Death, Drugs, and Muscle
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Whether it was an uneasy childhood or a traumatic event as a teenager, something led them to a life that is so far off the beaten path that it morphed into something evil. Some people use this as an excuse, while others merely point their fingers and say the person was destined to fail. Even worse, some say the person should never have been born. Humanity calls these lapsed people monsters, psychopaths, or even vermin. The law usually calls them felons. I am a felon, and this is my story. Nothing herein is trumped up, cushioned for effect, or otherwise overstated for shock value.
DEATH, DRUGS, AND MUSCLE
I might be convicted in the courts, but many would believe that I was behind a victimless crime. I never hurt anyone, yet so many people hurt me because of my actions. For years, I was a drug dealer. People hear the term and picture me slinging poison out of baggies stuffed away in the trunk of a beaten—down car. My product could even be regarded as medicinal. For many, it is. I sold hormones. Anabolic steroids were my drug of choice. In the s, if people were indulging in synthetic forms of what makes up the chemistry of men, they probably got it from me. Maybe not hand to hand, but somewhere along the line I was involved.
The operation was big, the profits were large, and the risks were high. Like all things, it eventually came crashing down. And when it did, there was no pretty picture to be painted. Tears had been cried, blood had been shed, lives had been ruined, and the ride came to a screeching halt when I found myself behind bars.
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When I was arrested, it was all over the national news. Some newspapers put the name Gregg Valentino in the same sentence as drug kingpins like Pablo Escobar and Manuel Noriega. These guys were traffickers of cocaine and heroin, poisons they knew were taking the life right out of people. Every night of my life after I started dealing drugs, I slept well, whether on the 1,—threadcount Egyptian cotton sheets of my New York home or on the paper—thin and stained rag they give you in jail.
The one thing that never bothered me was the thought that I had hurt someone. Convert currency. Add to Basket. Compare all 20 new copies.
Book Description Condition: New. New Book.
Shipped from UK in 4 to 14 days. Established seller since Seller Inventory EB More information about this seller Contact this seller. Language: English. Brand new Book. The book describes Valentino's involvement with bodybuilding and its association with steroids and underground behaviour, including the sex and muscle worship trade. Valentino eventually begins dealing drugs himself, and details the dangers and the fallout - including the death of his girlfriend, his arrest, and his rise as an unlikely celebrity.
Seller Inventory AAT Seller Inventory ZZN. The West Virginia University Institutional Review Board exempted these cases from review because they did not involve patients or research subjects.
A yr-old nurse practitioner was convicted in for the murder of her husband. She became a murder suspect after investigators discovered she had lied about an extramarital affair and had surreptitiously left work and driven to her house shortly before the house was discovered on fire with her husband inside.
The victim's body was badly burned. Blood carbon monoxide concentrations, however, were not increased, an indication that he was not breathing and already dead at the time of the fire. Investigators then sent heart, blood, and liver tissue samples for pharmacologic analysis, including muscle relaxants.
Results showed rocuronium concentrations of 4. Expert testimony sought by prosecutors involved a description of the effects of rocuronium on muscle function and consciousness, the kinetics of rocuronium after intramuscular administration, and the mechanism of death by muscle relaxants. Also required was an explanation of the availability of rocuronium in hospitals as well as a demonstration of how rocuronium is administered. Testimony by REJ in this case was particularly difficult because family members and friends of the victim sat in the courtroom facing the witness stand and reacted emotionally to descriptions of muscle paralysis while awake, air hunger, and the probable sequence of death.
Because the precise dose of rocuronium administered or site of administration was not known, onset times had to be given in ranges, with the disclaimer that effects depended on the actual dose. For example, intramuscular administration of 1. The wife of an anesthesiologist died suddenly and unexpectedly.
Although the initial death certificate did not list homicide as the cause of death, the father of the wife suspected foul play, and an investigation was launched. One of us RLK reviewing information about this case learned that the anesthesiologist had previously been tried for murder and was found not guilty. This previous trial followed the sudden and unexpected death of the husband of a woman with whom he had allegedly been having an affair. With the help of RLK, the district attorney theorized that the anesthesiologist had injected succinylcholine into the buttocks of the first victim while he slept.
The body was exhumed and detailed examination revealed a fractured hyoid bone. It was then speculated that an injected dose of succinylcholine produced apnea but had begun to wear off before death, so the first victim was strangled.
Death, Drugs & Muscle : Dr. Nathan Jendrick :
A second autopsy of the deceased wife found a high concentration of choline in her buttocks. Choline concentrations in plasma reflect those of succinylcholine. A yr-old pharmacist who worked in a large city crime laboratory was convicted of murdering her husband with fentanyl. She called after claiming to have discovered her husband unconscious and apneic in their apartment when she returned from an afternoon of shopping. She reported finding him lying in bed with their wedding picture and rose petals.
