Special Report: Sudden Death comes knocking at Phuket's door

[Lite Beer]

Special Report: Sudden Death comes knocking at Phuket's door
Phuket Gazette -

Special Report

Hans Lehner and his Thai partner Pranee Srijaem went out for somtam last Saturday night . The next day Pranee was dead. Stumped for any explanation as to why Pranee, 39, had died, doctors were forced to list the cause of death as ‘acute heart failure’ as a form of Sudden Unexplained Death Syndrome. The Phuket Gazette’s Saran Mitrarat investigates.

PHUKET: The death of Pranee Srijaem last week left many questions unanswered. The case is closed, but the incident raised the chilling specter of the unexplained deaths of Canadian sisters Audrey and Noemi Belanger on Phi Phi Island last year , and that of several tourists at the now-demolished Downtown Inn in Chiang Mai,.

Hans, a 68-year-old Dutchman, explained to police that he and Pranee, 39, went out for somtam at a local restaurant, then stopped off at a Family Mart convenience store before heading back to the apartment last Saturday night.

“When we got back home, Pranee had a bad case of diarrhea before going to sleep,” he told police.

“She always woke up at about 7am to make coffee, which we drank together each morning. But on that day, I did not wake up until 9am. I thought it was unusual that she let me sleep so long,” he said.

“I reached out and touched her hand, but it was cold. Then I checked, and she had stopped breathing… I was so frightened,” said Mr Lehner, visibly shaken.

Capt Patapee Srichai of the Patong Police confirmed that his officers were notified of the death at 9:30am.

“We rushed to the scene with rescue workers from the Kusoldharm Foundation and Patong Hospital medics,” he said.

“We found Ms Pranee’s body on the bed, covered by a quilt.

“We believe she died about three hours before we arrived. Rescue workers transported her body to Patong Hospital at about 10am,” he stated.

“In conducting our initial investigation, we checked her body and the room, but we found no signs of a struggle,” Capt Patapee confirmed.

INVISIBLE KILLER

Patong Hospital Director Sirichai Silpa-archa explained that his team of medical officers followed standard procedure in examining Ms Pranee’s body, but failed to find evidence of a potential cause of death.

“Our first step was to check for signs of a struggle. In this case, we did not find any bruises or any other signs of injury on the body,” said Dr Sirichai.

“After that, we focused on food as a potential cause, so we checked her blood, stomach and intestines. We did not find any harmful contaminants from food and there were no traces of toxins in her body, so we had no reason to suspect that she was poisoned by something she ate or any other contaminant,” he said.

However, in examining Ms Pranee’s body in order to assist a police investigation, doctors did not check for any signs of whether or not the 39-year-old had been smothered to death.

“We did not check for signs of smothering as we had already found no signs of a struggle,” he told the Gazette.

“As her heart had stopped long before she arrived at the hospital – meaning we could not check whether or not she suffered from irregular heartbeat patterns – we had nothing else to check to confirm her cause of death.

“The only thing we could put down as the cause of death was acute heart failure,” Dr Sirichai explained.

ACCEPTANCE

At about 7am on Tuesday, Ms Pranee’s relatives arrived at Patong Hospital to claim her body. Ms Pranee was originally from Tambon Du Lat, located in Sai Mun District in Yasothon province, in Thailand’s Northeast.

“Her relatives accepted the cause of death and did not want any further investigation,” said Dr Sirichai, without elaborating on who claimed the body or why the relatives accepted an unexplained heart attack of the 39-year-old as the cause of death.

“If Ms Pranee’s relatives wanted us to investigate her death further, we could have sent the body for forensic examination in Bangkok, but the cost of transferring the body and conducting such tests is high,” Dr Sirichai said.

CASE CLOSED

Capt Patapee explained that as doctors had given a cause of death, and his officers had not identified a possible violent cause or a motive for Ms Pranee’s demise, the case was now closed.

“Because there were no signs of a struggle, either on her body or in the room, we saw no reason to believe she died a violent death,” said Capt Patapee.

“There simply was no evidence that she died from unnatural causes,” he said.

“Her relatives accepted the death and did not request a further investigation. The case is now closed,” he added.

SUDDEN DEATH

Dr Sirichai told the Gazette that the phenomenon Sudden Unexplained Death Syndrome, also known by its acronym “SUDS”, is not uncommon in Thailand.

