An elderly woman is declared dead in the emergency room. Her husband says that she was snoring all night. He called 911 in the morning, when she wouldn’t wake up. On autopsy, the pathologist finds a diseased heart, and signs out the case as a death by natural disease. Then, while preparing the house for the funeral, the husband finds the woman’s recently-prescribed but empty medication bottles, and brings them to the coroner's office.
In the toxicology report, the woman’s drug levels appeared high but within therapeutic range, so the pathologist hadn’t considered poisoning as a cause of death. The distended bladder he pulled out of her body on autopsy should have steered him to take a closer look at the tox, however. Sleeping patients who are not intoxicated will wake up and go to the bathroom. A bladder with 400 or 500 ml of urine was reported. What is the most likely reason for death?…