When paramedics arrived at the apartment, the woman was performing cardiopulmonary resuscitation on her husband.
The paramedics took over resuscitation at the scene and in the ambulance but soon after arrival at the emergency department of the nearest hospital the husband was pronounced dead. Initial analysis of blood and gastric fluid samples found no barbiturates, benzodiazepines, or other drugs commonly taken for suicide. The discovery that fentanyl fentanyl patches, crystalline fentanyl, and vials of the opioid was missing from the woman's place of employment triggered a reanalysis of the husband's blood and gastric fluid samples for the presence of fentanyl.
The minimum effective blood concentration of fentanyl administered intravenously during patient-controlled analgesia is 0. At the trial the prosecuting attorney presented evidence that the pharmacist stole fentanyl from her place of employment and fed her husband soup laced with the drug.
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The prosecutor claimed that as the woman's husband became somnolent from the soup she was feeding him, she placed numerous fentanyl patches on his chest and arms. These patches were not on his body when the paramedics arrived but there was some evidence the patches had been previously applied. Finally, the attorney showed that the woman purchased roses using her own credit card a few hours before she called The motive for the murder was that her husband would not agree to a divorce that she wanted in order to continue an affair with another pharmacist at her place of employment.
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Her husband had also threatened if she pursued a divorce to reveal to her employer that she was a methamphetamine addict, which could have resulted in the loss of her job. Testimony in this case by THS involved confirming that the fentanyl blood concentration was high enough to produce apnea and death that could have resulted from the consumption of fentanyl-laced soup and fentanyl patches applied to the husband's body. The woman was sentenced to life in prison. A yr-old physician, general practitioner, called from a hotel room in a small agricultural community. The victim was a yr-old, lb, 6-ftin mentally challenged former patient whom the physician had befriended after caring for him in the emergency department of a large-city general hospital several months earlier.
The victim had suffered respiratory arrest after multiple intramuscular and intravenous injections of fentanyl and midazolam. The physician was performing cardiopulmonary resuscitation on the victim when the paramedics arrived. The paramedics took over resuscitation at the scene and in the ambulance, but the victim was dead on arrival at the hospital. Most of the film in the camera and approximately 25 other videos showed the victim lying supine and breathing quite slowly while deeply sedated with the physician applying oils and creams on the abdomen, genitals, and upper legs of the victim.
Blood samples of the victim taken in the emergency department demonstrated high concentrations of both fentanyl and midazolam. Testimony in this case by THS involved confirming that the fentanyl and midazolam blood concentrations were sufficiently high to produce apnea, especially when considering that the two drugs can act synergistically in decreasing respiratory function. The physician was sentenced to 10—20 yr in prison. Hospital personnel noted that several patients of a particular anesthesiologist had suddenly become apneic in the postanesthesia care unit after having seemingly recovered from their anesthetics.
Because administration of neostigmine restored ventilation in these patients, respiratory depression was diagnosed due to nondepolarizing muscle relaxants. Although a rebound effect of intraoperative muscle relaxants was initially suspected, one of the patients had not received muscle relaxants during surgery. A nurse reported that in one case she had seen a surgeon who had not operated on the patient at bedside shortly before he stopped breathing. That surgeon and the anesthesiologist for the apneic patients had been engaged in a bitter work dispute. When the locker of the surgeon was searched, full and empty vials of pancuronium were found, as well as syringes and needles.
Although one of us RLK helped develop a mechanism for attempted homicide in this case, prosecutors decided that the evidence was insufficient to bring it to trial. After the discovery of the muscle relaxant vials in the surgeon's locker and a public review of the known facts, no further cases of recovery room apnea occurred.
The public is learning from both novels and news reports that anesthetics and muscle relaxants can cause death. We report four homicides and one attempted homicide involving rocuronium, succinylcholine, fentanyl, and pancuronium in which we assisted the investigation and prosecution. These case reports have not previously been available to anesthesiologists and illustrate some areas where anesthesiologists can help criminal investigators and prosecutors.
In table 1 we list some ways anesthesiologists can assist homicide investigations and prosecutions. Table 1. Anesthesiologist Assistance during Homicide Investigations and Testimony.
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Because the legal defense in murder trials frequently relies on creating reasonable doubt in the minds of jurors about the involvement of the accused and the proposed cause of death, anesthesiologists should review the thoroughness of the investigation and prepare their testimony broadly and carefully.
Explanations must be presented in terms that jurors can understand. Press coverage, emotional responses from people in the courtroom, and confrontational questions can make testimony in murder trials particularly difficult. In addition, the person on trial in cases involving murder by muscle relaxant or anesthetic is often a healthcare worker, occasionally a physician. Expert testimony may be covered in front-page newspaper articles or network television shows.