Multi-victim Carbon Monoxide Poisoning from a Forensic Perspective: A Case Report

Abstract

Carbon monoxide poisoning is a leading cause of accidental death due to its colorless, odorless and ability to cause tissue hypoxia via carboxyhemoglobin formation. A multi-victim incident in Lalitpur, Nepal, took place where five of six family members died following indoor charcoal burning in a poorly ventilated room whereas a 23-year-old male survived. Autopsy findings included pinkish-red lividity, organ pinkish red discoloration, and visceral congestion. This case highlights the diagnostic challenges of carbon monoxide poisoning, where classical signs are inconsistent, and also emphasizes the importance of correlating scene investigation, autopsy findings, and toxicology. It shows the consequences of indoor combustion in enclosed environments and the potential for multi-victim fatalities in a single setting. The differential outcome observed in the sole survivor shows the influence of exposure and environmental factors in carbon monoxide toxicity. Preventive measures such as improved ventilation and public awareness are essential to reduce such fatalities.