title: Fatal outcome in a child after ingestion of a transdermal fentanyl patch.
abstract: The case history and toxicological findings of a fatal fentanyl intoxication due to ingestion of a transdermal patch are presented. A 1-year-old otherwise healthy girl was put to bed and 2 h later she was found dead. The autopsy revealed a 25-microg/h (4.2 mg) transdermal fentanyl patch in the stomach. Toxicological analysis by liquid chromatography-tandem mass spectrometry with positive electrospray ionization yielded fentanyl and norfentanyl concentrations in the peripheral blood of 5.6 and 5.9 ng/ml, heart blood 19.0 and 8.9 ng/ml, and liver 235 and 26 ng/g, respectively. The cause of death was determined to be a fentanyl overdose. The investigation established that the child has unintentionally swallowed the patch, which had been lying on the floor.
authors.affiliation: Institute of Legal Medicine, Hannover Medical School, Carl-Neuberg-Strasse 1, 30625, Hannover, Germany. teske.joerg@mh-hannover.de
authors.forename: Jörg
authors.initials: J
authors.lastname: Teske
authors.forename: Jens-Peter
authors.initials: JP
authors.lastname: Weller
authors.forename: Klaus
authors.initials: K
authors.lastname: Larsch
authors.forename: Hans Dieter
authors.initials: HD
authors.lastname: Tröger
authors.forename: Matthias
authors.initials: M
authors.lastname: Karst
mesh_terms: D000284:Administration, Oral; D000701:Analgesics, Opioid / Q000008:administration & dosage / Q000506:poisoning*; D001344:Autopsy / Q000379:methods*; D003692:Delayed-Action Preparations; D062787:Drug Overdose / Q000473:pathology; D005260:Female; D005283:Fentanyl / Q000008:administration & dosage / Q000506:poisoning*; D053593:Forensic Toxicology / Q000379:methods*; D006801:Humans; D007223:Infant; D021241:Spectrometry, Mass, Electrospray Ionization
chemical_list: D000701:Analgesics, Opioid; D003692:Delayed-Action Preparations; D005283:Fentanyl