During interrogation, a prisoner is repeatedly given low-voltage alternating current shocks across the chest wall. He collapses and dies during one application. At autopsy there are only minute crater-like contact burns on the skin and no other injuries. What is the MOST likely immediate cause of death?

• A Ventricular fibrillation ✓
• B Tetanic spasm of the diaphragm alone
• C Massive intracranial hemorrhage
• D Rhabdomyolysis-induced acute renal failure

Explanation

Alternating current passing across the trunk stimulates the myocardium and readily precipitates ventricular fibrillation, which is the classical immediate cause of death in electrocution at domestic voltages. Contact marks may be deceptively small when current density is high at a narrow point of entry. Renal failure from rhabdomyolysis takes hours to days and cannot cause instantaneous collapse, and intracranial hemorrhage is unsupported by the absence of head injury.

Reference: Parikh's Textbook of Medical Jurisprudence, Forensic Medicine and Toxicology, 7th ed.

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