The significant findings as seen at autopsy were congested lungs with oedema and patchy consolidation. The pancreas had a dull outer surface and a haemorrhagic cut surface. The stomach mucosa was hyperaemic.
Significant toxins detected in urine, post-mortem blood, stomach content samples (and trace amounts in white wine) included ethanol (alcohol), cocaine (and its metabolites/breakdown products), morphine (and its metabolites/breakdown products), codeine, chloroquine, cocaethlene and dextromethorphan.
The fact that some of these toxins/drugs were detected in the stomach contents is an indication that they may have been taken orally prior to death.
The detection of the products and their breakdown substances in the blood and urine indicates they were absorbed and distributed in the blood stream to various body organs and eventually excreted in the urine.
The post-mortem report (by Prof Wabinga indicates that the needle puncture wound seen at autopsy was for administering medication).
Here below is a brief on the detected drugs and their effect:
Detected in trace amounts, is used for treatment of malaria.
Used as a cough suppressant as well as for pain relief. The patchy consolidation seen at autopsy is a sign of Bronchopneumonia which may present as cough. The deceased was probably on medication for cough (or pneumonia).
Post-mortem findings are non-specific but include intense congestion of the gastric mucosa (reported as hyperaemia in this post-mortem), odour of alcholic beverages (probably the sweet smell reported at autopsy) and congestion of the organs.
The effects on the body could be due to cocaine or its breakdown products. Post-mortem findings include pulmonary edema and congestion (as seen at autopsy). Chronic use of cocaine is associated with cardiotoxicity especially heart rhythm disturbances (which cannot be seen at autopsy with the naked eye).
Morphine/Heroin/Codeine (and metabolites)
Depress the central nervous system which may lead to sudden death resulting from respiratory depression, cardiac arrest, heart rhythm disturbances (arrhythmias) or severe pulmonary oedema.
The observed pulmonary oedema and congestion, patchy consolidation of the lungs, dull pancreas, hyperaemic stomach at post-mortem may have an explained link to the toxicology findings.
NB: The effects of the toxins/drugs discovered in the blood potentiate each other as do the adverse effects.
Dr. Jane Ruth Aceng
Director General Health Services
Ministry of Health