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Ammonia fumes led to suffocation, report says

By LISA GREENE
Published May 6, 2006

Ammonia fumes, best known as smelling salts, have been used safely for centuries to help revive people who faint.

But the way guards at the Bay County sheriff's boot camp dosed Martin Lee Anderson with ammonia appears to have been far different from normal, according to new autopsy findings.

Anderson died of suffocation because he was forced to inhale ammonia while his mouth was blocked, said Dr. Vernard Adams, Hillsborough County chief medical examiner .

That caused his vocal cords to spasm and block his airway, so he could not breathe.

Adams' results are starkly different from an earlier autopsy report, which said Anderson died of complications from sickle cell trait.

Adams didn't give details Friday of how ammonia was used. Dr. Michael Baden, a noted pathologist who observed Anderson's second autopsy, said guards covered his mouth to force an ammonia capsule up his nose.

Federal dosage information says that ammonia inhalants should be held about 4 inches from the face and should not contact the skin.

"Usually smelling salts are pretty benign,'' said Dr. John Hunsaker, president of the National Association of Medical Examiners. "This probably would be very uncommon. I've never, in my 23-plus years, had a case of that type.''

But a heavy dose of ammonia, a compound of nitrogen and hydrogen, could cause a more extreme reaction, said Dr. Amyn Rojiani, pathology professor at the University of South Florida College of Medicine and director of neuropathology and autopsy at H. Lee Moffitt Cancer Center and Research Institute.

First, Rojiani said, an ammonia capsule placed directly in the nose would burn.

Usually, when somebody inhales a pungent odor, such as ammonia, Rojiani said, instinct follows.

"Normally, we open the mouth and try to blow it out,'' Rojiani said. "But if your mouth is closed, you're forced to breathe it in.''

The chemical could irritate the sinus tissues and the vocal cords, enough to make them swell and the cords to spasm, he said.

"When they go into spasm, they contract so tightly, they don't permit air to go into your windpipe,'' Rojiani said.

Such a reaction is rare, Rojiani said. Perhaps the most similar reaction would be swelling of the vocal cords during a severe allergic reaction.

[Last modified May 6, 2006, 08:02:20]