Table 4.

Fatal cases of poisoning by Taxus spp.

Anamnesis, Case History Clinical Findings	Autopsy Findings	Taxane Concentration	Analytical Method	Cause and Manner of Death	Ref.
20-year-old female, prepared tea (decoction) from three spoons of yew needles, let it brew for 0.5 h, then drank the tea and ate the infused yew needles with bread. After 1 h dizziness, strong palpitations, ringing in the ears, burning in the whole body, vomiting (vomits contained needles), soon unconsciousness. On admission to the hospital, pallor, tachycardia, hypotension, later hypertension, then tachycardia again. 24 h after ingestion death. Medical history: psychological problems, suicidal thoughts	Isolated needles of Taxus leaves found in the stomach throughout the small intestine and a large number of Taxus needles Mild necrosis of the gastric mucosa with small haemorrhages Dilation of heart chambers Blood flow to internal organs Histology: myocardium interstitial oedema, signs of fatty degeneration in the liver and kidneys	na	na	Cause of death: Heart failure in taxus intoxication Manner of death: Suicide	[159]
24-year-old male, a year after the death of his ex-fiancée, he suffered from depression, often expressing suicidal thoughts. He went to a ball, drank very little alcohol. When he was returning home, his current fiancée told him that she was probably expecting his child. About 4 h later, he was found at home lying in bed unconscious, breathing. On admission to the hospital, deep unconsciousness, gasping breathing, pale skin, cyanosis of the face, neck and upper chest, very wide unresponsive pupils (mydriasis), weak pulse, weak irregular heart activity, poor reflexes, unmeasurable blood pressure. Despite immediate treatment, respiratory and cardiac arrest in a short time → death.	In the stomach, approx. 200 mL of porridge mixed with vegetable matter (39 g of vegetable matter in total). In the duodenum, only a moderate amount of food (mass) mixed with isolated plant components. Slightly greenish mucus in the larynx, acute enlargement of the heart chambers, acute congestion and pulmonary oedema, severe acute congestion of the spleen, severe acute congestion of the liver, congestion and swelling of the kidneys, severe swelling of the brain Microscopic examination of stomach contents: found cut-up Taxus baccata presses	Taxine	UV Thin-layer chromatography	Cause of death: acute circulatory failure in case of poisoning by T. baccata Manner of death: Not reported	[160]
28-year-old female, teacher, she knew the toxicity of yew, she ingested 4 to 5 handfuls of yew needles with suicidal intent. A yew tree was in the garden in front of her house. About 1 h after taking dizziness, nausea, no vomiting, diffuse abdominal pain. Taken to the hospital, in a drowsy state, tonic-clonic seizure in the reception room, then unconsciousness, tachycardia, wide pupils (mydriasis), weak, later no reflexes, respiratory arrest, unmeasurable blood pressure. Subsequently, intubation, artificial ventilation, intensive care. In a few minutes, asystole → followed by cardiac stimulation and resuscitation, after 50 min resuscitation ended, heart, circulation and breathing stopped → death. Performed gastric lavage with 10 litres of water, a large number of needles and food residues obtained during the lavage.	2 to 3 cm long coniferous yew twigs found in the stomach Acute haemorrhagic gastroenteritis Acute congestion of the liver, kidneys and spleen, pulmonary and myocardial oedema, punctate subpleural haemorrhages, flaccid and dilated all cavities of the heart Histology: small necrosis of cardiomyocytes of the left ventricle of the heart, acute small hepatocellular necrosis in the liver, incipient diffuse fatty degeneration of the liver	na	na	Cause of death: Heart failure Manner of death: Suicide	[161]
40-year-old female, she intentionally ate about 150 yew leaves (Taxus baccata). 2 h after taking it, she sought medical help due to vomiting and abdominal pain. Admitted to hospital. Symptoms: hypotension, followed by shock and respiratory arrest. Immediate resuscitation (external cardiac massage, intubation, artificial ventilation, heart rhythm disorder on EKG, right ventricular pacemaker inserted). Aspiration of gastric fluid performed immediately after intubation showed the presence of yew leaves (needles). After 3 h, ventricular fibrillation unresponsive to treatment, death 5 h after yew leaves ingestion. Medical history: chronic psychosis.	Autopsy not performed	na	na	Cause of death: Cardiogenic shock Manner of death: Suicide	[162]
