27 December 2012

Uganda: Autopsy Reveals Cause of Lawmaker's Death

The significant findings as seen at autopsy were congested lungs with oedema and patchy consolidation. The pancreas had a dull outer surface and a haemorrhagic cut surface. The stomach mucosa was hyperaemic.

Director General Health Services Ministry of Health Dr Jane Ruth Aceng said the significant toxins detected in urine, post-mortem blood, stomach contents samples (and trace amounts in white wine) included ethanol (alcohol), cocaine (and its metabolites/breakdown products), morphine (and its metabolites/breakdown products), codeine, chloroquine, cocaethlene and dextromethorphan.

Dr Aceng says, "The fact that some of these toxins/drugs were detected in the stomach contents is an indication that they may have been taken orally prior to death."

The detection of the products and their breakdown substances in the blood and urine indicates they were absorbed and distributed in the blood stream to various body organs and eventually excreted in the urine. The post-mortem report (by Prof Wabinga indicates that the needle puncture wound seen at autopsy was for administering medication)

She added that various drugs were used as a cough suppressant as well as for pain relief. The patchy consolidation seen at autopsy is a sign of Bronchopneumonia which may present as cough. The deceased was probably on medication for cough (or pneumonia).

Post-mortem findings are non-specific but include intense congestion of the gastric mucosa (reported as hyperaemia in this post-mortem), odour of alcoholic beverages (probably the sweet smell reported at autopsy), and congestion of the organs.

Acute alcohol intoxication depresses the respiratory centre. Alcohol is also one of the predisposing factors to acute pancreatitis giving haemorrhage (bleeding) in the pancreas (Histology results of the pancreas and other organs are awaited).

The director in her press release obtained by The Independent added that, "The effects on the body could be due to cocaine or its breakdown products. Post-mortem findings include pulmonary edema and congestion (as seen at autopsy). Chronic use of cocaine is associated with cardiotoxicity especially heart rhythm disturbances (which cannot be seen at autopsy with the naked eye)."

Depress the central nervous system which may lead to sudden death resulting from respiratory depression, cardiac arrest, heart rhythm disturbances (arrhythmias) or severe pulmonary edema.

The observed pulmonary edema and congestion, patchy consolidation of the lungs, dull pancreas, hyperaemic stomach at post-mortem may have an explained link to the toxicology findings.

"The effects of the toxins/drugs discovered in the blood potentiate each other as do the adverse effects," says Dr Aceng.

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