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Death from Propofol: Accident, Suicide, or Murder?

Kirby, Robert R. MD*; Colaw, James M. JD†; Douglas, Michael M. BA Criminal Justice‡

doi: 10.1213/ane.0b013e318198d45e
Anesthetic Pharmacology: Case Report

A 24-yr-old woman was found dead in her home from apparent propofol “toxicity.” Her blood level of propofol was 4.3 μg/mL. She had no history of drug abuse and no evidence of such behavior at autopsy. The medical examiner and police investigators felt that she died from probable homicide. Attention was focused on a male registered nurse acquaintance, who had acquired propofol and other drugs in the course of his regular duties in a surgical intensive care unit. This is the first reported case of murder with propofol.

IMPLICATIONS: Propofol was introduced clinically in 1986 and is widely used for sedation/analgesia and anesthesia in operating rooms, endoscopy centers, intensive care units, and numerous other settings. Not widely recognized is its potential for abuse, psychological dependency, suicide, and perhaps homicide, all of which are of concern to anesthesia providers.

From the *Department of Anesthesiology, The University of Florida College of Medicine, Gainesville, Florida; †Eighth Judicial Circuit of Florida, Gainesville, Florida; and ‡SGT Tactical Impact Unit, Gainesville Police Department, Gainesville, Florida.

Accepted for publication November 7, 2008.

Reprints will not be available from the author.

Supported by institutional and/or departmental funds.

Address correspondence to Robert R. Kirby, MD, Department of Anesthesiology, University of Florida College of Medicine, Box 100254 JHMHSC, Gainesville, FL 32610-0254. Address e-mail to RKirby@anest.ufl.edu.

© 2009 International Anesthesia Research Society