The Case of Slobodan Milosevic

Talk about jumping on a case too late. Due to an extremely busy week of interviewing and clinic rotations I was unable to write about the case although I’ve been following closely.

Slobodan Milosevic, former Yugoslav president, who was on trial for war crimes, was found dead in his jail cell at the UN detention center in Hague. Mystery surrounding the cause of his death immediately emerged. Specifically concerning traces of a drug called Rifampin which was found in his blood on an earlier exam.

Rifampin is mainly used as one of the multitude of medications used to treat tuberculosis. It is unclear how traces of the chemical were ingested by Mr. Milosevic since he was not being treated for this condition at the time and the pharmacy at the detention center does not even carry the drug.

In addition, Milosevic, who later found out about the traces of the drug found in his system, wrote to the Russian embassy concerned the possibility that he was being poisoned. In November, Mr. Milosevic was complaining of headaches, fatigue and hearing problems, possibly as side effects of Rifampin use. Speculation about how traces of the drug were found in Milosevic still ruminate and includes poisoning and self ingestion. How Milosevic could have obtained the drug is unclear although reports say that he was in a “privileged setting” where many normal prison procedures were not always followed.

As for using Rifampin for the purpose of poisoning there are certainly better options. The side effects of Rifampin toxicity are numerous, however, they are generally not lethal. In addition, Rifampin can decrease the effects of other medications and there are speculations (I know you don’t like ‘speculations’) that Milosevic was ingesting the drug in order to prevent adequate treatment of his high blood pressure, possibly as a means of earning medical leave.

An Autopsy revealed the cause of Mr. Milosevic’s death to be, as one newspaper put it, a “mild” heart attack. As a matter of policy, I limit my use of the word “mild” to non-lethal myocardial infarctions.

In addition, as an anticlimax to this issue, traces of Rifampin were not found in his blood.