title: Fatality due to the use of a designer drug MDMA (Ecstasy).
abstract: Drugs of abuse belonging to the amphetamine derivatives, which are often taken by adolescents and young adults, pose a serious risk associated with uncontrolled ingestion that sometimes leads to fatal outcomes. The number of deaths, however, related to Ecstasy is small when compared to the frequency of its use. The report presents a fatal poisoning with MDMA--Ecstasy of a 22-year-old male with a documented history of drug abuse. The observations of witnesses to the event made within the period between the exposition and fatal outcome may document the characteristic behavior of a person in the course of progressive poisoning. Toxicological investigations of the autopsy specimens carried out by means of liquid chromatography-atmospheric pressure chemical ionization-tandem mass spectrometry (LC-APCI-MS-MS) demonstrated the presence of MDMA and its metabolite MDA in the blood of the victim, and the concentration level justified the fatal outcome (MDMA--1.42mg/L, MDA--0.17 mg/L), while the detection of high MDMA levels in a 6-cm long strand of hair separated into three segments (11.64 ng/mg in S1; 8.74 ng/mg in the S2; 15.51 ng/mg in the S3) confirmed the history of drug abuse. The report describing the results of macro and microscopic examinations aiming at assessing internal organ damage suggested a mild hepatic damage.
authors.affiliation: Department of Toxicology, Institute of Forensic Medicine, Collegium Medicum, Jagiellonian University, 16 Grzegórzecka St., Kraków, Poland. mpklys@cyf-kr.edu.pl
authors.forename: Małgorzata
authors.initials: M
authors.lastname: Kłys
authors.forename: Sebastian
authors.initials: S
authors.lastname: Rojek
authors.forename: Krzysztof
authors.initials: K
authors.lastname: Woźniak
authors.forename: Ewa
authors.initials: E
authors.lastname: Rzepecka-Woźniak
mesh_terms: D015104:3,4-Methylenedioxyamphetamine / Q000032:analysis / Q000097:blood; D000328:Adult; D001344:Autopsy; D002853:Chromatography, Liquid; D015198:Designer Drugs / Q000032:analysis / Q000506:poisoning*; D017809:Fatal Outcome; D006197:Hair / Q000737:chemistry; D006213:Hallucinogens / Q000032:analysis / Q000097:blood / Q000506:poisoning*; D006801:Humans; D008099:Liver / Q000473:pathology; D008297:Male; D013058:Mass Spectrometry; D018817:N-Methyl-3,4-methylenedioxyamphetamine / Q000032:analysis / Q000097:blood / Q000506:poisoning*; D011041:Poisoning / Q000473:pathology; D019966:Substance-Related Disorders / Q000401:mortality* / Q000473:pathology
chemical_list: D015198:Designer Drugs; D006213:Hallucinogens; D015104:3,4-Methylenedioxyamphetamine; D018817:N-Methyl-3,4-methylenedioxyamphetamine