Matthew Perry

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nimbus

nimbus

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Does anyone buy this? I’m trying to understand how he died by the “acute effects of ketamine”. Did he somehow get himself home after a ketamine infusion, get in the hot tub, pass out and drown?

www.theguardian.com

Matthew Perry died of ‘acute effects of ketamine’, autopsy report says

Contributing factors in Friends star’s death included ‘drowning, coronary artery disease and the effects of buprenorphine’
www.theguardian.com www.theguardian.com


variety.com

Matthew Perry’s Cause of Death Revealed as ‘Acute Effects of Ketamine’

Matthew Perry's cause of death has been revealed.
variety.com variety.com
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There are mobile IV services that also deal with ketamine, I wouldn’t be surprised if he had the option of doing it at home.
 
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Definitely the least common of street drugs and an odd choice. Seems like he was using it for depression or chronic pain in infusion form and maybe was self treating a bit at home? Guessing he would have been fine if he hadn't been in a body of water.
 
In the toxicology report, the ketamine and norketamine were in his stomach only ketamine 1.1mg though. It still seems odd if he were taking it PO.

Edit: I shouldn't call it special k -- I know it's a treatment given PO, but I sometimes call it that at work when giving it IV too.
 
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Oral ketamine is a treatment as well, you don’t need to get it illegally
 
GassYous said:
contributing factors: drowning

Lol
Click to expand...

Exactly. Media is goign to spin it as purely because of ketamine. Its the fact that he was high as a kite and didn’t even care that he literally under water and couldn’t breath in a shallow tub where he could have simply just gotten up
 
he traded his opioid addiction for ketamine addiction. for sure used at home .
 
It sounds like it is worded wrong to me. The cause of death should be drowning with “acute affects of ketamine” being a contributing factor. How is drowning only a
“contributing factor?” That makes no sense. I’m not a medical examiner or pathologist, but to me, drowning would be the primary cause of death here. If I drunk drive my car into a tree, blunt force trauma is the cause of death with alcohol intoxication being a contributing factor.
 
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Plasma concentration was 3500nf/ml. Awakening occurring at 1000ng/ml. If this were a steadier state concentration than an IV Bolus - ketamine was the cause of death.
 
coffeebythelake said:
What kind of dose is that equivalent to?
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I don’t know exactly. I got it from this publication.

Anesthesiology

pubs.asahq.org pubs.asahq.org

I tried typing in 150mg bolus IV on a 100kg male in an app and it peaked just over that - equilibrated with target tissues at about 3500, and rapidly fell below it within the first couple minutes. The app may be innacurate.
 
cytocide said:
I don’t know exactly. I got it from this publication.

Anesthesiology

pubs.asahq.org pubs.asahq.org

I tried typing in 150mg bolus IV on a 100kg male in an app and it peaked just over that - equilibrated with target tissues at about 3500, and rapidly fell below it within the first couple minutes. The app may be innacurate.
Click to expand...


Thx for the link.

But people don’t die with that dose of ketamine. Vitals remain stable, some are still interactive.
 
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His level was above maintenance of general anesthetic level (according to that article 2000-3000). Was he NPO and give himself oxygen?

Of course, if he fell asleep and drowned that would be one thing - he induced general anesthesia and drowned.
 
The lay public never understands proximate and immediate causes of death.
I have pushed 150 of ketamine on an addict and they’ll still respond.
Sounds like he drowned due to altered consciousness due to ketamine.
Whitney Houston died this way I think
 
Ketamine isn't exactly the most predictable drug, in my experience. I have seen patients lose consciousness at doses less than 150. I've used ketamine darts where I'm pretty sure the dose was not close to the equivalent of 150 IV, and seen them go unconscious. And obviously, you don't even need to be completely unconscious for the possibility of significant obstruction
 
amyl said:
The lay public never understands proximate and immediate causes of death.
I have pushed 150 of ketamine on an addict and they’ll still respond.
Sounds like he drowned due to altered consciousness due to ketamine.
Whitney Houston died this way I think
Click to expand...

Dolores O’Riordan too.
 
cytocide said:
His level was above maintenance of general anesthetic level (according to that article 2000-3000). Was he NPO and give himself oxygen?

Of course, if he fell asleep and drowned that would be one thing - he induced general anesthesia and drowned.
Click to expand...


If he aspirated it would have been obvious to the medical examiner.
 
Ezekiel2517 said:
Ketamine isn't exactly the most predictable drug, in my experience. I have seen patients lose consciousness at doses less than 150. I've used ketamine darts where I'm pretty sure the dose was not close to the equivalent of 150 IV, and seen them go unconscious. And obviously, you don't even need to be completely unconscious for the possibility of significant obstruction
Click to expand...


I suppose obstruction could have been in the sequence of events especially if he had sleep apnea and if he had others substances on board too.

