Case Reports: 3. Massive Pulmonary Embolism by Liver Tissue 85 carpet burns while thrashing about on the floor after PMA abuse in a described delirious state. The rapid onset of rigor appears to have started almost at the time of death as described by witnesses. Three hours after death, and in spite of dousing with water, the deceased's temperature was still 41.2C. SUMMARY If an unexpected death displays the apparent contradictory features of advanced rigor mor- tis associated with any inappropriately high body temperature, amphetamine abuse should be considered. REFERENCES Baselt R. C. (1989) Disposition of toxic drugs and chemicals in May, 3rd ed. Year Book of Medicine Publications, p.49. Ellenhorn J. and Barceloux D. G. (1988) Medical Toxicology Diagnosis and Treatment of Human Poisoning (Lst ed.) New York, Elsevier, pp.626-39. Henry J. A. (1992) Ecstasy and the dance of death B.M.J 305, 5-6. Pradhan S. N. (1977) Drug Abuse. Clinical and Basic Aspects. Missouri, C. V. Mosby, p.119. Simpson D. L. and Rumack B. H. (1981) Methylene dioxyamphetamine. Clinical description of over- dose death and a review of pharmacology. Arch. Intern. Med. 141, 1507-9. Richards K. C. and Borgstedt A. H. (1971) Near fatal reaction to ingestion ofhallucinogenic drug MDA. J.A.M.A. 218, 1826-7 3. Massive Pulmonary Embolism by Liver Tissue M MICHALODIMITRAKIS, MD JD Professor of Forensic Pathology, Chief Medical Examiner A TSATSAKIS, Phd Associate Professor of Toxicology, Chief Toxicologist Department of Forensic Sciences, Schoo/ of Medicine, University of Crete, Herak/ion, Vautes 71409, Greece ABSTRACT An unusual accidental death due to acute massive occlusion of the right pulmonary arteries by liver tissue is reported. A 17-year-old motorcyclist was run over by a heavy truck, resulting in multiple injuries. Multiple lacerations of the liver and tears in the wall of the inferior vena cava resulted in the complete occlusion of the right pulmonary artery by liver tissue. Although the victim sustained other potentially lethal injuries, the final mechanism of death is attributed to pulmonary embolism. INTRODUCTION Pulmonary embolism from foreign material in the lung is not a common or ordinary finding in forensic pathology. Even in major compression injuries to tissue and organs the introduction of hepatic parenchyma to the circulation and blockage of the pulmonary arteries has not been described. Also, pulmonary embolism is not a frequent cause of death in traffic fatal- ities. We had the opportunity to investigate a case where the victim was run over by a heavy truck, sustaining multiple blunt injuries to the chest, abdomen and extremities. Although death was contributed to these multiple in- juries the dying victim had symptoms of acute pulmonary occlusion. Also of interest, but not uncommon, was the lack of thoracic fractures despite the heavy weight of the truck. CASE REPORT The victim was a 17-year-old motorcyclist who tried to illegally overtake a heavy truck (weighing 9 tons) from the right side. Accord- ing to eye witnesses, the speed of the moving truck was not more than 20 krnlh, while the motorcyclist was travelling at a slightly higher speed. The street was quite narrow and as the motorcyclist tried to pass from the right he encountered a series of parked cars on the side ofthe road. He lost his balance and bounced off a parked car, landing in the street. The truck then ran over him and dragged him about 1.5 m along the road. The driver did not realize what had happened until he felt his right back tyres passing over the victim. The motorcyclist immediately became comatosed. He was trans-