308 Med. Sci. Law (1986) Vol. 26, No.4 Printed in Great Britain Death Associated with the Abuse of Typewriter Correction Fluid D. L. RANSON, BMedSci, BM, BS, LLB Lecturer in Pathology, Department of Pathology, University of Bristol, The Medical School, University Walk, Bristol BSB 1TD P. J. BERRY, BA, MB, BChir, MRCP, MRCPath Consultant Paediatric Pathologist, The Bristol Royal Hospital for Sick Children, St. Michael's Hill, Bristol BS2 BBJ ABSTRACT A case is reported of a 13-year-old boy who died suddenly during physical exercise. Post-mortem examination showed no macroscopic or histological abnormalities and it was only later that he was discovered to be a regular solvent abuser of typewriter correcting fluid containing the solvent III Trichloro- ethane. Typewriter correcting fluid is a relatively unusual substance for solvent abuse, and this case demonstrates the wide range of products which are inhaled by children. The implications of the abuse of III Trichloroethane are discussed, with particular reference to the possible mode of death in such cases. CASE REPORT A previously healthy 13-year-old boy was playing with a friend by a footpath when he suddenly got up and ran along the path shouting, and then fell to the ground apparently lifeless. His friend said he thought he had broken his neck when he collapsed, and a nearby adult who quickly arrived on the scene could find no pulse. Cardio- pulmonary resuscitation was attempted by the adult and an ambulance was called; however, the boy was found to be dead on arrival at hospital. This was the only clinical information available prior to autopsy. POST-MORTEM EXAMINATION The body was that of a well-nourished pre- pubertal Caucasian male wearing a T-shirt, jeans, white socks and track shoes. Some soil and vegetable debris were present on the body and clothing, but apart from a few small bruises of various ages over the lower limbs, there was no evidence of any significant bodily injury. The mouth showed no evidence of any vomit or food material and no abnormality was seen in the nasal vestibules. There was no evidence of oedema, jaundice or any rashes over the body and no petechial haemorrhages were seen in the oral mucosa, conjunctiva or skin of the face. On internal examination there was no evidence of any head or neck injury and the brain appeared normal. There was some congestion of the mucosa of the trachea and major bronchi but no evidence of inhalation of any foreign material or of gastric contents. The heart appeared anatomically normal and showed no macroscopic pathology. The stomach . contained partly digested food material only and there was no evidence of recent ingestion of tablets. The remainder of the post-mortem examination and subsequent histological examination of body tissues showed no evidence of any natural disease, and in the absence of any significant macroscopic pathology the cause of death was thought to have been due to a cardiac arrhythmia. However, during the external examination of the body, some white material had been noticed around the bed of the left thumb nail and samples of this, together with venous blood and lung tissue, were taken for toxicological analysis. The analysis subsequently revealed the presence of the solvent III Tri- chloroethane in the venous blood and lung tissue, and the white material on the left thumb nail showed traces of Titanium Dioxide. In view of