2004/03/01 by J Yazzie, SC Kelly, RE Zumwalt +2 · 1 citation
Medicine · #Anesthesia and Pain Management #Opioid Use Disorder Treatment #Pain Management and Opioid Use
paper · doi:10.1520/jfs2003193
openalex publication_date 2004/03/01 · openalex created_date 2025/10/10 · openalex updated_date 2026/07/29
A fatal drug overdose is described which involved unusual erotic practices. A 54-year-old male was discovered supine on the floor surrounded by sexual paraphernalia, syringes, and medications including three empty bottles of bupivacaine. Acute and chronic injection sites of the external genitalia with contusions, scarring, focal necrosis, and calcification were present at autopsy. Toxicology revealed femoral blood, heart blood, and vitreous bupivacaine concentrations of 3.8, 2.8 and 1.3 mg/L, respectively. The urine bupivacaine concentration was 11.4 mg/L. The cause of death was attributed to bupivacaine intoxication and the manner of death was accidental.