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Carboxyhemoglobin Levels in a Series of Automobile Fires: Death Due to Crash or Fire?

Wirthwein, Darren P. M.D.; Pless, John E. M.D.

The American Journal of Forensic Medicine and Pathology: June 1996 - Volume 17 - Issue 2 - p 117-123
Article

The determination of death by trauma versus fire can be of major consideration, especially in civil product liability litigation. Blood carboxyhemoglobin levels can be instrumental in that differentiation. Twenty-eight fatalities involving fire in automobiles were reviewed. All subjects displayed some degree of body burn, and in 25 severe charring and/or incineration was present at autopsy. In only one case was there a history of explosion or flash fire. Carboxyhemoglobin levels varied from 92% to values of <10%. In seven cases no collision occurred. In six of these subjects COHb values were ≥47%. In all 16 cases with carboxyhemoglobin levels of ≤10% a collision occurred. In 12 of 16 of these subjects, blunt force injury sufficient to cause death was discovered. Data presented in this article indicate that a carboxyhemoglobin level of >30% strongly suggests inhalation of combustion products as the cause of death. In contrast, a level of <20% should prompt a search for other causes.

From the Division of Forensic Pathology, Indiana University, Indianapolis, Indiana, U.S.A.

Received December 24, 1994; accepted June 20, 1995.

Address correspondence and reprint requests to Dr. John E. Pless, Department of Forensic Pathology, Indiana University, 635 Barnhill Dr., MS 157, Indianapolis, IN 46202-5120, U.S.A.

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