Suicidal death due to the toxicity of the organophosphorus pesticide ethoprophos

The current case report concerns the first reported fatality due to ethoprophos toxicity after intentional ingestion of the toxicant, to the best of authors' knowledge, documented with autopsy findings and toxicological data, including the identification and quantification of ethoprophos in blood by LC-MS/MS. The deceased was a 60-year-old man, who was found dead in his vehicle by his family. Initially the death was considered as sudden, and the decedent was subjected to postmortem investigation. Upon autopsy, no external injuries were observed, nor macroscopic lesions or signs of underlying disease were noticed. Internal examination revealed cerebral and pulmonary edema and partially digested gastric contents with multiple black granules attached to his gastric mucosa. Peripheral blood, urine, and gastric contents, with the black granules, were collected for toxicology analysis. The GC-MS screening analysis of the granules revealed that their active component was ethoprophos. To determine this pesticide in blood, an analytical protocol based on LC-MS/MS analysis was developed that allowed the identification of trace amounts of ethoprophos in blood. The toxicological results indicated that ethoprophos was the only toxic substance that could have contributed to the death, and the manner of death was reported as suicide. In the present case, death was attributed to the intake of ethoprophos, and the manner of death was reported as suicide.