Suicide by drowning after Bromazepam intoxication: a case report

Abstract

The authors report a case of a floating body recovered from a well. A 62-year-old woman committed suicide by drowning herself in a well. According to information given by her relatives she had a 13-year history of depression and she wanted to commit suicide. Liquid chromatography with electrospray ionization mass spectrometry (LC-ES I-MS ) was used to determine bromazepam in blood. Samples were extracted using Oasis® HLB solid-phase cartridges, and separation and quantitation was done using positive–mode electrospray ionization in the single ion monitoring (SIR) mode. Chromatographic separation was achieved using an Atlantis® T3 column (2.1x150 mm, 5 μm), eluted in a gradient system with acetonitrile and formic acid 0.1%, at a flow rate of 300 μL/min. Quantitation was achieved by the addition of diazepam deuterated (DZP-d5) as internal standard. The compounds were detected monitoring two ions for bromazepam (m/z 318, and m/z 288) and m/z 290 for the deuterated, DZP-d5. Toxicological results revealed in blood a toxic concentration of bromazepam of 418 ng/mL. This finding might be important for the interpretation, not of the cause of death (since the drowning was confirmed by autopsy), but for the state of mind of the victim that had, somehow, helped her to committ suicide (concomitant existence of a psychotropic substance).