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Repeated poisoning of the life partner by thallium — a case of questionable Munchausen by adult proxy syndrome with ensuing attempted murder

International Journal of Legal Medicine volume 136, pages 695–704 (2022)Cite this article

A Correction to this article was published on 09 March 2022

This article has been updated

Abstract

After the use of thallium as rat poison was banned, the knowledge about the severe and treacherous course of poisonings with this toxic metal has widely been lost. In the present case, the male victim sustained two insidious poisoning attacks in 2017 and 2020 by the perpetrator, his female life partner. In the first poisoning episode, he suffered from increasing heavy pain of the abdomen, stinging pain of both legs, persistent obstipation, hyperesthesia, and, after about 2 weeks, tuft-wise loss of hair as typical symptoms of the thallium poisoning. Within 7 weeks, he was successively examined in six hospitals with a wide variety of diagnostic methods, but a conclusive explanation of the complaints was not found. The possibility of a metal intoxication was then suggested by the perpetrator who privately arranged the analysis of a blood sample with the result of 175 µg/l thallium. Although a criminal poisoning was assumed, the perpetrator was not identified. After the victim left the perpetrator, she subtly executed a second poisoning attack with thallium sulfate (blood level 1230 µg/l after 1 day, urine level 4760 µg/l after 10 days, and hair concentrations 3.26–0.49 from proximal to distal in 9 segments). The perpetrator was sentenced to 10.5 years imprisonment for grievous bodily harm and attempted murder. Because of the behavior of the perpetrator, a Munchausen by proxy syndrome was discussed as a motivation of the first poisoning but was excluded by the psychiatric expert because of a missing antisocial personality disorder.

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Acknowledgements

The authors thank Dr. Peter Heitland and Dr. Helmut D. Köster (Medical Laboratory Bremen) for the determination of the thallium concentrations in blood, urine, and hair and Dr. Kristian Wittke (Police Office of Criminal Investigations Berlin) for the analytical investigation of the sized substances.

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  1. Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt- Universität zu Berlin, Institute of Forensic Medicine, Turmstraße 21 (Haus N), 10559, Berlin, Germany

    Fritz Pragst & Sven Hartwig

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The original online version of this article was revised: The original article contain an error. In page 3, Table 1: The line in the middle of the Table must be removed. In page 6, left column, line 7: reference citation [17] must be replaced by [60].

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Pragst, F., Hartwig, S. Repeated poisoning of the life partner by thallium — a case of questionable Munchausen by adult proxy syndrome with ensuing attempted murder. Int J Legal Med 136, 695–704 (2022). https://doi.org/10.1007/s00414-022-02791-4

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Keywords

  • Attempted murder
  • Hair analysis
  • Munchausen by proxy
  • Poisoning
  • Thallium