multi-organ failure due to severe lactic acidosis due to metformin toxicity
AI-generated summary
A 41-year-old man with depression, anxiety, and substance abuse history deliberately ingested 390 metformin tablets on 24 December 2009 in a suicide attempt. He presented to the ED conscious and coherent, reporting the overdose. He was admitted to ICU where dialysis was commenced. Despite appropriate management including intubation and ventilation, severe lactic acidosis developed consistent with lethal metformin concentrations, leading to multi-organ failure and death on 26 December 2009. The coroner found the hospital provided appropriate care and made no recommendations, noting that the quantity ingested was inevitably fatal.
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