22-year-old male, 4th year university student of agriculture. Found on a winter morning lying on the “step” of a high bridge; he did not respond. A bag with washed clothes was next to the body. He was seen walking down the road a few minutes before. After an examination, the doctor at the emergency room declared the man dead; alcohol test negative. Medical history: loner, marijuana user. A bag of marijuana was found in his pocket.	Fresh green grass-like leaves found in jejunum—identified by agronomist as yew leaves Smell of fresh yew leaves detected during autopsy Cannabinoids present in urine at a concentration of more than 75 ng/mL	na	GC-FID	Cause of death: Yew poisoning Manner of death: Not reported	[163]
19-year-old female, found dead. She had told her friend she was considering suicide.	Green particles found in the stomach, identified as parts of Taxus baccata Congestion of lungs, liver, kidneys Dilation (expansion) of heart chambers	na	na	Cause of death: Yew poisoning Manner of death: Suicide	[164]
70-year-old female, admitted to the hospital after a suicide attempt by diazepam intoxication. After recovery, she was taken to a psychiatric hospital, where she was allowed to walk around the campus. After several days of severe abdominal pain, she admitted to the doctor that she had eaten parts of Taxus tree bark. Hypotension, bradycardia, cardiac arrest → resuscitation unsuccessful → death.	Autopsy not performed	na	na	Cause and manner of death: Not reported	[164]
23-year-old female, hospitalized at psychiatry, found dead.	Green mass with plant fibres found in the stomach and duodenum—identified as parts of Taxus leaves. Congestion of organs Dilated heart chambers	na	na	Cause of death: Yew poisoning (intoxication) Manner of death: Not reported	[164]
26-year-old female, psychiatric patient, found dead. She was known to hear voices urging her to commit suicide.	The stomach and duodenum contained a brown liquid in which green plant parts were present. These were identified as Taxus baccata leaf fragments. Congestion of organs Dilated heart chambers	na	na	Cause of death: Yew poisoning (intoxication) Manner of death: Not reported	[164]
37-year-old female, prisoner, found dead in her prison cell bed. She was considering suicide. A small Taxus plant was found in her prison cell.	Green plant parts were found in the stomach and duodenum, which were identified as leaves and leaf parts of Taxus baccata	na	na	Cause of death: Yew poisoning (intoxication) Manner of death: Suicide	[164]
19-year-old male, found dead by friends in a remote cellar after leaving home two days earlier. He was lying on the couch, partially undressed. An empty teapot with fragments of brown-green leaves on the sides was found on the floor. Boiled and pressed leaves with a teaspoon were piled on the carpet near the teapot. Cellar was with no signs of vomiting or diarrhoea. Medical history: depression	Fragments of greenish needle-like leaves found in the mouth, oesophagus, stomach and intestines (not in the anus) (30% of the stomach contents were made up of leaves, i.e., 150 out of 500 g) All organs were heavily blood-stained, bronchial epithelium was inflamed Histology: significant to severe congestion of organs, slight damage to brain neurons, massive desquamation of the alveolar epithelium in the lungs, small to medium vacuolar degeneration of the myocardium	3,5-DMP stomach 20,000 ng/g cardiac blood 0.32 mg/kg, 1.31 g/kg ethanol	HPLC, UV, GC-MS, IR 1H-NMR	Cause of death: Acute cardio-circulatory failure Manner of death: Not reported	[165]
