
Carbon Monoxide Poisoning in a Motel
Charles W. Harlan, MD
Office of the Medical Examiner Metropolitan Government of Nashville and Davidson County (Tenn)
JAMA. 1989;262(6):771-772.
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To the Editor.—
Much of the information in the article by Wharton et al1 entitled "Fatal Carbon Monoxide Poisoning at a Motel" and the editorial by Dr Dan2 is incorrect.
The admitting hospital diagnosis of patient 2 was bacterial food poisoning, probably clostridial. An admission blood sample was sent to a private laboratory for drug analysis.
The police, promptly notified of the death of patient 1 and near death of patient 2, examined the scene and called me. I pronounced patient 1 dead there at 1:40 PM, observing red livor mortis (the differential diagnosis being cyanide poisoning, systemic hypothermia, and carbon monoxide poisoning). That the room was interior with controlled temperature excluded hypothermia. That this room had no apparent source of carbon monoxide and occupants of adjacent rooms were unaffected in the early afternoon tended to exclude carbon monoxide poisoning. Three antecedent cyanide deaths in Nashville and discovery in
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