Death due to anaphylactic shock secondary to intravenous self-injection of Toradol: a case report and review of the literature

Clin Toxicol (Phila). 2007 Sep;45(6):709-13. doi: 10.1080/15563650701397076.

Abstract

A fatality due to the intravenous self-injection of Ketorolac (Toradol) is reported. Ketorolac is a nonsteroidal anti-inflammatory drug (NSAID) with marked analgesic activity. There is limited information of fatalities attributed to ketorolac toxicity. Here we report the case of a 53-year-old woman with a medical history of depression that was found deceased at home with no evidence of trauma or injuries. Near the body, a syringe and three empty vials (30 mg) of Toradol were found. A fresh needle mark on the right arm was noticed. Toxicological analyses were performed using a gas chromatography-mass spectrometry (GC/MS) technique. The estimated ketorolac concentration in the blood was 8 mug/ml; urine and gastric content were negative for this compound. Based on the autopsy, histologic findings and toxicological results of anaphylactic shock associated with ketorolac self-administration was assumed to be the underlying pathophysiological mechanism of death and the manner, suicide.

Publication types

  • Case Reports

MeSH terms

  • Anaphylaxis / chemically induced*
  • Anaphylaxis / diagnosis*
  • Anti-Inflammatory Agents, Non-Steroidal / administration & dosage
  • Anti-Inflammatory Agents, Non-Steroidal / blood
  • Anti-Inflammatory Agents, Non-Steroidal / poisoning*
  • Diagnosis, Differential
  • Fatal Outcome
  • Female
  • Gas Chromatography-Mass Spectrometry
  • Humans
  • Injections, Intravenous
  • Ketorolac Tromethamine / administration & dosage
  • Ketorolac Tromethamine / blood
  • Ketorolac Tromethamine / poisoning*
  • Middle Aged
  • Postmortem Changes
  • Suicide

Substances

  • Anti-Inflammatory Agents, Non-Steroidal
  • Ketorolac Tromethamine