Case report on postmortem fentanyl measurement after overdose with more than 67 fentanyl patches

© 2021. The Author(s)..

PURPOSE: Fentanyl is an analgesic that is frequently prescribed, which resulted in non-intentional as well as intentional misuse and deaths. Here, we present a postmortem case of a patient who clearly died of a fentanyl overdose due to an extensive number of fentanyl patches combined with oral intake of fentanyl and cocaine. We aimed to show how postmortem analysis can be used to interpret postmortem fentanyl concentrations in unique cases like the one we present.

CASE DESCRIPTION: A 23-year-old male was found dead in his bedroom with 67 non-prescribed patches of fentanyl on his body. In the room, there also were fentanyl tablets of 100 µg and cocaine powder, which had possibly also been taken by the deceased. To confirm the cause of death, urine and subclavian blood were retrieved to perform a standard postmortem toxicology screening. The toxicological screening revealed the presence of several drugs, including cocaine, fentanyl, lidocaine and paracetamol. Further analysis of the quantitative postmortem values of fentanyl with ultra-performance liquid chromatography-tandem mass spectrometry revealed a fentanyl concentration of 57.9 µg/L. Considering several issues around postmortem drug analyses, this value seemed to be in line with concentrations found in previously reported postmortem cases.

CONCLUSION: We were able to confirm the expected cause of death with an extensive toxicological screening in combination with the circumstantial evidence. We identified fentanyl as most important cause for the fatal outcome in this specific case and simultaneously contributed to the limited availability of knowledge on postmortem fentanyl concentrations.

Medienart:

E-Artikel

Erscheinungsjahr:

2022

Erschienen:

2022

Enthalten in:

Zur Gesamtaufnahme - volume:40

Enthalten in:

Forensic toxicology - 40(2022), 1 vom: 01. Jan., Seite 199-203

Sprache:

Englisch

Beteiligte Personen:

Peeters, L E J [VerfasserIn]
Vleut, I T [VerfasserIn]
Tan, G E [VerfasserIn]
Croes, E A [VerfasserIn]
Bethlehem, C [VerfasserIn]

Links:

Volltext

Themen:

Case Reports
Cocaine
Drug overdose
Fentanyl
Humans
I5Y540LHVR
Journal Article
Postmortem
Tandem mass spectrometry
Toxicology
UF599785JZ

Anmerkungen:

Date Completed 05.12.2022

Date Revised 16.12.2022

published: Print-Electronic

Citation Status MEDLINE

doi:

10.1007/s11419-021-00598-3

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM349671362