title: Analysis of clothing and urine from Moscow theatre siege casualties reveals carfentanil and remifentanil use.
abstract: On October 26, 2002, Russian Special Forces deployed a chemical aerosol against Chechen terrorists to rescue hostages in the Dubrovka theatre. Its use confirmed Russian military interest in chemicals with effects on personnel and caused 125 deaths through a combination of the aerosol and inadequate medical care. This study provides evidence from liquid chromatography-tandem mass spectrometry analysis of extracts of clothing from two British survivors, and urine from a third survivor, that the aerosol comprised a mixture of two anaesthetics--carfentanil and remifentanil--whose relative proportions this study was unable to identify. Carfentanil and remifentanil were found on a shirt sample and a metabolite called norcarfentanil was found in a urine sample. This metabolite probably originated from carfentanil.
authors.affiliation: Detection Department, Defence Science and Technology Laboratory-Dstl, Porton Down, Salisbury, Wiltshire SP4 0JQ, UK.
authors.forename: James R
authors.initials: JR
authors.lastname: Riches
authors.forename: Robert W
authors.initials: RW
authors.lastname: Read
authors.forename: Robin M
authors.initials: RM
authors.lastname: Black
authors.forename: Nicholas J
authors.initials: NJ
authors.lastname: Cooper
authors.forename: Christopher M
authors.initials: CM
authors.lastname: Timperley
mesh_terms: D000336:Aerosols / Q000009:adverse effects; D002853:Chromatography, Liquid; D003020:Clothing; D005260:Female; D005283:Fentanyl / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000097:blood / Q000652:urine; D006801:Humans; D008297:Male; D008875:Middle Aged; D009031:Moscow; D010880:Piperidines / Q000009:adverse effects / Q000097:blood / Q000652:urine*; D000077208:Remifentanil; D012304:Riot Control Agents, Chemical / Q000009:adverse effects / Q000097:blood / Q000652:urine*; D052616:Solid Phase Extraction; D013048:Specimen Handling; D053719:Tandem Mass Spectrometry; D023481:Terrorism / Q000517:prevention & control
chemical_list: D000336:Aerosols; D010880:Piperidines; D012304:Riot Control Agents, Chemical; C017114:carfentanil; D000077208:Remifentanil; D005283:Fentanyl