Four cases of self-injected insulin overdose in nondiabetic individuals are presented. Included are two cases of presumed insulin overdose (no autopsy), one case with elevated vitreous insulin (autopsy), and one case with elevated postmortem blood insulin and low blood C peptide (autopsy). These cases demonstrate the need for a thorough scene investigation, complete autopsy, and proper collection and storage of specimens to certify a death caused by insulin intoxication as well as to determine the manner of death. Appropriate collection and preservation of postmortem blood samples are discussed.
From the Department of Pathology, Wake Forest University, Baptist Medical Center, Winston-Salem, North Carolina, U.S.A.
Manuscript received January 10, 2000; accepted March 22, 2000.
Address correspondence and reprint requests to David C. Winston, Department of Pathology, Wake Forest University, Baptist Medical Center, Medical Center Boulevard, Winston-Salem, NC 27157, U.S.A.; email: firstname.lastname@example.org.