title: A Case Review of the First Analytically Confirmed 25I-NBOMe-Related Death in Washington State.
abstract: This case was submitted to the Washington State Patrol Toxicology Laboratory in September 2014. A 15-year-old male went to a party where he ingested 25I-NBOMe and mushrooms. A short time later, he started to vomit and began seizing until he eventually passed out. Resuscitation efforts were made, but were unsuccessful. He was transported to a local hospital, where he died three days later of multi-system organ failure following cardiopulmonary arrest. The hospital admission samples were negative for ethanol and basic drugs and their metabolites. The hospital serum confirmed positive for delta-9-tetrahydrocannabinol (THC) and carboxy-THC at 4.1 and 83 ng/mL, respectively. On the basis of the case history, the hospital blood and urine were sent to NMS Labs for NBOMe and psilocin confirmation. The blood was positive for 25I-NBOMe, and the urine was positive for 25C-, 25H- and 25I-NBOMe, as well as, psilocin. Antemortem and postmortem blood were also sent to AIT Laboratories for NBOMe confirmation. The antemortem blood confirmed positive for 25I-NBOMe with a concentration of 0.76 ng/mL. The manner of death was ruled an accident as a result of combined 25I-NBOMe and psilocin intoxication.
authors.affiliation: Toxicology Laboratory Division, Washington State Patrol, 2203 Airport Way S. Ste. 360, Seattle, WA 98134, USA lyndsey.lowe@wsp.wa.gov.
authors.forename: Lyndsey M
authors.initials: LM
authors.lastname: Lowe
authors.affiliation: Toxicology Laboratory Division, Washington State Patrol, 2203 Airport Way S. Ste. 360, Seattle, WA 98134, USA.
authors.forename: Brianna L
authors.initials: BL
authors.lastname: Peterson
authors.affiliation: Toxicology Laboratory Division, Washington State Patrol, 2203 Airport Way S. Ste. 360, Seattle, WA 98134, USA.
authors.forename: Fiona J
authors.initials: FJ
authors.lastname: Couper
mesh_terms: D000293:Adolescent; D004118:Dimethoxyphenylethylamine / Q000031:analogs & derivatives* / Q000032:analysis / Q000506:poisoning; D017809:Fatal Outcome; D006801:Humans; D008297:Male
chemical_list: D004118:Dimethoxyphenylethylamine; C554181:2-(4-iodo-2,5-dimethoxyphenyl)-N-(2-methoxybenzyl)ethanamine