An Acute Acetyl Fentanyl Fatality: A Case Report With Postmortem Concentrations.
In this case report, we present an evaluation of the distribution of postmortem concentrations of acetyl fentanyl in a fatality attributed to the drug. A young man who had a history of heroin abuse was found deceased at his parents' home. Toxicology testing, which initially screened positive for fentanyl by ELISA, subsequently confirmed acetyl fentanyl by gas chromatography-mass spectrometry specific ion monitoring (GC-MS SIM) analysis following liquid-liquid extraction. No other drugs or medications, including fentanyl, were detected. The acetyl fentanyl peripheral blood concentration was quantified at 260 ng/mL compared with the central blood concentration of 250 ng/mL. The liver concentration was 1,000 ng/kg, the vitreous was 240 ng/mL and the urine was 2,600 ng/mL. The cause of death was certified due to acute acetyl fentanyl intoxication, and the manner of death was certified as an accident.
County of San Diego Medical Examiner's Office, 5570 Overland Ave., Suite 101, San Diego, CA 92123, USA iain.mcintyre@sdcounty.ca.gov.
Iain M
IM
McIntyre
County of San Diego Medical Examiner's Office, 5570 Overland Ave., Suite 101, San Diego, CA 92123, USA.
Amber
A
Trochta
County of San Diego Medical Examiner's Office, 5570 Overland Ave., Suite 101, San Diego, CA 92123, USA.
Ray D
RD
Gary
County of San Diego Medical Examiner's Office, 5570 Overland Ave., Suite 101, San Diego, CA 92123, USA.
Mark
M
Malamatos
County of San Diego Medical Examiner's Office, 5570 Overland Ave., Suite 101, San Diego, CA 92123, USA.
Jonathan R
JR
Lucas
D000059:Accidents; D000279:Administration, Cutaneous; D000328:Adult; D000701:Analgesics, Opioid / Q000097:blood*; D001344:Autopsy; D002140:California; D002423:Cause of Death; D005283:Fentanyl / Q000031:analogs & derivatives* / Q000097:blood / Q000633:toxicity / Q000652:urine; D053593:Forensic Toxicology / Q000379:methods*; D008401:Gas Chromatography-Mass Spectrometry; D006801:Humans; D059625:Liquid-Liquid Extraction; D008099:Liver / Q000737:chemistry*; D008297:Male; D015813:Substance Abuse Detection / Q000379:methods*; D014822:Vitreous Body / Q000737:chemistry*; D055815:Young Adult
D000701:Analgesics, Opioid; C000594854:N-(1-phenethylpiperidin-4-yl)-N-phenylacetamide; D005283:Fentanyl