The role of post-mortem investigations in deaths due to fermenting grape gas: A case series of four fatalities

Carbon dioxide (CO2) is an endogenous molecule produced by cellular respiration and therefore present in our body and in the atmosphere. It is known that, at high levels, CO2 causes fatal toxic effects. The production of CO2 can prove particularly dangerous in closed and unventilated environments. A...

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Main Authors: Matteo Antonio Sacco, Saverio Gualtieri, Loris Rivalta, Caterina Nesci, Raffaele La Russa, Cristina Juan, Pietrantonio Ricci, Isabella Aquila
Format: Article
Language:English
Published: Elsevier 2024-01-01
Series:Forensic Science International: Synergy
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Online Access:http://www.sciencedirect.com/science/article/pii/S2589871X24001086
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author Matteo Antonio Sacco
Saverio Gualtieri
Loris Rivalta
Caterina Nesci
Raffaele La Russa
Cristina Juan
Pietrantonio Ricci
Isabella Aquila
author_facet Matteo Antonio Sacco
Saverio Gualtieri
Loris Rivalta
Caterina Nesci
Raffaele La Russa
Cristina Juan
Pietrantonio Ricci
Isabella Aquila
author_sort Matteo Antonio Sacco
collection DOAJ
description Carbon dioxide (CO2) is an endogenous molecule produced by cellular respiration and therefore present in our body and in the atmosphere. It is known that, at high levels, CO2 causes fatal toxic effects. The production of CO2 can prove particularly dangerous in closed and unventilated environments. Although some cases of death due to CO2 are described in forensic literature, today this diagnosis of CO2 intoxication on cadaver is still a challenge as it is a volatile endogenous molecule and strongly increased after death due to anoxia. In this paper, we describe six cases of simultaneous CO2 intoxications which was caused by a fermentation of grape must in a closed environment. Four people died while the other two were rescued. Scene investigation with measurement of environmental gas levels using sensors was performed. Autopsies were carried out with toxicological investigations and histopathological analyses. Finally, a review of the scientific literature on deaths related to fermenting grape gas was carried out. The results demonstrated toxic levels of CO2 at the scene. The corpses showed initial transformative phenomena such as skin discoloration and slippage, while toxicological investigations demonstrated a peak of HbCO2 (carbaminohemoglobin) with alcohol positivity in the blood of the deceased subjects. Histopathological investigations showed must yeasts (Saccharomyces) in the pulmonary alveoli. The paper reports the procedures performed proposing the introduction of new experimental investigations for the post-mortem diagnosis of CO2 intoxication with a forensic diagnostic protocol.
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spelling doaj-art-a1bf28a36ffc415eac8ff650098898b22025-08-20T01:56:49ZengElsevierForensic Science International: Synergy2589-871X2024-01-01910056110.1016/j.fsisyn.2024.100561The role of post-mortem investigations in deaths due to fermenting grape gas: A case series of four fatalitiesMatteo Antonio Sacco0Saverio Gualtieri1Loris Rivalta2Caterina Nesci3Raffaele La Russa4Cristina Juan5Pietrantonio Ricci6Isabella Aquila7Institute of Legal Medicine, Department of Medical and Surgical Sciences, “Magna Graecia” University, 88100, Catanzaro, ItalyInstitute of Legal Medicine, Department of Medical and Surgical Sciences, “Magna Graecia” University, 88100, Catanzaro, ItalyASP Catanzaro, 88100, Catanzaro, ItalyASP Catanzaro, 88100, Catanzaro, ItalyDepartment of Clinical Medicine, Public Health, Life Sciences, Environmental Sciences, University of L'Aquila, 67100, L'Aquila, ItalyLaboratory of Food Chemistry and Toxicology, Faculty of Pharmacy and Food Science, Av. Vicent Andrés Estellés S/n, 46100, Burjassot, University of Valencia, València, SpainInstitute of Legal Medicine, Department of Medical and Surgical Sciences, “Magna Graecia” University, 88100, Catanzaro, ItalyCorresponding author.; Institute of Legal Medicine, Department of Medical and Surgical Sciences, “Magna Graecia” University, 88100, Catanzaro, ItalyCarbon dioxide (CO2) is an endogenous molecule produced by cellular respiration and therefore present in our body and in the atmosphere. It is known that, at high levels, CO2 causes fatal toxic effects. The production of CO2 can prove particularly dangerous in closed and unventilated environments. Although some cases of death due to CO2 are described in forensic literature, today this diagnosis of CO2 intoxication on cadaver is still a challenge as it is a volatile endogenous molecule and strongly increased after death due to anoxia. In this paper, we describe six cases of simultaneous CO2 intoxications which was caused by a fermentation of grape must in a closed environment. Four people died while the other two were rescued. Scene investigation with measurement of environmental gas levels using sensors was performed. Autopsies were carried out with toxicological investigations and histopathological analyses. Finally, a review of the scientific literature on deaths related to fermenting grape gas was carried out. The results demonstrated toxic levels of CO2 at the scene. The corpses showed initial transformative phenomena such as skin discoloration and slippage, while toxicological investigations demonstrated a peak of HbCO2 (carbaminohemoglobin) with alcohol positivity in the blood of the deceased subjects. Histopathological investigations showed must yeasts (Saccharomyces) in the pulmonary alveoli. The paper reports the procedures performed proposing the introduction of new experimental investigations for the post-mortem diagnosis of CO2 intoxication with a forensic diagnostic protocol.http://www.sciencedirect.com/science/article/pii/S2589871X24001086Forensic sciencesCarbon dioxideCarbaminohemoglobin
spellingShingle Matteo Antonio Sacco
Saverio Gualtieri
Loris Rivalta
Caterina Nesci
Raffaele La Russa
Cristina Juan
Pietrantonio Ricci
Isabella Aquila
The role of post-mortem investigations in deaths due to fermenting grape gas: A case series of four fatalities
Forensic Science International: Synergy
Forensic sciences
Carbon dioxide
Carbaminohemoglobin
title The role of post-mortem investigations in deaths due to fermenting grape gas: A case series of four fatalities
title_full The role of post-mortem investigations in deaths due to fermenting grape gas: A case series of four fatalities
title_fullStr The role of post-mortem investigations in deaths due to fermenting grape gas: A case series of four fatalities
title_full_unstemmed The role of post-mortem investigations in deaths due to fermenting grape gas: A case series of four fatalities
title_short The role of post-mortem investigations in deaths due to fermenting grape gas: A case series of four fatalities
title_sort role of post mortem investigations in deaths due to fermenting grape gas a case series of four fatalities
topic Forensic sciences
Carbon dioxide
Carbaminohemoglobin
url http://www.sciencedirect.com/science/article/pii/S2589871X24001086
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