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September 22, 1978

Fatal Hyperkalemia From Accidental Overdose of Potassium Chloride

Author Affiliations

University of Miami School of Medicine Dade County Medical Examiner's Office Miami

JAMA. 1978;240(13):1339. doi:10.1001/jama.1978.03290130033008

To the Editor.—  We have recently investigated the deaths of two previously healthy individuals who died of hyperkalemia following accidental oral overdose of potassium chloride.

Report of Cases.—Case 1.—  A 32-year-old medical secretary became hypokalemic after she had begun taking a liquid protein diet. She was given slow-release potassium chloride for this, and subsequently used the medication indiscriminately whenever she felt weak or tired. One evening diarrhea developed; she said she had taken "a lot of potassium pills." She was told that the diarrhea probably resulted from potassium chloride, to take no more pills, and that the diarrhea would probably remove the excess potassium. She was found dead the next morning. Findings from an autopsy showed that she had ingested 47 tablets of potassium chloride. The ocular fluid potassium level (about 18 hours postmortem) was 10.8 mEq/liter. Results of toxicologic analysis of fluids and tissues were normal, except

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