ABSTRACT
A 30-year-old man reportedly ingested pills and used illicit drugs with another person. They both fell asleep that night and the following afternoon the other person found him dead. There were used hypodermic needles and a metal spoon with dark tarry substance at the death scene, and two recent puncture sites were found on his body. It was uncertain if he had a history of illicit drug use. Postmortem blood initially screened borderline positive for methamphetamine by ELISA. An alkaline drug screen-detected ethylone which was subsequently confirmed and quantified by a specific GC-MS SIM analysis following solid-phase extraction. Concentrations were determined in the peripheral blood (0.39 mg/L), central blood (0.38 mg/L), liver (1.4 mg/kg), vitreous (0.58 mg/L), urine (20 mg/L) and gastric contents (12 mg). Other compounds detected in peripheral blood were morphine (0.05 mg/L), alprazolam (<0.05 mg/L), delta-9-THC (<1 ng/mL), delta-9-carboxy-THC (3.6 ng/mL) and naproxen (<5 mg/L). A urine screen (GC-MS) also confirmed 6-monoacetylmorphine, codeine and sildenafil. The cause of death was certified due to mixed ethylone, heroin and alprazolam intoxication. The manner of death was certified as accident.
Subject(s)
Acetone/analogs & derivatives , Drug Overdose/diagnosis , Ethylamines/poisoning , Illicit Drugs/poisoning , Substance-Related Disorders/diagnosis , Accidents , Acetone/analysis , Acetone/poisoning , Adult , Alprazolam/analysis , Autopsy , Cause of Death , Drug Overdose/metabolism , Enzyme-Linked Immunosorbent Assay , Ethylamines/analysis , Fatal Outcome , Forensic Toxicology/methods , Gas Chromatography-Mass Spectrometry , Heroin/analysis , Humans , Illicit Drugs/analysis , Male , Predictive Value of Tests , Solid Phase Extraction , Substance Abuse Detection/methods , Substance-Related Disorders/metabolismABSTRACT
There has been an increased awareness of illicit opiate abusers using the narcotic oxymorphone (Opana) by inhalation. Many laboratory screening techniques currently in use cannot detect oxymorphone in blood or urine. Consequently, biological specimens containing low to moderate concentrations of oxymorphone will likely go undetected. The circumstances, pathology findings, and toxicology results of two fatalities involving oxymorphone are presented. An opiate confirmation gas chromatography-mass spectrometry (GC-MS) procedure, described in detail was able to detected, confirm, and quantify oxymorphone in both subjects. The blood concentrations were 0.05 mg/L (50 microg/L) and 0.12 mg/L (120 microg/L).
Subject(s)
Analgesics, Opioid/poisoning , Opioid-Related Disorders/complications , Oxymorphone/poisoning , Analgesics, Opioid/blood , Autopsy , Drug Overdose/blood , Fatal Outcome , Female , Forensic Toxicology/methods , Gas Chromatography-Mass Spectrometry , Humans , Male , Middle Aged , Opioid-Related Disorders/blood , Oxymorphone/blood , Substance Abuse Detection/methodsABSTRACT
Toxicological investigations were performed on an intracerebral hematoma, antemortem blood, and postmortem blood of an individual who was found unresponsive in his home. The hematoma was found to have ethanol at a concentration of 0.05% (w/v), and benzoylecgonine (a cocaine metabolite) was also confirmed at a concentration of 0.43 mg/L by specific analysis using gas chromatography/mass spectrometry (GC/MS). These results enabled the pathologist to record the cause of death as intracerebral hemorrhage due to acute cocaine intoxication.