“Of all the people who have died from SUDS in Thailand, most were from the Northeast, with most of the rest coming from Northern Thailand,” he said.

“There are theories that those people may have died from SUDS brought on by eating sticky rice, drinking alcohol or consuming a fermented product [somtam often can include fermented fish], but there is no research to support this idea,” Dr Sirichai said.

“However, sudden death can happen from something as simple as a chemical imbalance in the body,” he explained.

“If you eat a particular food or even stay in an unfamiliar environment, that might cause a chemical imbalance and sudden death may occur.

“For example, as shown by recent cases in Thailand, if you sleep in a car – or leave your baby in a car – with the air conditioning on for a long time, it’s possible to die from sudden death,” he said.

THE BRUGADA SYNDROME

Doctors listing Ms Pranee’s cause of death as acute heart failure coincidentally shone a light on one of the top causes for sudden death: Brugada syndrome.

The syndrome is only one form of SUDS, and is a well-documented genetic disease characterized by bouts of irregular heartbeats, which bring an increased risk of sudden cardiac arrest.

People with Brugada syndrome exhibit abnormal electrocardiogram (ECG) findings. Not having access to any ECG data for Ms Pranee, doctors have no idea whether or not she suffered from any irregularities of the heart.

“We checked her records here at Patong Hospital, and as best we can tell, Ms Pranee had no known previous heart condition,” Dr Sirichai said.

HISTORY OF MYSTERY

Dr Bancha Kakhong, chief of the Phuket Provincial Health Office, and hence the top administrator for all government hospitals on the island, said the circumstances of Ms Pranee’s death was no cause for alarm.

“We are not overly concerned about sudden death in Phuket, and the cause of death in this instance seems to have been heart failure,” he said.

Dr Bancha also pointed out both similarities and differences between the death of Ms Pranee and those of Audrey and Noemi Belanger on Phi Phi Island last year and the unexplained deaths of at least three foreigners at the infamous Downtown Inn in Chiang Mai in 2011.

“The cases are similar in that we have not been able to precisely identify the cause of death, but they do differ in that the deaths in Chiang Mai included men. Men and women have different physiologies, and the effect of undetected chemicals can differ between men and women,” Dr Bancha said.

“But I cannot summarily say whether or not the cases are the same. Sudden death can affect nearly anyone,” he added.

Dr Bancha explained that the variety of factors involved, and the lack of in-depth tests conducted in Ms Pranee’s case, made it nearly impossible to identify a likely culprit for her death.

“The food people consume, and the environment they are in, are very important factors that can cause sudden death. For example, in the northeast of Thailand people use blue plastic PVC pipes to steam sticky rice.

“This can introduce toxins that can collect in the body until they reach fatal levels, but this can be difficult to establish without conducting in-depth tests,” he explained.

Source: http://www.phuketgazette.net/phuket_news/2013/Special-Report-Sudden-Death-comes-knocking-at-Phuket-s-door-21993.html

-- Phuket Gazette 2013-08-18

[Briggsy]

Slimming pills.

I know of at least 3 Thai women that died in their sleep due to abuse of black market slimming pills illegally available all over Thailand. They cause heart failure. They are some kind of amphetamine-group chemical that suppresses appetite and may reduce tiredness.

Edited August 18, 2013 by Briggsy

[animatic]

"...“After that, we focused on food as a potential cause, so we checked her blood, stomach and intestines. We did not find any harmful contaminants from food and there were no traces of toxins in her body, so we had no reason to suspect that she was poisoned by something she ate or any other contaminant,” he said..."

And this was last saturday? And they ';say' 'have complete toxicology screens' back now... < Total BS

This smacks of Medical Examiner incompetence, and/or jumping to conclusions under official pressure,

and potentially tourist business saving coverup. This stinks.

Edited August 18, 2013 by animatic

[animatic]

Slimming pills.

I know of at least 3 Thai women that died in their sleep due to abuse of black market slimming pills illegally available all over Thailand. They cause heart failure. They are some kind of amphetamine-group chemical that suppresses appetite and may reduce tiredness.

A very likely possibility.

Poor woman was 39 and likely feeling she had to compete with the 22 year olds,

that will still go after 50-60 something cash trees. RIP, so sad.

