[ad_1]
The death of Naomi Musenga, who died on December 29 at the age of 22 after being mocked on the phone by an operator of the Samu de Strasbourg, is "the consequence of a paracetamol intoxication absorbed by self-medication over several days. Said Wednesday the prosecutor of the Alsatian capital, Yolande Renzi (L'Alsa-ce yesterday). "The evolutionary destruction of the cells of his liver has brought about a failure of all his organs, leading quickly to his death," according to Yolande Renzi.
Disputed conclusions by the family: "I do not believe that taking paracetamol is the cause that precipitated the death of my daughter, "who was" well informed on how to take this drug, "reacted Mukole Musenga, father of the young woman. Several elements of Naomi Musenga's medical file, after her visit to the Strasbourg emergency room, cast doubt on the reason given for her death
Very high-dose toxicity
Paracetamol itself is not toxic for liver. It is its main degradation product, Napqi (N-acetyl-p-quinonimine) which is toxic. In therapeutic doses, this compound is neutralized by a natural antioxidant. In case of overdose, the antioxidant is no longer sufficient and the NAPQI will attack the liver cells.
According to the scientific literature, the toxicity of an overdose does not lead to an immediate death. It takes four hours for ingested paracetamol to enter the bloodstream. It is from there, and up to 24 hours after the taking, that one measures it in the blood to know if there has been overdose. From a concentration of 200 mg / l, four hours after ingestion, it is estimated that there is toxicity. But you need to know when and how many times the person has taken paracetamol. And it is also considered that a dose of more than 150 mg / kg must be absorbed in order to have a risk of toxicity.
Naomi should have absorbed at least 8 g of paracetamol, ie a complete box containing 1 g of paracetamol per tablet in one go, or 6 g per day for two or three days. And in addition, depending on the dosage form, for the same dosage (for example 1 g per tablet), the concentrations in the blood can vary from one to three.
Silent poisoning
It is only after three at five days after an overdose, serious signs of liver failure appear, including jaundice (jaundice). Before, intoxication does not usually cause symptoms.
If Naomi suffered from liver failure during her call to Samu, as suggested by the conclusions of the Strasbourg public prosecutor's office, the doctors would not have failed to notice signs of jaundice. However, the medical file contains no mention of this symptom. There was also no determination of liver transaminases in the blood, which could have invalidated or confirmed destruction of the liver.
The only postmortem specimen in which paracetamol was recovered at a concentration of 100 mg / l, is the pleural fluid, in the lungs. But the presence of this liquid is in itself abnormal and pathological. The autopsy report states that this fluid was present around each lung and contained blood.
According to the report of the toxicologist, this pleural fluid is "close to blood". But we did not find the different products administered between 13:50 and 15:00 by the Samu to the young woman, during treatment, including morphine, nor alcohol. On the other hand, the badysis of gastric contents does not mention any presence of paracetamol.
"Early stage"?
Another contradiction: the complementary badysis of the liver sections indicates, according to the pathologist, signs of Hepatic pain "which could indicate an early stage of paracetamol poisoning". But this early stage, so silent, can not explain the young woman's multi-organ failure.
Finally, the report of SOS Médecins who saw Naomi before the arrival of Samu, mentions "hyperalgia of the lower limbs" of the young woman, in clear, an abnormally high pain sensation in the legs. This is one of the signs of compartmental syndrome, caused in particular by mbadive haemorrhages in the abdomen, which are not part of the clinical picture of early intoxication with paracetamol.
Source link
