Pesticide Exposure Leads to Death
This case study summarizes events relating to the death of a man with a history
of seizure disorder who was fatally exposed to pesticides in his unventilated basement
apartment. It illustrates the role of an impartial toxicological assessment in litigation
involving pesticides. The county coroner suspected pesticide exposure as a contributing
factor in the cause of death. Later, during civil litigation, the victim's exposure
underwent toxicological examination.
Toxic Assessment of Pesticide Exposure
A 57 year old male was found dead in his basement apartment located near Philadelphia,
Pennsylvania. The decedent was fully clothed, wearing his glasses with the Sunday
paper nearby, lying face down on the floor. His past medical history was
significant only for seizure disorder. Family members reported that the apartment
had been treated for termites the day before the decedent's death by a nationally-known
pesticide application company. The decedent had remained inside the non-ventilated
basement apartment while the pesticides were applied. Later that day, he complained
of respiratory difficulties and abdominal pain with nausea.
Coroner's Report and Conclusion
Due to the nature of this case, an examination of the body was performed by the
coroner's office. The toxicology report revealed 2.6 ug/ml of phenytoin in the cardiac
blood as well as methanol in the liver at 5.1% by weight. Phenytoin is an anti-convulsant
agent used to control epilepsy and was within the range for desirable therapeutic
results. Methanol is found in formalin embalming products and would be expected
in a formalin-preserved liver sample but only at approximately 1.5% by weight (based
on certified analysis). The coroner concluded that the cause of the decedent's death
lay in whatever agent was sprayed around the decedent's apartment.
Spoliation of Pesticide Application Documents
Per Pennsylvania law, a pesticide application business must keep a record for each
pesticide application, and such records must be maintained for at least three years.
However, the pesticide-application company failed to keep records of the brand name
and formulation of the pesticides used at the decedent's apartment. The company
also failed to keep a record of the amount and dosage rate of the pesticides applied.
In a legal context, the act of destroying, altering or hiding a document relevant
to current litigation is known as "spoliation." The legal system has established
that when spoliation occurs, any inference that might be drawn against the offending
party is permitted. In this matter, it was unclear as to the exact chemicals applied,
quantity and dose due to the company's lack of records and their history of deliberately
falsifying records. The applicator could only testify that he used Cy-Kick as well
as the pesticide mixture that was left over in his truck's tank from the previous
The toxicological finding of methanol within the decedent's liver at 5.1% by weight
was greater than could be reasonably explained by the formalin used to preserve
the liver sample. Rather, the objective toxicological data was consistent with high-level
methyl bromide poisoning as methyl bromide is metabolized to methanol in the liver.
Methyl bromide is a colorless, odorless, highly toxic gas banned for use inside
residential structures. Instead, it is used to sterilize buildings via a process
known as fumigation. The building is evacuated and a tent-like structure is used
to encapsulate the outside of the building. After treatment, the tent is removed
and the poisonous gases are ventilated. Pets and humans can then re-enter the sterilized
building. However, in this instance, the applicator failed to surround the building
with a tented structure, ventilate the building or even evacuate residents. Application
of just ounces of highly volatile methyl bromide within a closed, unventilated room
would produce lethal vapor levels.1
After inhalation exposure, methyl bromide is rapidly metabolized to methanol in
the liver. As a neurotoxin, this gas causes central nervous depression with respiratory
paralysis and/or circulatory failure as the immediate cause of death generally preceded
by convulsions and coma. The onset of symptoms is usually delayed with a latent
period from 30 minutes to several hours. Due to a high odor threshold, most people
may not realize that a harmful exposure is occurring.
The applicator testified that he used a pesticide called Cy-kick formulated from
99.9% petroleum distillates and 0.1% cyfluthrin. Respiratory and gastrointestinal
abnormalities, such as those described by family members who communicated with decedent
prior to his death, are consistent with cyfluthrin toxicity.2 Cyfluthrin exposure
at high dose exposures prolongs sodium channel inactivation in human neurons. Peer-reviewed
toxicological studies have documented profuse salivation, pulmonary edema, seizures,
opisthotonos (e.g. spinal column bent forward such that a supine body rests on its head
and heels as was found in this case), coma and death at high doses.3
Dr. Sawyer provided forensic evidence based on the transformation of methyl bromide
to methanol within the liver. This evidence indicated that methyl bromide may have
been used to treat the apartment. Additionally, Dr. Sawyer provided sufficient peer-reviewed
study evidence with respect to exacerbation of decedent's seizure disorder by defendants'
admitted use of cyfluthrin within the unventilated basement apartment. The finding
of opisthotonos was also consistent with cyfluthrin intoxication. While it could
not be determined with absolute certainty which pesticide (or both) was responsible,
both cyfluthrin and methyl bromide have the propensity to induce convulsions in
an individual with an underlying seizure disorder.
It was also noteworthy that the decedent was present both during and after pesticide
application in the small, unventilated basement apartment. As the pesticide application
company was guilty of spoliation, it could not argue against either of these scenarios.
In this instance, causation was ultimately attributed to toxic pesticide exposure
in an unventilated apartment. The matter settled favorably for the plaintiff's estate.
(Disclaimer: Toxicology case studies are impartial and objective summaries of
toxicological matters in which TCAS was retained for the purpose of assessing
health-based factors which, in some cases, led to a determination of causation.
No names or identifying information have been provided due to privacy and legal
considerations. In the above matter, Dr. Sawyer was retained by plaintiff's estate.)
Notes and References
- Wagner, SL., "Clinical Toxicology of Agricultural Chemicals," 1981,
Oregon State University Environmental Health Sciences Center, Oregon, pp. 10-33.
- Lifshitz, M., et al., "Hydrocarbon Poisoning in Children: A 5-Year Retrospective
Study," 2003, Wilderness & Environmental Medicine, Vol. 14(2), pp. 78-82.
- California Department of Pesticide Regulation, "Worker Illness
Related to Ground Application of Pesticide," May 12, 2005 in USCDC,
MMWR Weekly, May 5, 2006, Vol. 55(17), pp. 486-488.
- Adapted from image by Matthew Field (Creative Commons)