The reason I started the thread is because ketamine is one of the safest drugs we have. It’s included in the WHO list of essential drugs because of its utility for procedural sedation and anesthesia in low resource settings. Of course dose matters but we use it in hemodynamically unstable tamponade patients when we want to maintain spontaneous ventilation. I was curious about others’ thoughts on how it could kill him.
 
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One part of the book details the near-death experience in 2019 in which Perry's colon burst because of his opioid use. He was left in a coma for two weeks and hospitalized for five months, and he had to use a colostomy bag.

During the health scare, he was placed on an ECMO (extracorporeal membrane oxygenation) machine, which provides prolonged cardiac and respiratory support to the heart and lungs. Perry recalled that doctors told his family he had a “2% chance to live.”
 
nimbus said:
The reason I started the thread is because ketamine is one of the safest drugs we have. It’s included in the WHO list of essential drugs because of its utility for procedural sedation and anesthesia in low resource settings. Of course dose matters but we use it in hemodynamically unstable tamponade patients when we want to maintain spontaneous ventilation. I was curious about others’ thoughts on how it could kill him.
Click to expand...
Relative to other induction agents we use, I suppose it is "safer". I wouldn't call anything that can cause unconsciousness to be safe, however. Unfortunately for Mr. Perry, maintaining spontaneous ventilation is not an advantage when you are comatose and underwater.
 
why-not-both.jpg
 
BLADEMDA said:
One part of the book details the near-death experience in 2019 in which Perry's colon burst because of his opioid use. He was left in a coma for two weeks and hospitalized for five months, and he had to use a colostomy bag.

During the health scare, he was placed on an ECMO (extracorporeal membrane oxygenation) machine, which provides prolonged cardiac and respiratory support to the heart and lungs. Perry recalled that doctors told his family he had a “2% chance to live.”
Click to expand...
So does Cedars just throw all celebrities on ECMO? I imagine he had some sort of aspiration PNA/ARDS, but I wouldn't be surprised if that's part of the celebrity package.
 
thinkorswim said:
I can’t wait for patients to start asking if I’ll be giving them “the Matthew Perry drug” or “the Michael Jackson drug.”
Click to expand...
Don't forget to add a little Prince....

But, just of note, Michael Jackson, had a decent number of benzos in his system. Valium, Ativan, and Versed were all found in his system. I think Propofol may just been the straw that broke the camel's back.
 
0kazak1 said:
Don't forget to add a little Prince....

But, just of note, Michael Jackson, had a decent number of benzos in his system. Valium, Ativan, and Versed were all found in his system. I think Propofol may just been the straw that broke the camel's back.
Click to expand...


Amy Winehouse had a cocktail including ketamine too.
 
amyl said:
The lay public never understands proximate and immediate causes of death.
I have pushed 150 of ketamine on an addict and they’ll still respond.
Sounds like he drowned due to altered consciousness due to ketamine.
Whitney Houston died this way I think
Click to expand...
The pathologist identified it as the immediate cause of death. A forensic pathologist in one of the busiest counties with a lot of swimming pools.

I’m trying to figure out the tci model calculations, and not quite confident in this, but in bolus doses 200mg is followed by 50 mg every five minutes gets you near his steady state at 20 mins or so - assuming it is steady state.
 
www.dailymail.co.uk

Who is Jasveen Sangha?

The 41-year-old was charged in an 18-count superseding indictment in relation to distributing ketamine to the Friends star in the weeks before he died aged 54.
www.dailymail.co.uk www.dailymail.co.uk

Indian drug dealer in LA that sold Matthew Perry ketamine
 
thinkorswim said:
I can’t wait for patients to start asking if I’ll be giving them “the Matthew Perry drug” or “the Michael Jackson drug.”
Click to expand...

You just gotta lean into it. Some Michael Jackson to get you off to sleep, some Prince and a touch of Mathew Perry for pain.

I actually love when patients bring up ketamine and Matthew Perry.

“I wasn’t planning on chucking you in a hot tub and walking away after I give it, so you should be fine.”
 
after Perry's death was reported in the news, one of the street dealers text the other: "Delete all our messages."
Click to expand...

Every time I read something like this, I wonder how rich I'd be right now if I, as a person with an IQ above 75, had chosen a life of crime instead of this medicine gig.
 
Ezekiel2517 said:
Interesting updates on this, to say the least

View attachment 390808

smdp.com

Santa Monica doctor charged in connection with Matthew Perry’s fatal overdose - Santa Monica Daily Press

A prosecutor says five people have been charged in connection with Matthew Perry's death from a ketamine overdose last year, including the actor's assistant and two doctors. US Attorney Martin Estrada announced the charges Thursday, saying the doctors supplied Perry with a large amount of...
smdp.com smdp.com
Click to expand...
Insane
 
pgg said:
Every time I read something like this, I wonder how rich I'd be right now if I, as a person with an IQ above 75, had chosen a life of crime instead of this medicine gig.
Click to expand...
Did you get tested?
 
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