Of course the bad diarrhoea is also a sign, might be from the somtam crabs,

and then that was enough to trigger a diet pill setup heart failure.

Edited August 18, 2013 by animatic

[anon467367354]

someone I met from the US went out and had some street food and had irregular heartbeats and severe anxiety attacks when she had never had that before.

the only thing I can think of is a major dose of MSG. This exito-neuro toxin is extremely dangerous and should not be administered by the uneducated much less

be put in something to be consumed.

I've seen people preparing large pots of something at restaurants and just pouring a whole bag of this stuff in it.

Is there a test for the presence of MSG? Most of us are not used to it and the reason I rarely eat out, and if I do I only go to places that know me

and know do not put MSG in anything I'm going to eat because I will not return.

[wdr]

MSG?

[LivinginKata]

MSG?

Monosodium glutamate (MSG), also known as sodium glutamate

Industrial food manufacturers market and use MSG as a flavor enhancer because it balances, blends and rounds the total perception of other taste

[Felt 35]

Its just so sad and crazy

Only 39 and possible died from food, R.I.P.

[Lite Beer]

Some off topic nonsense has been removed.

[andreandre]

someone I met from the US went out and had some street food and had irregular heartbeats and severe anxiety attacks when she had never had that before.

the only thing I can think of is a major dose of MSG. This exito-neuro toxin is extremely dangerous and should not be administered by the uneducated much less

be put in something to be consumed.

I've seen people preparing large pots of something at restaurants and just pouring a whole bag of this stuff in it.

Is there a test for the presence of MSG? Most of us are not used to it and the reason I rarely eat out, and if I do I only go to places that know me

and know do not put MSG in anything I'm going to eat because I will not return.

Much/most of the hysteria about MSG being so bad is unproven nonsense . ...more and more research has shown MSG is not the 'ogre' its been made out to be in the past 40 odd years since one theory about it made the news.

[jbrain]

“Because there were no signs of a struggle, either on her body or in the room, we saw no reason to believe she died a violent death,” said Capt Patapee.

However, in examining Ms Pranee’s body in order to assist a police investigation, doctors did not check for any signs of whether or not the 39-year-old had been smothered to death.

In other words : We think the farang killed her, since Thais would never die from food poisoning when eating Som tam, but we let him of the hook.

[Thai at Heart]

Diet pills. Take enough and can put a lot of stress on a weak heart.

[pedro01]

Sometimes, people just die

[asdecas]

Perhaps a more appropriate acronym might be SUDIPS (Sudden Unexplained Death In Phuket Syndrome), except of course when it's a case of SEDBYMIPS (Sudden Explained Death By Motorcycle In Phuket Syndrome) or ABYTDIPS (Assaulted By Taxi Driver in Phuket Syndrome).

[PEP]

MSG! Yes or NO?

There is more harm in a bottle of coke and a BIG MAC than in a dish with MSG. Before Here is a quote on a study done on behalf of the US FDA, A controlled double-blind multicenter clinical trial failed to demonstrate the relationship between MSG symptom complex and the consumption of MSG in individuals who believed they reacted adversely against MSG. No statistical association has been demonstrated, there were few responses and they were inconsistent." Another one - "Adequately controlling for experimental bias includes a double-blind placebo-controlled experimental design (DBPC) and the application in capsules because of the strong and unique after-taste of glutamates. In a study performed by Tarasoff and Kelly (1993). Seventy one fasting participants were given 5 g of MSG and then administered a standard breakfast. There was only one reaction, and it was to the placebo in a self-identified MSG-sensitive individual."

[hellodolly]

"...“After that, we focused on food as a potential cause, so we checked her blood, stomach and intestines. We did not find any harmful contaminants from food and there were no traces of toxins in her body, so we had no reason to suspect that she was poisoned by something she ate or any other contaminant,” he said..."

And this was last saturday? And they ';say' 'have complete toxicology screens' back now... < Total BS

This smacks of Medical Examiner incompetence, and/or jumping to conclusions under official pressure,

and potentially tourist business saving coverup. This stinks.

Well the article went on to say

"“If Ms Pranee’s relatives wanted us to investigate her death further, we could have sent the body for forensic examination in Bangkok, but the cost of transferring the body and conducting such tests is high,” Dr Sirichai said."