43-year-old male, schizophrenic, undergoing treatment several times, attempted suicide by cutting his wrist in the past. He was prescribed antipsychotic perazine (Taxilan) for a long time. Due to frequent side effects, he was looking for an alternative medicine. For this purpose, he bought a small yew tree, made a decoction from its leaves and drank it. He later told the nurse that he was tolerating yew better than perazine, and that he intended to replace this antipsychotic drug with regular use of yew tea. It is not known when he drank the second yew tea. Then, he sat with the nurse, complaining of nausea and lack of blood circulation. He told her that he had taken Taxus baccata leaves but did not specify the amount. He started vomiting, the nurse carried him to bed. When she went to check on him after 3 h, she found him lying dead in bed. There was an empty tea strainer in the kitchen, which the nurse later cleaned up.	Acute organ congestion, massive brain oedema, haemorrhagic pulmonary oedema, stomach dilatation Histology: significant interstitial oedema and signs of myocardial hypoxia, mild fatty degeneration of the liver, massive dilatation of submucosal gastric vessels Smears of aqueous stomach contents were not successful in identifying particles typical for Taxus baccata	11,000 ng taxine/g blood (sum of taxine B and isotaxine B)	LC-MS LC-MS/MS	Cause of death:Taxus baccata intoxication Manner of death: Not reported	[166]
24-year-old male, ingested yew needles with the aim of committing suicide.	Many yew leaves present in the stomach; other autopsy findings not stated	Taxine B/isotaxine B Blood-105 ng/g Stomach content 2000 ng/g Urine 0 ng/mL	LC-MS/MS	Cause of death: Not reported Manner of death: Suicide	[167]
33-year-old female, a glass with red yew fruits was found near the dead body. Yew plant material was ingested; it is not known whether she ate any berries or drank a decoction of them.	No plant material was found in the body; other autopsy findings not stated	Taxine B/isotaxine B Blood-174 ng/g Stomach content 50,000 ng/g Urine 3000 ng/mL	LC-MS/MS	Cause of death: Not reported Manner of death: Not reported	[167]
23-year-old female, long-term psychiatric treatment, found dead in her apartment. Information materials about toxic plants found in the apartment. Previous suicide attempts. The police investigation found that the woman sought medical help 2 weeks before her death due to symptoms similar to yew poisoning—dizziness and arrhythmia. However, she refused hospitalisation.	Approx.. 200 g of greenish-brown plant particles, identified as whole leaves and fragments of Taxus baccata leaves, were found in the duodenum and large intestine Advanced decomposition of the body	Cardiac blood (ng/mL) 47 Femoral blood (ng/mL) na Urine (ng/mL) 8700 Brain (ng/g) < 30 Liver (ng/g) 161 Kidney (ng/g) 275 duodenum (ng/g) 7800	HPLC-PDA HPLC-UV	Cause of death: Taxus intoxication (poisoning) Manner of death: Suicide	[168]
20-year-old male, found dead in the park inappropriately dressed for the season.	Approx. 150 g of green leaves found in the stomach and duodenum, identified as parts of T. baccata Significantly dilated pupils (mydriasis), blood flow to the lungs and brain, dilated heart chambers	Cardiac blood (ng/mL) 97 Femoral blood (ng/mL) 29 Urine na Brain (ng/g) 35 Liver (ng/g) 512 Kidney (ng/g) 382 Stomach content (ng/g) 13,400	HPLC-PDA HPLC-UV	Cause of death: Taxus intoxication (poisoning) Manner of death: Not reported	[168]
26-year-old male, found dead in an upstairs room of the house, lying dressed on the bed, his face resting on a pillow. In the room found a blender containing the remains of green porridge and a bowl with green porridge stuck to it.	Greenish plant material was found in the stomach, in which fragments of yew needles were identified Marked swelling of the brain, acute organ congestion	Cardiac blood (ng/mL) 528 Femoral blood na Urine na Brain na Liver (ng/g) 918 Kidney (ng/g) 418 Stomach content (ng/g) 118,000	HPLC-PDA HPLC-UV	Cause of death: Taxus intoxication (poisoning) Manner of death: Not reported	[168]
23-year-old male, student, found dead on the stairs of the convention centre around lunchtime Before his death, he felt sick, dizzy. He was last seen drinking tea 2 h before his death. The owner of the apartment found a small plastic bag with yew leaves in his backpack	200 mL of stomach contents contained green particles Perfusion of organs (brain, liver, spleen, kidneys)	Cardiac blood (ng/mL) 110 Femoral blood (ng/mL) 217 Urine na Brain na Bile (ng/g) 175 Kidney (ng/g) na Stomach content (ng/g) 1400	HPLC-PDA HPLC-UV	Cause of death: Yew intoxication (poisoning) Manner of death: Not reported	[168]
