title: Drug facilitated sexual assault with lethal outcome: GHB intoxication in a six-year-old girl.
abstract: A very serious case of DFSA (drug facilitated sexual assault) is presented, in which a six-year-old girl died following sedation with γ-hydroxybutyric acid (GHB). She had been sexually abused by a relative. Samples of cardiac blood, bile, vitreous humour, liver, kidney, brain tissues and hair were analysed by a LC-MS/MS method. The following GHB concentrations were determined: cardiac blood: 150 mg/l; bile: 292mg/l; vitreous humour: 58mg/l; liver: 100 mg/kg; kidney: 124.5 mg/kg, brain: 110 mg/kg. Very high GHB levels were found in the proximal part of the hair sample (about 40.9 ng/mg). In distal segments of hair - up to 12 cm distant from the hair scalp - GHB concentrations were higher than the overall found endogenous range of 2-3 ng/mg. Police investigations revealed that the uncle had also administered GHB to the older half-sister. Therefore, a sample of her hair was analysed accordingly, but unremarkable results were obtained. Comparing our toxicological results with police investigations and the offender's statements it can be assumed that the 6-year-old girl had ingested GHB. By exclusion of other causes of death a lethal intoxication with GHB could be confirmed.
authors.affiliation: Institute of Forensic Medicine, University of Bonn, Stiftsplatz 12, D-53111 Bonn, Germany.
authors.forename: Lena-Maria
authors.initials: LM
authors.lastname: Mehling
authors.affiliation: Department of Forensic Medicine, University of Copenhagen, Frederik V's Vej 11, DK-2100 Copenhagen, Denmark.
authors.forename: Sys Stybe
authors.initials: SS
authors.lastname: Johansen
authors.affiliation: Department of Forensic Medicine, University of Copenhagen, Frederik V's Vej 11, DK-2100 Copenhagen, Denmark.
authors.forename: Xin
authors.initials: X
authors.lastname: Wang
authors.affiliation: Institute of Forensic Medicine, University of Bonn, Stiftsplatz 12, D-53111 Bonn, Germany.
authors.forename: Elke
authors.initials: E
authors.lastname: Doberentz
authors.affiliation: Institute of Forensic Medicine, University of Bonn, Stiftsplatz 12, D-53111 Bonn, Germany.
authors.forename: Burkhard
authors.initials: B
authors.lastname: Madea
authors.affiliation: Institute of Forensic Medicine, University of Bonn, Stiftsplatz 12, D-53111 Bonn, Germany. Electronic address: cohess@uni-bonn.de.
authors.forename: Cornelius
authors.initials: C
authors.lastname: Hess
mesh_terms: D002648:Child; D002853:Chromatography, Liquid; D017809:Fatal Outcome; D005260:Female; D005554:Forensic Medicine; D006197:Hair / Q000737:chemistry; D006801:Humans; D006885:Hydroxybutyrates / Q000097:blood / Q000506:poisoning*; D011902:Rape; D053719:Tandem Mass Spectrometry
chemical_list: D006885:Hydroxybutyrates; C111420:4-hydroxybutyric acid
keywords: Drug facilitated sexual assault; Gamma hydroxybutyric acid; Hair analyses; Post mortem