Prolonged Low-Level Carbon Monoxide Exposure Leads to Death

This case study explores the health implications of long-term low-level carbon monoxide exposure, focusing on an individual's prolonged exposure due to a water heater pipe leak.

ByWendy Ketner, M.D.


Published on February 16, 2024

Water heater

Case Overview

This case study delves into a complex scenario involving an individual who was subjected to low-level carbon monoxide (CO) exposure over an extended period due to a water heater pipe leak. The primary objective is to ascertain the potential health implications of this prolonged exposure and its possible contribution to the individual's untimely demise.

A toxicologist, with dual-board certification in Medical Toxicology and Emergency Medicine, was consulted to provide expert insights into the effects of long-term CO exposure.

Questions to the Toxicology expert and their responses


Can you describe your experience analyzing/treating/evaluating patients with long-term exposure to low-level CO?

As a professional dual-boarded in Medical Toxicology and Emergency Medicine, I have encountered cases involving CO exposure. However, it's important to note that long-term low-level CO exposure isn't common. While I've considered it several times in differential diagnoses clinically, I haven't come across a case exactly like this one.


What are some common symptoms that can be caused by long-term exposure to Carbon Monoxide?

The symptoms depend largely on the extent of exposure. CO acts as a simple asphyxiant, meaning it displaces oxygen in the air, leading to oxygen deprivation in the body. However, it also has direct physiological effects, especially as CO concentrations increase in the body.

About the expert

This expert is a seasoned professional in emergency medicine and toxicology, with over a decade of experience. They are dual-board certified in both fields and have contributed significantly to medical research, authoring 50 peer-reviewed articles and 13 chapters. Their extensive career includes roles as an associate director of clinical toxicology at a major hospital, an assistant professor of emergency medicine at a leading university, and currently serving as a medical toxicology consultant for a poison control center.

Expert headshot



About the author

Wendy Ketner, M.D.

Wendy Ketner, M.D.

Dr. Wendy Ketner is a distinguished medical professional with a comprehensive background in surgery and medical research. Currently serving as the Senior Vice President of Medical Affairs at the Expert Institute, she plays a pivotal role in overseeing the organization's most important client relationships. Dr. Ketner's extensive surgical training was completed at Mount Sinai Beth Israel, where she gained hands-on experience in various general surgery procedures, including hernia repairs, cholecystectomies, appendectomies, mastectomies for breast cancer, breast reconstruction, surgical oncology, vascular surgery, and colorectal surgery. She also provided care in the surgical intensive care unit.

Her research interests have focused on post-mastectomy reconstruction and the surgical treatment of gastric cancer, including co-authoring a textbook chapter on the subject. Additionally, she has contributed to research on the percutaneous delivery of stem cells following myocardial infarction.

Dr. Ketner's educational background includes a Bachelor's degree from Yale University in Latin American Studies and a Doctor of Medicine (M.D.) from SUNY Downstate College of Medicine. Moreover, she is a member of the Board of Advisors for Opollo Technologies, a fintech healthcare AI company, contributing her medical expertise to enhance healthcare technology solutions. Her role at Expert Institute involves leveraging her medical knowledge to provide insights into legal cases, underscoring her unique blend of medical and legal acumen.

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