Fatal cold medication intoxication in an infant.
The case history and toxicological findings of an infant fatality involving pseudoephedrine, brompheniramine, and dextromethorphan are presented. Concentrations of brompheniramine and dextromethorphan were measured in both postmortem blood and liver specimens using a gas chromatograph equipped with a nitrogen-phosphorus detector. Brompheniramine and dextromethorphan were 0.40 mg/L and 0.50 mg/L, respectively, in the blood sample and 0.16 mg/kg and 0.57 mg/kg in the liver sample. The concentration of pseudoephedrine in blood and liver specimens was measured using gas chromatography-mass spectrometry and was determined to be 14.4 mg/L in the blood and 16 mg/kg in the liver. Additionally, a baby bottle allegedly administered to the infant was collected as evidence and sent to the Medical Examiner's Office for evaluation. The amounts of total brompheniramine, dextromethorphan, and pseudoephedrine remaining in the baby bottle were 1.4 mg, 9.4 mg, and 40 mg, respectively.
Boland
Diane M
DM
Miami-Dade Medical Examiner Department, Toxicology Laboratory, 1851 NW 10th Avenue, Miami, Florida 33136, USA.
Rein
Joseph
J
Lew
Emma O
EO
Hearn
W Lee
WL
D001977:Brompheniramine / Q000032:analysis / Q000097:blood / Q000506:poisoning; D002849:Chromatography, Gas; D003139:Common Cold / Q000188:drug therapy; D003915:Dextromethorphan / Q000032:analysis / Q000097:blood / Q000506:poisoning; D004809:Ephedrine / Q000032:analysis / Q000097:blood / Q000506:poisoning; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D007223:Infant; D008099:Liver / Q000737:chemistry; D004366:Nonprescription Drugs / Q000032:analysis* / Q000506:poisoning*
D004366:Nonprescription Drugs; D003915:Dextromethorphan; D004809:Ephedrine; D001977:Brompheniramine