Suicide by ingesting domestic floor cleaner is not an uncommon mode of attempting suicide. Patients with depression and suicidal thoughts tend to use easily available methods to commit suicide. Here is a case presentation of a 52-year-old farmer who drank a cleaning liquid to commit suicide.
A 52-year-old male presented to the emergency department after he attempted suicide by ingesting domestic floor cleaner. The patient had a history of chronic alcoholism for the past 15 years. The patient had attempted suicide 3 months back by overdosing on sleeping pills.
Three weeks prior to the current emergency presentation, he had been suffering from mental instability. He felt sad, easily fatigued, sleepy with lack of concentration, appetite, and interest in daily activities of life. Finally, 3 days before committing suicide, the patient had locked himself in the room.
The patient’s relative who brought the patient to the ER told that he is unaware of the floor cleaner’s constituents.
After ingestion, he complained of severe epigastric pain, burning sensation in the chest, vomiting, dyspnea, and hematemesis. Thereafter, he lost consciousness after 4 hours.
However, despite adequate management in the ER, the patient deteriorated gradually over the next few hours of admission. Ultimately, the patient succumbed to death 5 hours after the admission.
The deceased underwent medico-legal autopsy 12 hours after death. The post-mortem examination revealed a thin, softened, and friable stomach wall. Moreover, gastric mucosa showed inflammation, erosion, and ulceration. It appeared blackish-brown. Similarly, post-mortem also revealed similar inflammation and erosion of the mucosa of the oral cavity, pharynx, and oesophagus. All these findings strongly suggested poisoning as the cause of death.
The spleen was also pulpy and soft. Additionally, the liver and spleen were not fixed to the thoracic cage. Also, it showed congested tracheal mucosa and inflamed skin of the palmer side of the right hand. The heart also showed signs of corrosive necrosis.
All in all, his post-mortem examination findings confirmed the diagnosis of corrosive poisoning.
The poisons that are easily available in the daily life can be grouped into three categories:
1- Domestic household poisons like domestic cleaners.
2- Medicinal poisons
3- Garden poisons
The easy availability of the domestic clear and the patient’s depression played a part in the suicide attempt using the cleaner. When an individual ingests any strong alkali or acid, and the organs come in contact with the ingested poison, the organs undergo coagulative necrosis and tissue ulceration and disintegration. The corrosives, such as present in cleaner, bleaches, drain openers, etc. are highly irritative and can lead to choking and gagging upon ingestion. Subsequently, it can lead to respiratory spasm and death.
It is imperative to diagnose patients with suicidal ideation ad subsequently admit and manage such patients. Moreover, it is equally important to counsel and educate the family members and those who live with the patient to remove easy access to agents that be used for suicidal attempts. It is crucial to adequately counsel the patients and the family members in a timely manner to avoid fatalities.
Reference:
Manjhi SN, Buktar SB, Mukherjee BB, Farooqui JM; Suicide death due to floor cleaning material; Prava Med Rev, 2015;79(1)
