Hello, I have a question. My brother died of three years back and doctors cited methanol ingestion as the cause of death. Admittedly, he used to consume alcohol and the doctors told us that too much alcohol could result in such a condition. At that time we were in too much shock to ask for a post mortem or an investigation. Following his burial, we started suspecting that he was poisoned by his wife. We even filed a case with the police, but could never pursue that due to a host of reasons. He died in Jan 2008. I want to ask if we have his body exhumed now, is it possible to detect the poison? I have read that arsenic stays in the body many years after the burial. Is that true for methanol ingestion too.

Please do answer if anybody has knowledge about the subject. Thank you.

On what evidence were the doctors saying it was methanol poisioning? Where was he when he died and who was with him?

I wonder if the doctor cited ethanol poisoning as opposed to methanol? Methanol poisoning does not develop from heavy drinking. Rather, methanol is an industrial solvent.

Notwithstanding, even a medical reference to ethanol poisoning, should have necessitated an autopsy.

Do you have a copy of the death certificate? Also, are you certain that an autopsy was not performed? A medical doctor had to sign the death certificate... I find it difficult to believe that an MD would cite any type of poisoning absent at least confirmatory lab/toxicology report.

There may be some tests available but much of the easily obtainable evidence has been perfused by embalming and cavity fluids. Searching for an unidentified poison is difficult and expensive.

I don't know, but it doesn't take more than a small amount to be fatal.
I'm confused by what you perceive to be the difference between 'ingestion' and 'poisoning' and how would an autopsy help prove how it got in his system? Sure, someone could have substituted it for ethanol, or even had him absorb it through his skin, but again, how would an autopsy prove it.
And if that was the cause of death, it sounds like an autopsy was done? The liver would show formate, or formic acid. A coroner won't just go by symptoms, unless someone is very elderly.
Only his wife or a court order can have him exhumed.
You will have a tough time getting a court order with nothing but suspicions.
You could hire a PI to check out his wife's past and present and any secret insurance policies.

Dear all,
Many thanks for your reply. We are based in Pakistan where autopsy is not a requisite until family asks for it. Even a former Prime minister Benazir Bhutto who died in a case of shooting and bomb blast in Dec 2007 did not have an autopsy done because the doctors said there was no family permission.

We could have given a permission for autopsy if we were given an honest account by the doctors. We were made to believe by the doctors that methanol ingestion is an outcome of heavy drinking and that his death was bound to happen. I am not saying that doctors were complicit, but hospitals usually avoid getting into controversies and I believe that's what the doctors did that day. I am reproducing the letter issued by the hospital a month after his death, when we pressed for investigation. The letter is produced as it is, so please bear with insignificant details.

March 03, 2008
Healthcare Hospital (Pvt) Ltd
To Whom It May Concern
“Mr Shoukat Saleem S/O Shoukat Ali, aged 34 years, REF: no HIN/IPD 1313 was referred to this hospital from Aga Khan University Hospital due to non availability of ventilator and bed in Intensive Care Unit. He was diagnosed as a case of methanol ingestion with severe Metabolic Acidosis and Respiratory Failure. Patient had been incubated there given emergency management with I/V Ethanol.

Upon arrival in HCH (Healthcare Hospital) at 1:48am on 31st January 2008, patient was directly shifted to ICU due to his critical condition. He received with following clinical condition, on Umbo Bag ventilation with ETT insitu. He was haemodynamically unstable with low GCS 2/10. Immediately attached with ventilator, blood samples were sent for relevant investigations. Consultant on call was consulted for treatment, inotropic support started I/V fluids given along with empirical therapy for hyperkalemia.
Patient gradually deteriorated in spite of all our best efforts and treatment, he continued to be in critical condition. His laboratory investigations revealed abnormal arterial blood gases, liver and kidney functions with significant electrolyte imbalance.

Patient's family members who accompanied him were kept aware of their patients critical condition; they were also informed regarding the poor prognosis.

At 5:00 AM patient went into Cardiopulmonary Arrest and CPR (Cardiopulmonary Resuscitation) done for half an hour but patient could not be revived. His death declared at 5:30 AM on 31st January.”

I hope this helps in further clarifying the situation. Please guide if you have any suggestions.
Many thanks again.

Zeenia

....he used to consume alcohol and the doctors told us that too much alcohol could result in such a condition.

Methanol poisoning can only be caused by methanol. The information that he had ingested methanol had to come from him or someone who observed him. I find it interesting that the letter notes alcohol ingestion without further clarification, i.e. accidental, deliberate, or the source of the methanol.

However, the brief reference to symptoms and treatment, as far as they go, are consistent with methanol poisoning.

It seems to me that there is no need to look for methanol in his remains. The hospital has certified that he died as a result of poisoning by methanol. The blood work referenced would probably support that conclusion as well and should still be part of the hospital records.

The letter clearly indicates that he ingested methanol. Not that methanol toxicity developed through some metabolic aberration. Which could not happen.