and the postmortem examination revealed unexpected lesions in the cervical spine. Investigations of the cervical spine (computed tomography, magnetic resonance imaging, and histological examination) showed that a piece of bone was torn of the anterior part of vertebra C6 and that there was fresh bleeding in the surrounding tissue. The cause of death remained unclear but was most likely cardiac arrhythmia initiated by beta-2 agonist inhalation due to an acute asthmatic attack. Data from biomechanical investigation using finite element analysis supported the conclusion that the cervical spine injury was secondary to impact during falling as a consequence of the cardiac arrhythmia.
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Ejlersen et al. (2007) conducted a case report in Sudden unexpected death (n=1). Postmortem investigation and biomechanical analysis was evaluated on Cause of death and mechanism of cervical spine injury. Postmortem and biomechanical investigations suggested the cause of death was likely cardiac arrhythmia initiated by beta-2 agonist inhalation, with cervical spine injury secondary to a fall.
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