A study published in March’s issue of Anesthesiology examines several homicides involving anesthetic drugs and calls on anesthesiologists to assist in the investigation and prosecution of criminals who divert and kill with these drugs.
The 2009 death of singer Michael Jackson from propofol, a widely used anesthetic, along with the ruling that the death was a homicide, heightened the profile of this issue. The article outlines the experiences of anesthesiologists in several investigations and prosecutions.
Dr. Johnstone also calls on anesthesiologists to continue to work with health care providers and administrators to stop drug diversion.
Recommending to prosecutors specific anesthetic drugs, muscle relaxants and metabolites for tissue and blood analysis.
Explaining the meaning and limitations of drug tests.
Explaining how muscle relaxants and anesthetic drugs can cause death.
Describing probable routes for drug administration.
Explaining drug dosages and effect timing.
Explaining anesthetic drug storage and access issues in institutions.
Explaining the probability of various natural causes of death.
Describing the anesthesiologist’s expert qualifications.
The article reports on four homicides and one attempted homicide involving medications typically used during anesthesia such as rocuronium, succinylcholine, fentanyl, and pancuronium. These are cases where anesthesiologists provided insight into the investigation and prosecutions.
The Drug Enforcement Agency has not classified muscle relaxants or propofol as controlled substances, so they are not individually tracked in most hospitals.
To learn more about the specific cases, please visit the journal's website to access the complete article.