A patient is found unresponsive in his closet with the doors sealed shut and a sign that says “Do not enter”. Empty bottles of formic acid and sulfuric acid were next to the patient. What is the likely toxin?
Carbon Monoxide. Carbon monoxide is formed when sulfuric acid and formic acid are combined. Carboxyhemoglobin levels have been reported to be > 30% in patients mixing these chemicals as a chemical suicide attempt.
Kruetz K et al. Suicidal Carbon Monoxide Poisoning by Formic and Sulfuric Acids. Academic Forensic Pathology 2019; 9 (Issue 3-4). https://doi.org/10.1177/1925362119891703