Sawaguchi A., Sawaguchi T., Ohue O.

Dept. of Legal Medicine, Tokyo Women's Medical College, 8-1 Kawadacho, Shinjuku, Tokyo, Japan

Lidocaine is an amide-type anesthetic that was developed in Sweden in 1948. It is used widely throughout the world but it occasionally causes a shock. Though rarely, fatal cases have been reported in association with the use of this agent.
We encountered a fatal case of shock caused by lidocaine during a breast augmentation procedure.
An unlicensed Filipino male performed rhinoplasty and breast augmentation procedures on a Filipino female (30 years old) in his own apartment. During surgery, the procedure was interrupted after augmentation of the nose and the right breast. Around 6 pm of the next day, the Filipino male came out of his room upon hearing knocking at the adjacent door and found the patient leaning on the door in obvious agony. He took her to the Emergency Department of a Hospital where she expired shortly thereafter.
The procedures performed by an unqualified person and inadequacy of the treatment where blamed in the present case. Based on the autopsy findings and the results of chemical analysis, it was concluded that shock from the anesthetic was caused by injection of an excessive quantity of lidocaine, a local anesthetic that was used during the breast augmentation procedure.