A 54-year-old man was found dead in the driver's seat of his vehicle on a winter's day. Investigations of the vehicle revealed that the engine was running, and the car heater was left on with the maximum temperature and velocity. The body was found excessively sweating. Rectal temperature of the body was 43oC at 10 h post mortem. In autopsy, several superficial skin burns were observed on the face, the shoulders and the legs. The lungs were heavily congested and haemorrhagic. The liver showed typical alcohol-induced micro nodular cirrhosis. The alcohol concentrations were 0.17% in the blood of both the left and the right heart, 0.1 7% in the femoral-vein blood, 0.21% in the bladder urine and 0.34% in the gastric contents. A reconstruction experiment demonstrated that the temperature inside the vehicle rose rapidly and reached 50-58oC in 3 h. Animal experiments showed that the temperature threshold for rats to succumb to heat was between 40 and 45oC. This case shows that heat stroke in a vehicle can occur in adults with chronic diseases or alcoholism, such as in this particular case, even in the winter. (A)
Samenvatting