16-year-old female, found dead in the bathroom of her parents’ apartment. Several hours before death registered dizziness, nausea, abdominal pain, unconsciousness. Medical history: mental disorders, depression	A large number of fragments of Taxus baccata leaves found in the mouth, oesophagus, stomach and duodenum, as well as in the trachea, wide dilated pupils (mydriasis), pulmonary oedema, acute congestion of organs (liver, spleen and kidneys)	Cardiac blood (ng/mL) 31 Femoral blood na Urine (ng/mL) 2700 Brain na Liver na Kidney na Stomach content (ng/g) 600	HPLC-PDA HPLC-UV	Cause of death: Taxus baccata poisoning Manner of death: Suicide	[168]
41-year-old male, found dead lying on the ground near the parking lot where his car was parked. His hands were clenched in spasms. History and cause of death unknown, suspected epileptic seizure	In the stomach and small intestine (not in the large intestine) found fragments of greenish needle-like leaves (chopped leaves) identified as yew. Autopsy and histological findings in agreement with the literature Examined bone marrow—oedematous, slightly hypocellular, with irregular distribution of hematopoietic cells	3,5-dimethoxyphenol quality	GC-MS	Cause of death: Yew poisoning (intoxication) Manner of death: Not reported	[169]
30-year-old male; found dead in his bed; near the bed found a light brown vegetable matter in a plastic bag—it looked the same as dried or partially macerated coniferous leaves	Plant material found in the stomach similar to that found in the plastic bag near the bed—botanically identified as Taxus baccata leaf fragments All organs were markedly congested Non-specific morphological findings	3,5-DMP Blood 146 ng/mL Urine 56 ng/mL Bile 50 ng/mL Gastric content 360 ng/g	GC-MS	Cause of death: Fatal cardiac arrythmia Manner of death: Not reported	[170]
28-year-old male, found dead in the basement of the family home. He ingested a decoction of yew mixed with sodium hydroxide	Acute catarrhal inflammation of the oesophagus with mucosal sloughing, acute superficial gastritis crushed plant material in the stomach and duodenum—needles and small twigs of T. baccata (3.6 g in dry state), blood effusions under the pleura, epicardium and in the soft coverings of the skull, brain swelling, haemorrhagic pulmonary oedema, congestion of internal organs, liquid blood	The presence of 3,5-dimethoxyphenol and 11-nor-A9-tetrahy-drocanabi-nol-carboxylic acid was detected in blood and urine. The presence of 3,5-dimethoxyphenol was further demonstrated in gastric and duodenal contents. In the gastric contents and urine, substances of the same nature as those contained in yew were detected by TLC.	TLC	Cause of death: T. baccata poisoning Manner of death: Suicide	[171]
20-year-old male, found dead in the area of the psychiatric hospital	Presence of a large number of green needles in the stomach, less in the small intestine—identified as yew Dark red-purple post-mortem spots, (dilated pupils)—mydriasis, conjunctival congestion signs of suffocation with dilatation of the right ventricle of the heart Histology: myocardial interstitial oedema, rarely increased eosinophilia of cardiomyocytes	The presence of taxine B, isotaxine B and other yew substances was proven in the blood and stomach contents. The presence of 3,5-dimethoxyphenol was proven in the blood and stomach contents.	LC/MS GC/MS	Cause of death: Taxus baccata poisoning Manner of death: Suicide	[171]
43-year-old female, intentionally ingested an unknown amount of Taxus needles. Dizziness, impaired consciousness, dysrhythmias, circulatory failure, asystole, death.	Not reported	na	na	Cause of death: Not reported Manner of death: Suicide	[158]
22-year-old male, a professional gardener with a history of drug abuse (cannabis), brought to the hospital for detoxification. After 3 weeks, he was transferred to another hospital, where he announced his intention to commit suicide using poisonous plants. In the following days, he collected twigs from the hospital garden (which were later identified as yew twigs) and brought them to his room. He ingested an unknown amount of yew leaves. On the morning of the day of death, severe nausea, heaviness without vomiting, hypotension. The evening shortly before his death, he was found unresponsive in bed, with breathing difficulties.	