title: Investigation of postmortem absorption and redistribution after the application of a fentanyl patch.
abstract: Fentanyl deaths have increased with availability of transdermal patches. Interpretation of postmortem fentanyl levels may be complicated by postmortem redistribution and absorption of fentanyl from a patch. We applied an unused 100-μg/h fentanyl patch onto the lower abdomen of a decedent with no premortem fentanyl exposure. Ocular fluid, blood, and urine were collected prior to placement, and the decedent was refrigerated for 23 h. Prior to the autopsy, urine, subcutaneous tissue under the patch, and samples from the same anatomic sites were obtained. We observed no fentanyl in any postpatch placement samples (LOD: 0.1 ng/mL for blood and vitreous fluid, 1.0 ng/mL urine, 2.0 ng/g for tissues). Although we observed no postmortem absorption of fentanyl, this was only a single case; therefore, we recommend that patches be removed after receipt of a cadaver before initiation of an autopsy, with the location of removed patch documented.
authors: San Francisco General Hospital, 1001 Potrero Ave., San Francisco, CA 94110.
authors: Alan H B
authors: AH
authors: Wu
authors: Rebecca
authors: R
authors: Hamilton
authors: Robert
authors: R
authors: Middleberg
authors: Sherri
authors: S
authors: Kacinko
authors: Thomas
authors: T
authors: Kearney
mesh_terms: D001923:Brain Chemistry; D005283:Fentanyl / Q000032:analysis* / Q000493:pharmacokinetics*; D053593:Forensic Toxicology; D006801:Humans; D007668:Kidney / Q000737:chemistry; D008099:Liver / Q000737:chemistry; D008168:Lung / Q000737:chemistry; D008297:Male; D008875:Middle Aged; D009294:Narcotics / Q000032:analysis* / Q000493:pharmacokinetics*; D011180:Postmortem Changes; D050151:Subcutaneous Fat / Q000737:chemistry; D014018:Tissue Distribution; D057968:Transdermal Patch; D014822:Vitreous Body / Q000737:chemistry
chemical_list: D009294:Narcotics; D005283:Fentanyl
keywords: fentanyl transdermal patch; forensic science; liquid chromatography/mass spectrometry; postmortem absorption; postmortem redistribution; stratum corneum