Soon after transfer from an intensive care unit to a normal ward within a hospital a 59-year-old female patient died. The investigation revealed that oxygen was insufflated accidentally through a nasogastric tube into the stomach and the intestinum. Autopsy showed a distended abdomen and odorless free gas streaming out of the opened abdomen. In the gastric wall, a 12 cm long rupture and 5 more incomplete ruptures were found. A most possible mechanism of gastric rupture due to overstretching by insufflated gas is presented. Criminal responsibility was excluded as the cause of the death could not be stated without reasonable doubt. The problem of selecting patients for intensive care to the disadvantage of others who also might profit from this special treatment is discussed.