301. An Acute Butyr-Fentanyl Fatality: A Case Report with Postmortem Concentrations.
- Author
-
McIntyre IM, Trochta A, Gary RD, Wright J, and Mena O
- Subjects
- Adult, Analgesics, Opioid analysis, Analgesics, Opioid blood, Cocaine analogs & derivatives, Cocaine analysis, Drug Overdose blood, Enzyme-Linked Immunosorbent Assay, Fatal Outcome, Fentanyl analysis, Fentanyl blood, Fentanyl poisoning, Forensic Toxicology, Gas Chromatography-Mass Spectrometry, Humans, Liquid-Liquid Extraction, Male, Opioid-Related Disorders blood, Substance Abuse, Intravenous blood, Analgesics, Opioid poisoning, Drug Overdose diagnosis, Fentanyl analogs & derivatives, Opioid-Related Disorders diagnosis, Substance Abuse, Intravenous diagnosis
- Abstract
In this case report, we present an evaluation of the distribution of postmortem concentrations of butyr-fentanyl in a fatality attributed principally to the drug. A man who had a history of intravenous drug abuse was found unresponsive on the bathroom floor of his home. Drug paraphernalia was located on the bathroom counter. Toxicology testing, which initially screened positive for fentanyl by enzyme-linked immunosorbent assay, subsequently confirmed butyr-fentanyl, which was then quantitated by gas chromatography-mass spectrometry-specific ion monitoring (GC-MS SIM) analysis following liquid-liquid extraction. The butyr-fentanyl peripheral blood concentration was quantitated at 58 ng/mL compared with the central blood concentration of 97 ng/mL. The liver concentration was 320 ng/g, the vitreous was 40 ng/mL, the urine was 670 ng/mL and the gastric contained 170 mg. Acetyl-fentanyl was also detected in all biological specimens tested. Peripheral blood concentration was quantitated at 38 ng/mL compared with the central blood concentration of 32 ng/mL. The liver concentration was 110 ng/g, the vitreous was 38 ng/mL, the urine was 540 ng/mL and the gastric contained <70 mg. The only other drug detected was a relatively low concentration of benzoylecgonine. The cause of death was certified as acute butyr-fentanyl, acetyl-fentanyl and cocaine intoxication, and the manner of death was certified as accident., (© The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.)
- Published
- 2016
- Full Text
- View/download PDF