Doctors say death uncommon at Treanor’s BAC level

Sophomore Laura Treanor’s blood alcohol content was more than three times the legal limit to drive in the District the night she died, but three doctors interviewed said death from alcohol poisoning is uncommon at that level.

Treanor’s BAC was 0.29, according to her autopsy report, which was given to The Hatchet by her family. The autopsy lists her cause of death as acute alcohol intoxication, or alcohol poisoning. This means the alcohol depressed Treanor’s nervous system so much that she simply stopped breathing.

Three doctors interviewed, however, said that a 0.29 BAC does not usually lead to death in a woman of Treanor’s stature – a 19-year-old woman at 5 feet 7 inches. All three doctors said death in patients with a BAC around 0.29 is usually due to asphyxiation by choking on vomit, or by another factor, like an irregular heart beat or a bad fall that causes head trauma. Treanor had an abrasion over her eye but no evidence of head trauma or signs of asphyxiation, according to the autopsy report. She also did not have any food in her stomach and had not taken any drugs, according to the report.

Dr. Robert Shesser, chair of the Department of Emergency Medicine at GW Hospital, said the hospital often breathalyses patients and regularly sees patients with the same blood alcohol content. A 0.29 BAC “would not be unusual” in a patient taken to an emergency room for alcohol intoxication, Shesser said in an e-mail.

Dr. William Chiang, who specializes in medical toxicology at the New York University Medical Center, said different people tolerate alcohol differently.

“At 0.29, for most people, you would be not awake, comatose, and there is potential risk,” Chiang said, referring to the potential of death by choking on vomit and asphyxiating.

Chiang added, “It is extremely unusual to stop breathing with a blood alcohol level of 0.29. You would think that most people would be closer to 0.5, somewhere in that range group to stop breathing.”

Chiang said a woman of Treanor’s size could metabolize one drink per hour on average.

“It would probably take eight or nine drinks to get a level that high of. 29,” Chiang said.

Dr. Jonathan Braun, a professor in the department of pathology and laboratory medicine at the University of California-Los Angeles, echoed Chiang’s sentiments. He said that while a 0.29 BAC is high, “death is uncommon but not unheard of.”

Braun said that a 0.29 BAC usually only leads to death when a person’s airways are obstructed by vomit, they experience cardiac irritability that leads to an irregular heartbeat, or have a heartbeat that is either too fast or too slow. Treanor’s autopsy report does not list any of these conditions as a cause of her death, and said her main airway was unobstructed.

Dr. Miguel Fernandez, director of the South Texas Poison Center at the University of Texas Health Science Center in San Antonio, Texas, said he is not surprised that a young woman of Treanor’s size could die of a 0.29 BAC. He agreed, however, that there is usually another factor that causes death at that level.

“You can choke on a little bit of spit, you can drown in a little bit of water. It does not take a lot to block an airway, and it is unclear whether or not the autopsy can always tell that,” Fernandez said.

Braun questioned what time Treanor’s blood was drawn after her death, as the time for a blood sample can affect how high or low someone’s BAC is.

“The timing of the blood sample is an issue, because it could be on its way up (or down),” Braun said in an e-mail. “So the relationship of the blood sample to the actual blood level at the time of death can be uncertain.”

Beverly Fields, spokeswoman for the D.C. Office of the Chief Medical Examiner, said the examiner who performs the autopsy is the expert in each specific case and it is impossible for those who have not viewed a body to determine a cause of death.

“Unless he examined the body, he wouldn’t be able to determine in any way,” Fields said. “The only people who are able to make any determination on a particular case are those who examine the body itself to make a ruling.”

Fields said autopsies are completed within 24 hours – including Treanor’s – and that medical examiners make their determination of the cause of death in each specific case based on the evidence in front of them.

“They don’t make their ruling based on what normally happens with death, they base their ruling on this specific case, because every case is different,” Fields said. “Every case has different circumstances. Rulings are not based on what normally happens. Death is death, and each death is different.”

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