Bad Ways to Die, Part 137,…

HARLESTON, West Virginia (AP) — A nurse was convicted Friday of killing her husband with paralyzing drugs and setting fire to their house to claim the insurance money.

Michelle Michael, 35, had taken the stand in her own defense and denied killing James Michael.

Authorities determined that the 33-year-old businessman was injected with a fatal dose of rocuronium, a paralyzing drug, as he lay in bed in couple’s Morgantown home in November 2005.

Prosecutors argued that his wife drugged him, left for work, then returned later that morning to set fire to the bed in an effort to cover her tracks.

Rocuronium is a nice little drug, and I’ve used it a few times during intubations, when I need to induce unconsciousness in a patient (with a different drug) and then paralysis, which is the role of rocuronium. I don’t use it much, as in the recommended doses it takes a little longer than I’d usually like for a rapid sequence intubation (I like Sux).

I mention this because the deceased, according to the article, died from rocuronium. As a single agent. So, he died of suffocation due to paralysis, quite possibly awake until the end. And unless she used an IV and a whopping overdosage, it took a few minutes.

Another bad way to die…


  1. That gave me the shivers. I know how long rocuronium takes to go into effect. And I’ll almost guarantee he was awake for most of it.

  2. what can i say, your blog is addictive! i really enjoy reading it, and if it’s ok with you, i’m adding you to the “blogs i read” list on my blog…!

  3. Carrie (NeoNurseChic) :) says:

    Wow! Awful story!!! We use pancuronium for the babies. And that’s gotta be a worst nightmare – dying because you’re too paralyzed to breathe… Although it’s probably better that he died from suffocation from paralysis as opposed to being awake, still breathing, but paralyzed and unable to get out of the house as you burn to death in a fire… What an awful story!! I cannot even imagine what would go through someone’s mind to do something like this!!! And it’s quite frightening that someone who is supposed to save lives would carry out such a horrific act!

  4. GD,
    reminds me of a story which i can’t find right now where a british neonatologist is on trial for murder of a non-viable preemie. the paper got it wrong, he didn’t gently ease the infant into the great beyond with something like morphine or valium, he gave the child pancuronium which was called, in the story, a “muscle relaxant”. well i had to comment on it. went to a trauma presentation the other day and evidently our local trauma facility gets patients all the time who are intubated but not sedated and their pressures are through the roof. he called it “screaming in the box” and i thought that was apt.

  5. The House Whisperer says:

    If I know I have a working line, I’ll ask for the Roc first, followed by Etomidate–then they hit at about the same time. It makes it seem just like giving Sux. The risk, of course, is that you’ll somehow lose your IV access right after the Roc but before the Sux, and then you darn well better have some versed handy for its amnestic effect!

  6. I just don’t see that as such a bad way to die. I can think of much worse ways.

  7. worse than being alive, concious, and paralyzed…but burned??? Wow…what’s it like in your head?

  8. TheNewGuy says:

    That would definitely be a bad way to die… paralyzed and suffocating? No thanks.

    As an aside, intubation with paralytics alone is pretty punitive… and you really want to be careful with punitive medicine. You don’t really want to approach that line of using your medical skills to harm or deliberately inflict pain on somebody, and it’s hard to justify not throwing the appropriate sedative/induction agent into the mix.

    That said, we’ve all seen it done… the last time was on an inner-city antisocial dirtbag who decided he was going attempt to punch out one of the nurses, and one of my female colleagues. Needless to say, they were neither gentle, nor merciful with him… and IIRC, the Sux was given, but the etomidate was either mislabeled, or the IV infiltrated before it could be given.

  9. Erm… wow. Definitely a bad way to die. Go justice system.

  10. 8. I’ve never seen that happen. I myself have been pretty ticked off at some screamingly-combative patients, but have never crossed that line, or seen it crossed, if only because making people deliberately angry is a good way to meet them in the parking lot a few months later, when they’re wide awake.

    9. Yes, prosecute her.

  11. Speaking of which, the cover story in the current issue of Texas Monthly is about a nurse who killed a bunch of her patients with mivacurium.

  12. He was apparently burned after he was already dead, from what I can gather. To hide the evidence. Being burned alive is one of the worse ways I was thinking of.

  13. Whether he was alive when he was burned is almost immaterial. The fact that she chose that particular agent, having expert knowledge of its effects, is enough to say she not only committed murder but she tortured her husband to death.

  14. The fact that she did both definitely shows that she premeditated the murder. She should be made an example of, regardless of her sex.