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Fatal Venous Air Embolism Following Intravenous Infusion

NCJ Number
Journal of Forensic Sciences Volume: 54 Issue: 3 Dated: May 2009 Pages: 682-684
Swapnil Sudhirkumar Agarwal M.D.; Lavlesh Kumar M.D.; Krishnadutt Harishankar Chavali M.D.; Shashidhar Chennamallapa Mestri M.D.
Date Published
May 2009
3 pages
This paper reports on the autopsy procedures and findings in the death of a 14-year-old boy who was determined to have died from an “air embolism following intravenous infusion.”
This determination of the cause of death was based on the following findings: intravenous infusion by unqualified attendants, sudden death after about 3.5 hours of respiratory distress, the presence of fine frothy blood in the right side of the heart and draining major vessels, subcutaneous emphysema over upper parts of the body, and negative findings regarding any other cause of death. The authors’ advice on diagnosing air embolism is to conduct a pre-autopsy chest radiograph, which is the best way to detect air in sufficient quantities to be fatal. If air embolism is substantial enough to cause death, frothy blood oozing from the ventricular lumen, almost invariably in the right ventricle, will be evident. This condition can be observed on the pre-autopsy radiograph. Venous air embolism is a possibility in all cases in which intravenous infusion is given. In fact, any needle placed in the venous system carries the risk of causing air embolism. Such incidents can be minimized if the doctor is aware of its possibility and follows correct procedures in administering intravenous fluids. 11 references