Accidental Deaths Due to Toxic Industrial Cyanide Inhalation: An Autopsy Case Report

Abstract

Autopsies of accidental deaths in industrial scenarios have always been a challenging job for a forensic pathologist. Industries that employ chemical agents pose a unique risk, especially when safety protocols are ignored. Exposure to cyanide salts creates an additional risk since death may occur quickly. We present one such incident of the accidental deaths of three industrial workers, which could have been prevented if proper safety measures had been followed. Four workers fell unconscious while cleaning the electroplating chamber of the handicraft industry. Three were declared dead on arrival at the emergency department, while one survived. Autopsy of all three victims showed similar findings of pink-colored post-mortem staining and multiple petechial hemorrhages over the heart and lungs. After histopathological and chemical analysis, the cause of death was opined to be due to complications of cyanide poisoning. In accidental industrial deaths, the forensic pathologist should consider the possibility of death due to toxic chemicals, such as cyanide, used in the manufacturing process. The industrial personnel should be educated about the risks involved, and proper use of safety equipment should be encouraged to avoid such hazardous outcomes. Additionally, the people employed in the autopsy of the deaths related to chemical disasters should ensure their personal safety and preventive measures.

Keywords: chemical accident; electroplating; forensic autopsy; industrial accidents; personal protective equipment (ppe).

Figure 1. Scene of the incident where electroplating chambers were used in the process of electroplating (yellow circles)

Figure 2. Pink colored post-mortem staining over the back of the body except in pressure areas in all three victims (A, B, and C) and over the left side of the neck and shoulder in one victim (D)

Figure 3. Histopathology of the organs

A) Photomicrograph shows subcapsular hemorrhage in the kidney with underlying cortex showing congestion of glomerular capillary loops, blood-filled peritubular capillaries (black arrow), and acute tubular injury (H&E 100X). B) Myocardium shows fresh hemorrhage and congested capillaries (H&E 100X). C) Low-power view of the lung shows the diffuse accumulation of thin proteinaceous fluid in the alveoli with alveolar dilatation (H&E 100X). D) High power from the lung shows carbon pigment laden macrophages and heart failure cells (red arrow) in the alveoli, along with the presence of amorphous pink material (H&E 400X)