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Head Injuries, Pentobarbital, and the Determination of Death

Molina, D Kimberley MD; McCutcheon, J R. BS; Rulon, Jennifer J. MD

The American Journal of Forensic Medicine and Pathology: March 2009 - Volume 30 - Issue 1 - p 75-77
doi: 10.1097/PAF.0b013e31818738dd
Case Report

The Bexar County Medical Examiner's Office in San Antonio, Texas, has encountered 3 cases within a 15-month period involving decedents who were pronounced dead by brain death or cardiac death examination and who had elevated, if not toxic concentrations of pentobarbital present at the time of examination. The elevated levels of pentobarbital were discovered during an autopsy examination performed for medicolegal reasons. The diagnosis of brain death and the implications of pentobarbital intoxication during a brain death examination are discussed.

From the Bexar County Medical Examiner’s Office, San Antonio, Tex.

Manuscript received April 16, 2008; accepted May 7, 2008.

Reprints: D. Kimberley Molina, MD, Bexar County Medical Examiner's Office, 7337 Louis Pasteur Dr, San Antonio, TX 78229. E-mail:

© 2009 Lippincott Williams & Wilkins, Inc.