title: Deaths involving methylenedioxypyrovalerone (MDPV) in Upper East Tennessee.
abstract: Two deaths involving 3, 4-methylenedioxypyrovalerone (MDPV) are reported. MDPV is a synthetic cathinone stimulant found in "bath salts" with neurological and cardiovascular toxicity. Biological specimens were analyzed for MDPV by GC/MS and LC/MS. A White man was found dead with signs of nausea and vomiting after repeatedly abusing bath salts during a weekend binge. Femoral venous blood and urine had MDPV concentrations of 39 ng/mL and 760 ng/mL. The second fatality was a White man with a history of drug and bath salt abuse found dead at a scene in total disarray after exhibiting fits of anger and psychotic behavior. Femoral venous blood and urine had MDPV concentrations of 130 ng/mL and 3800 ng/mL. The blood and urine MDPV concentrations are within the reported recreational concentration ranges (blood 24-241 ng/mL and urine 34-3900 ng/mL). Both decedents' deaths were attributed to relevant natural causes in a setting of MDPV abuse.
authors.affiliation: Toxicology, William L. Jenkins Forensic Center, East Tennessee State University, PO Box 70422, Johnson City, TN.
authors.forename: Trista H
authors.initials: TH
authors.lastname: Wright
authors.forename: Karen
authors.initials: K
authors.lastname: Cline-Parhamovich
authors.forename: Dawn
authors.initials: D
authors.lastname: Lajoie
authors.forename: Laura
authors.initials: L
authors.lastname: Parsons
authors.forename: Mark
authors.initials: M
authors.lastname: Dunn
authors.forename: Kenneth E
authors.initials: KE
authors.lastname: Ferslew
mesh_terms: D000328:Adult; D052117:Benzodioxoles / Q000009:adverse effects* / Q000032:analysis; D002853:Chromatography, Liquid; D015198:Designer Drugs / Q000009:adverse effects* / Q000032:analysis; D016883:Diabetic Ketoacidosis / Q000175:diagnosis; D053593:Forensic Toxicology; D008401:Gas Chromatography-Mass Spectrometry; D015658:HIV Infections / Q000150:complications; D006801:Humans; D008297:Male; D008875:Middle Aged; D018410:Pneumonia, Bacterial / Q000175:diagnosis; D011619:Psychotropic Drugs / Q000009:adverse effects* / Q000032:analysis; D011759:Pyrrolidines / Q000009:adverse effects* / Q000032:analysis; D012128:Respiratory Distress Syndrome / Q000175:diagnosis; D019966:Substance-Related Disorders / Q000150:complications*; D013714:Tennessee; D000094982:Synthetic Cathinone
chemical_list: D052117:Benzodioxoles; D015198:Designer Drugs; D011619:Psychotropic Drugs; D011759:Pyrrolidines; D000094982:Synthetic Cathinone
keywords: bath salts; blood; forensic science; methylenedioxypyrovalerone (MDPV); postmortem; urine