Vegetables and small green needle-like particles found in the stomach Flat green parts of plant materials found on the tongue and in the oesophagus—needle-like yew leaves Congestion and cyanosis of internal organs Brain and lung oedema Small haemorrhages in the epicardium Expansion (dilatation) of the atria and the right heart ventricle	PTX Stomach content 20 ng/mL Urine < 0.5 ng/mL Cardiac blood < 0.5 ng/mL Femoral blood < 0.5 ng/mL Bile 24 ng/mL Brain < 0.5 ng/g 10-DAT Stomach content 36 ng/mL Urine < 0.5 ng/mL Cardiac blood < 0.5 ng/mL Femoral blood < 0.5 ng/mL Bile 4900 ng/mL Brain < 0.5 ng/g BAC III Stomach content 4.5 ng/mL Urine 19 ng/mL Cardiac blood < 0.5 ng/mL Femoral blood < 0.5 ng/mL Bile 6.2 ng/mL Brain < 0.5 ng/g 10-DAB III Stomach content 132 ng/mL Urine 200 ng/mL Cardiac blood 12 ng/mL Femoral blood 7.3 ng/mL Bile 290 ng/mL Brain < 0.5 ng/g CEPH Stomach content 23 ng/mL Urine 1 ng/mL Cardiac blood < 0.5 ng/mL Femoral blood < 0.5 ng/mL Bile 37 ng/mL Brain < 0.5 ng/g 3,5-DMP Stomach content 150 ng/mL Urine 7250 ng/mL Cardiac blood 110 ng/mL Femoral blood 60 ng/mL Bile 250 ng/mL Brain < 2 ng/g	HPLC-MS LC-MS/MS	Cause of death: Circulatory arrest Manner of death: Suicide	[172]
38-year-old male, found dead in bed. Small fragments of greenish needle-like leaves found at the site (on the table in the bowl, next to the bed, on the blanket, on the chin and mouth of the deceased man). Scissors on the table, which he probably used to cut the leaves into small pieces before eating. According to the police report, the green leaves were identified as Christmas tree needles.	Fragments of green needle-like leaves found on the chin, mouth and stomach Non-specific autopsy findings	PTX Stomach content 82 ng/mL Bile 800 ng/mL Urine, cardiac blood, femoral blood < 0.1 ng/mL 10-DAT Stomach content 39.1 ng/mL Bile 325 ng/mL Urine, cardiac blood, femoral blood BAC III Stomach content 14.7 ng/mL Bile 292 ng/mL Urine 64.5 ng/mL Cardiac blood 8.25, femoral blood 8.5 ng/mL 10-DAB III Stomach content 69.5 ng/mL Bile 1690 ng/mL Urine 74 ng/mL Cardiac blood 19.9 ng/mL Femoral blood 19.8 ng/mL CEPH Stomach content 45.7 ng/mL Bile 482 ng/mL Urine, cardiac blood, femoral blood, <0.1 ng/mL 3,5-DMP Stomach content 423 ng/mL Bile 138 ng/mL Urine 5750 ng/mL Cardiac blood 820 ng/mL Femoral blood 283 ng/mL		Cause of death: Taxine intoxication Manner of death: Suicide	[173]
43-year-old male, for suicidal reasons he ate the leaves of the common yew (T. baccata). Symptoms: severe hypokalaemia, ventricular arrhythmia, hemodynamic instability, respiratory insufficiency, acid-base imbalance disorder, hepatic dysfunction, renal failure, coma, and 12 h after ingestion of T. baccata, despite intensive medical care and resuscitation, death. Stomach lavage performed in the hospital with evacuation of T. baccata leaves	Congestion and pulmonary oedema Brain oedema Enlarged liver Histology: acute dystrophic changes in the liver; dilation of blood vessels in the myocardium	na	na	Cause of death: Not reported Manner of death: Suicide	[174]
43-year-old male, found unconscious at home by his family. Taken to hospital: coma (GCS 3 points), tachycardia, acute respiratory and hepatic failure, hypokalaemia, hypotension, mixed acidosis. Gastric lavage, administered activated charcoal, supportive hemodynamic treatment. After 4 h of admission, unresponsive cardiac arrest → death. Medical history: about 10 years of repeated depressive disorders treated irregularly, recently without treatment, he gradually stopped working, became interested in computers and suicide methods, and consulted information on the Internet about the yew plant and its toxic effects. A farewell letter and an empty plastic bag with the remains of green leaves were found near the body. A police investigation revealed that several yew bushes were found near the house.	In the stomach approx. 450 mL of dark liquid—partially digested food fragments and green-brown plant particles—botanically identified as whole leaves and fragments of yew leaves Non-specific symptoms of intoxication: swelling of the brain, blood flow to internal organs, pleural, pericardial and peritoneal effusions, hepatomegaly (2600 g) Histology: dystrophic changes of the liver and kidneys	na	na	Cause of death: Heart failure Fatal cardiac arrhythmia Manner of death: Suicide	[175]
