ABSTRACT:
Sodium nitrite (NaNO2) ingestion results in methaemoglobinemia which can cause hypoxia, metabolic acidosis and death. [1,2] NaNO2 is an inorganic salt, easily accessible and widely used as a colorant, food preservative and corrosion inhibitor. [1-4] Although previously rarely seen in medicolegal practice, NaNO2 poisoning cases are increasing globally. [1,4,5] This case series examines three fatalities investigated at the Observatory Forensic Pathology Institute in Cape Town, Western Cape (formerly Salt River Mortuary) between 2020 and 2023, involving NaNO2 with labelled containers found at the scene. Postmortem findings included chocolate-brown discolouration of the blood, blue-grey discolouration of the nail beds and distinctive skin lividity. Toxicological analyses included ethanol, common drugs of abuse, methaemoglobin, and NaNO2 analysed in various matrices. This report highlights the importance of thorough death scene investigations, challenges in ancillary testing, and contributes to literature on sodium nitrite-related suicides. The chemical’s accessibility and rapid lethality underscore the need for greater awareness among medical professionals and policymakers regarding its misuse.