So no there was not a complete analysis or investigation. The Doctors worked with what they had.

The problem with these kind of things is we are completely clueless of all the facts. Unless a foreigner is involved we never here of these things happening. They could be a common daily occurrence among the Thai's

Then the press sensationalizes things until we have a full grown conspiracy.

I live in Chiang Mai and was here through out the Downtown incident. There was four deaths in the hotel in a short period of time. Very suspicious. But what is over looked is that two of them were an elderly couple who died of a heart attack with in a very short period of time. An elderly couple with both having a bad heart could easily in my opinion happen. One dies of a heart attack and the other one's heart can not take the strain and dies also.

I am not saying that is what happened but I am saying it is a very good possibility. Also there was a New Zealand lady and a American lady who got sick but did not die. the New Zealand lady was the room mate of of the other New Zealander. Could they not have eaten food at the same place. The Downtown Inn was located next to a large outdoor food court in the Night Bazaar. The Lady from the states returned to Seattle while she was still sick and doctors there were unable to find the cause.

We had one want to be reporter here who blamed the death of a fellow on the fact that a friend of a fellow who died in Chiang Mai was invited to go swim at the Downtown inn pool the next day. No proof if the guy went or not and the fellow was not staying there any how. There was no check to see if there was other death's in the area. There could have been Thai's that died but that is of no interest to the English press unless there is a foreigner involved.

It was how ever strange. The first death was not talked about because it was a Thai tour guide and happened a month before the New Zealand Girl died.

[bangon04]

SUDS... a new HUB opportunity for Thailand. It could potentially save a lot of police time. (or maybe not...)

[sevenhills]

someone I met from the US went out and had some street food and had irregular heartbeats and severe anxiety attacks when she had never had that before.

the only thing I can think of is a major dose of MSG. This exito-neuro toxin is extremely dangerous and should not be administered by the uneducated much less

be put in something to be consumed.

I've seen people preparing large pots of something at restaurants and just pouring a whole bag of this stuff in it.

Is there a test for the presence of MSG? Most of us are not used to it and the reason I rarely eat out, and if I do I only go to places that know me

and know do not put MSG in anything I'm going to eat because I will not return.

Much/most of the hysteria about MSG being so bad is unproven nonsense . ...more and more research has shown MSG is not the 'ogre' its been made out to be in the past 40 odd years since one theory about it made the news.

You may need to do a bit more research....MSG is Poison.

[jmccarty]

Poor girl. RIP and sorry to the partner too.

[andreandre]

someone I met from the US went out and had some street food and had irregular heartbeats and severe anxiety attacks when she had never had that before.

the only thing I can think of is a major dose of MSG. This exito-neuro toxin is extremely dangerous and should not be administered by the uneducated much less

be put in something to be consumed.

I've seen people preparing large pots of something at restaurants and just pouring a whole bag of this stuff in it.

Is there a test for the presence of MSG? Most of us are not used to it and the reason I rarely eat out, and if I do I only go to places that know me

and know do not put MSG in anything I'm going to eat because I will not return.

Much/most of the hysteria about MSG being so bad is unproven nonsense . ...more and more research has shown MSG is not the 'ogre' its been made out to be in the past 40 odd years since one theory about it made the news.

You may need to do a bit more research....MSG is Poison.

Sorry, you are absolutely wrong...if you care to open a new thread on it i will discuss it in full

Dont want to hi jack this one and go too far off topic.

Edit..check #15...

Edited August 19, 2013 by andreandre

[Rimmer]

A post in weird oversized fonts has been removed

[OKF]

I do not believe anything reported about MSG beeing harmless that especially come from the US as the food industry is not interested in any proper research. This industry is extremly powerful. In the US the industries and therfore money rules everything MSG does cross the blood brain barrier and therefore could also be responsible for e.g. Parkinsons Desease. Read about it in Wiki....not a lot to read...read between the lines...

[MikeThaison]

“For example, as shown by recent cases in Thailand, if you sleep in a car – or leave your baby in a car – with the air conditioning on for a long time, it’s possible to die from sudden death,” he said.

&lt;deleted&gt; is this doctor smoking? I can't believe no one commented on this statement.