25-year-old male, drank a decoction of red yew with suicidal intent. Shortly after consuming the concoction, he reported it to his girlfriend, who called for medical help. When admitted to the hospital, about 1 h after taking it, conscious, with stable blood pressure, sinus tachycardia. Gastric lavage in the emergency room and in the hospital ward. Acidosis, liver and kidney functions and mineralogram were normal. After about 0.5 h ventricular fibrillation, cardiogenic shock, unconsciousness. Intubation, artificial pulmonary ventilation, repeated cardiopulmonary resuscitation, established temporary cardiostimulation. Hypokalaemia, acidosis, haemodialysis treatment without effect, cardiogenic shock, asystole → death approx. 6 h after administration.	Yew needles found in the small intestine. cerebral blood flow Congestion of the lungs with haemorrhages in the pulmonary alveoli Dilatation (enlargement) of the right atrium and heart chamber	na	na	Cause of death: Cardiac arrest due to red yew intoxication Manner of death: Suicide	[176]
22-year-old female, after leaving the exhibition in the botanical garden she collapsed, tonic-clonic convulsions, no pulse, not breathing (apnoea). Laic cardiopulmonary resuscitation was started, medical help was called, transport to the hospital. Symptoms: hypotension, bradycardia, restoration of circulation, plant material found in the mouth, green plant material aspirated from the stomach with a nasogastric tube; a bag of plant material, identified as T. baccata was found in the woman’s purse. Despite the intensive care of heart rhythm disorders, after approx. 1.5 h death since admission to hospital.	Not reported	Serum 3,5-DMP 86.9 ng/mL Gastric content 73,200 ng/mL taxine B serum 80,900 ng/mL Gastric content 40.5 mg/mL	HPLC-MS	Cause of death: Not reported Manner of death: Not reported .	[177]
19-year-old female, admitted to a closed department of a psychiatric hospital due to a suicide attempt. Found dead in bed in the morning. A document about the toxic effects of yew was found in her notebook. Inspection of the apartment—found several yew needles, 1 litre of tea from yew leaves, a teacup. No traces of yew leaves were found on the body, mouth and pharynx.	Autopsy not performed.	BAC III 10-DAB III 10-DAT Taxine B Isotaxine B PTX CEPH 3,5 DMP	LC-MS LC-MS/MS GC-MS HPLC-PDA	Cause of death: Not reported Manner of death: Based on the document in her notebook, yew leaves and a half-empty teacup, it was concluded that it was suicide by means of yew tea.	[22]
30-year-old female, found dead at home lying in bed. Green plant material in a plastic bag was found near the bed.	A mass of dark green needle-like leaves found in the stomach, similar to those found in the plastic bag—identified as Taxus baccata leaves Acute congestion of the organs, significant pulmonary oedema	3,5-DMP from Blood Kidney Bile Brain	GC-MS	Cause of death: Yew intoxication Manner of death: Suicide	[149]
40-year-old female, had a video call with a friend, she suddenly developed breathing difficulty. The friend suggested calling an ambulance, the woman was unable to respond, the friend called her mother, who called an ambulance. Rescuers tried resuscitation, but without success. Numerous branches of plant material found at the scene of death, as well found in the stomach at autopsy (as if she had cooked/consumed it). Medical history: during her life, she had a tendency to collect natural herbs and edible plant material from forests.	Numerous partially digested plant leaves in the shape of needles and small twigs found in the stomach contents Significant pulmonary oedema Hepatosplenomegaly Obesity (BMI 38.8 kg/m2) Hepatic steatosis	MAT 1 MAT 2 Taxine B Isotaxine B MHDAT1 MHDAT 2 TAT MHTAT Blood	LC-MS/MS	Cause of death: Acute cardiorespiratory arrest. Manner of death: Not reported	[178]
20-year-old female, brought to the emergency department by a friend. She stated that after reading information on the Internet, she consumed a large amount of yew leaves as a suicide attempt. Symptoms: 4 h after ingestion, nausea, flushing, hypotension, tachycardia, generalized tonic-clonic seizure, cardiac arrest. After resuscitation, restoration of spontaneous circulation, intubation, then arrhythmia. A small amount of green fluid and leaves present in the gastric lavage. Activated charcoal was administered, a transvenous pacemaker was introduced for heart rhythm disturbances, and she was transferred to the coronary unit, subsequently arrhythmias—tachycardia unresponsive to anti-arrhythmics. After consultation with the family, invasive medical measures were stopped and resuscitation ended—death shortly thereafter. Medical history: anxiety, bipolar disorder, obsessive-compulsive disorder, self-harm since age 12.	Not reported	na	na	Cause of death: Not reported Manner of death: Suicide	[179]
