SOFT - TIAFT 1998 Poster Session 3 Thursday October 8, 1998

Susan B. Gock, Steven H. Y. Wong, Susan E. Venuti, John R. Teggatz, and Jeffrey M. M. Jentzen

Milwaukee County Medical Examiner's Office and Department of Pathology, Medical College of Wisconsin, Milwaukee, WI 53223, U.S.A.

A 36 year old female was found dead in bed in her secured home. An apparent suicide note was found posted on the refrigerator door. The decedent had a history of psychiatric illnesses including: paranoid disorder, depression with panic episodes, and post-tramatic stress disorder. As a result, she had been home bound. For the above disorders, she was medicated with risperidone, and sertraline. Previously, the decedent was also prescribed zolpidem (Ambien), a hypnotic agent.

The postmortem examination showed an obese individual weighing 262 lbs with an unremarkable external examination. The heart weighed 400 gm and was grossly normal. Examination of the respiratory system revealed white foam within the larynx and upper tracheal. Histological diagnoses included intra-alveolar pulmonary edema and hepatic steatoisis. Toxicological analyses showed the presence of caffeine, risperidone, and zoplidem in urine, and in the blood, 9-hydroxyrisperidone, 5.6 mg/L, and zolpidem, 4.5 mg/L. The latter corresponded to a toxic concentration. The cause of death was determined to zolpidem overdose, and manner of death - suicide.

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