title: Determination of methamphetamine in sudden death of a traffic accident inpatient by blood and hair analyses.
abstract: A female in her late thirties, who was hospitalized for 13 days with rib fractures suffered in a traffic accident, was found in supine position on the patient's bed in a state of cardiopulmonary arrest. The resuscitation failed to recover consciousness and her death was confirmed 1.75 h later. The autopsy revealed neither severe injuries nor lesion as a cause of death. Histological examinations revealed contraction band necrosis (CBN) in the cardiac muscle of the left and right ventricles, as well as congestion and edema in both lungs. Toxicological screening of urine using Triage revealed the presence of methamphetamine (MA). By gas chromatography-mass spectrometry (GC/MS), the concentrations of MA and its metabolite amphetamine (AP) in the heart blood were shown to be 0.178 and 0.051 microg/ml, respectively. From these findings, we conclude that the cause of her death was circulatory failure due to MA poisoning. Further, the stored scalp hair analysis demonstrated both MA and AP in 0-3 cm segments from the scalp. The results suggested that she was a MA abuser at least about 3 months before her death. In this case, preservation of hair samples collected during an autopsy was useful for providing evidence of MA abuse.
authors.affiliation: Department of Legal Medicine, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima 890-8544, Japan. agomiho@m.kufm.kagoshima-u.ac.jp
authors.forename: Mihoko
authors.initials: M
authors.lastname: Ago
authors.forename: Kazutoshi
authors.initials: K
authors.lastname: Ago
authors.forename: Mamoru
authors.initials: M
authors.lastname: Ogata
mesh_terms: D000063:Accidents, Traffic; D000328:Adult; D000661:Amphetamine / Q000032:analysis; D019969:Amphetamine-Related Disorders / Q000175:diagnosis*; D001929:Brain Edema / Q000473:pathology; D000697:Central Nervous System Stimulants / Q000032:analysis* / Q000506:poisoning; D016757:Death, Sudden, Cardiac / Q000209:etiology*; D005260:Female; D049429:Forensic Pathology; D053593:Forensic Toxicology; D008401:Gas Chromatography-Mass Spectrometry; D006197:Hair / Q000737:chemistry*; D006323:Heart Arrest / Q000209:etiology; D006801:Humans; D008694:Methamphetamine / Q000032:analysis* / Q000506:poisoning; D009206:Myocardium / Q000473:pathology; D009336:Necrosis; D011654:Pulmonary Edema / Q000473:pathology
chemical_list: D000697:Central Nervous System Stimulants; D008694:Methamphetamine; D000661:Amphetamine