# A Case Report and Literature Review of Death by Potassium Chloride: Is it a Forensic Medicine Enigma?

## TL;DR

This paper discusses the forensic challenges of diagnosing death from potassium chloride and proposes protocols to prevent such incidents.

## Contribution

The paper introduces a forensic protocol and control measures to accurately diagnose and prevent potassium chloride-related deaths.

## Key findings

- Potassium chloride is hard to trace in forensic cases due to its natural presence in the body.
- A forensic protocol is proposed to aid in accurate diagnosis and prevent misuse.
- Control measures like double authorization and documentation are recommended for potassium-containing drugs.

## Abstract

The diagnosis of death from potassium chloride (KCl) injection is complex because it is a natural ion, so it is very difficult to trace the exogenous administration of drugs containing potassium. In these cases, it is important to perform a careful cadaver inspection, with the collection of circumstantial data on the scene, and proper autopsy investigations, in order to avoid errors regarding the reconstruction of the cause of death. The aim of this paper is to propose a forensic protocol, including evidence collected from the literature, that could help the medical examiner to perform the correct diagnosis, and also encourage control measures to avoid similar events, especially in nosocomial environments. This is important, especially for health professionals who can easily access drugs containing potassium. For this reason, we need to strengthen control measures of these drugs by proposing a double check in cases of pharmacological use, specifying the volume taken with a double authorization signature and the reasons for the withdrawal.