Journal List > Korean J Leg Med > v.42(2) > 1095163

Joo, Kim, Park, and Ha: Various Forms of Fatal Nicotine Intoxications: Three Cases Report


Recently, fatal nicotine intoxications with electronic cigarette liquid have increased in Korea, but various kinds of cigarettes and smoking cessation aids may also cause fatal poisoning. We report cases of fatal nicotine intoxications involving causes other than the use of liquid nicotine. A 29-year-old woman (case 1) found dead in a hotel room with about 70 patches (21 mg dose) of nicotine on her body. Blood nicotine levels were 7.68 mg/L (heart) and 3.25 mg/L (femoral). A toxic level of zolpidem was also detected. A 28-year-old Uzbekistan man (case 2) was found dead in his uncle's room with his face covered with chewing tobacco. Blood nicotine levels were 7.3 mg/L (heart) and 4.6 mg/L (femoral). Blood alcohol level was 0.139%. A 55-year-old man (case 3) bit his tongue. As he was taken to the hospital, his wife put tobacco powders in his mouth for hemostasis, and he died of cardiac arrest. Blood nicotine levels were 2.01 mg/L (heart) and 0.96 mg/L (femoral). Nicotine-related deaths can be caused by various types of administration including transdermal and transmucosal routes, and relatively small doses may cause death, so meticulous investigation should be taken when such deaths are suspected.

Figures and Tables

Fig. 1

Multiple rectangular or circular intradermal hemorrhages were observed in the neck and chest (A), back (B), and waist (case 1).

Fig. 2

Foci of yellowish green discolorations were observed on his head and face (case 2).

Fig. 3

There was a sutured laceration to the left of the tongue and a small amount of blood in the oral cavity (case 3).

Fig. 4

The stomach contained some black brown foreign material (case 3).



Conflicts of Interest No potential conflict of interest relevant to this article was reported.


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