35-year-old male, called 911 himself because he felt sick—his head was spinning. When medical help arrived, he was found in the car in the driver’s seat, with slightly impaired consciousness (somnolence), vomited. He stated that he had ingested ground needles mixed into yogurt. He repeatedly passed out on the spot, had apnoeic phases and convulsions, vomited contents with ground green needles, aggressive, resisted examination Transferred to the hospital for emergency admission—impaired consciousness, bradycardia, asystolic pauses, unmeasurable blood pressure and pulse, post-defecation, vomiting, acral cyanosis, pronounced mydriasis, vomiting and full of ground needles in the mouth. Resuscitation started—intubation, inserted nasogastric tube, gastric lavage—brown content with ground needles came out, external cardiostimulation, blood and urine collection for toxicological examination. Despite 185 min of resuscitation on EKG asystole, death was declared. Toxicology results: traces of 3,5-dimethoxyphenol (GC-MS)—a yew metabolite—were proven in the urine sample. In the car, on the back seat 2 grinders containing ground (crushed) green yew needles, on the driver’s seat and in front of the seat on the floor ground (crushed) green plant—yew, in the vehicle two plastic bags filled with green needles and yew twigs. Next to the car, a sweatshirt soiled by a green plant. Medical history: according to his brother, he was hospitalized in psychiatry a year earlier, ID no. without treatment.	A green mushy mass with flat green needles present in the small intestine—approx. 35 g in total a coating of black liquid on the tongue, in the pharynx and in the oesophagus Thin-mushy black matter in the stomach and duodenum Congestion of the gastric mucosa Pronounced mydriasis Significant blood flow to internal organs. Liquid blood Enlarged right atrium and heart chamber Marked swelling of the brain Swelling of the lungs Petechiae under the pleura Slightly underweight (64 kg) Signs after resuscitation Histology: significant swelling of the brain and dystrophic changes of nerve cells, swelling and acute emphysema of the lungs, dispersed acute ischemic changes in the myocardium with signs of acute blood circulation failure, dystrophic changes up to necrosis of individual liver cells; dystrophic changes in kidney tubule cells	Urine: qualitatively 3,5-dimetoxyphenol —a yew metabolite Caffeine Nicotine	GC/MS	Cause of death: Cardiac failure due to acute intoxication with T. baccata Manner of death: Most likely accidental intoxication	Our case I 2022
24-year-old female, found in the afternoon lying dead in the hallway of the rented apartment, in front of the toilet. A jug filled with coniferous branches, with a cooking pot and a strainer, was found in the kitchen. The previous evening, she wrote an e-mail to her friend with the text “I made mistakes, I love you”. In her notebook, the keywords “Suicide” and “Yew” were found in the history of the Internet browser.	Significant mydriasis (0.7 cm) Congestion of internal organs Swelling of the brain and lungs	Kidney: qualitatively present taxine Tea from the place: qualitative taxine Yew needles: qualitative taxine	TLC	Cause of death: Acute yew intoxication Manner of death: Suicide	Our case II 2022
39-year-old male, found dead lying in a meadow under the forest. Near the body, a plastic bag containing T. baccata needles. Medical history: psychiatric illness 2 months before his death, he had already consumed yew.	Green needles of T. baccata plant in oesophagus and stomach contents Marked swelling of the lungs Brain swelling Petechiae in the soft coverings of the skull Mydriasis	Stomach content and urine: 3,5- dimetoxyphenol	GC-MS, LC-MS Q-TOF	Cause of death: heart failure due to T. baccata intoxication Manner of death: Suicide	Our case III