title: Case Report of Methylone, Oxymorphone and Ethanol in a Fatality Case with Tissue Distribution.
abstract: It is reasonable to expect the presence of multiple drugs to present a complicated picture of toxicity. We report a fatal case involving a young man who purchased illicit drugs and knowingly consumed them. After consuming these drugs and going to sleep in his friend's car, he was found unresponsive the next morning with no signs of physical violence. Drugs found in the peripheral blood at autopsy were oxymorphone, methylone and ethanol at concentrations of 0.106, 0.50 and 130 mg/dL, respectively. The levels of oxymorphone and methylone in peripheral blood were comparable to those observed in other reported fatalities. Cocaine and benzoylecgonine were detected in the urine but not in the blood. Measureable concentrations were also observed for oxymorphone and methylone in urine, liver, kidney and bile. The physical findings at autopsy included pulmonary edema. This is the only reported fatal case involving this combination of drugs encountered in our laboratory.
authors.affiliation: Division of Forensic Toxicology, Armed Forces Medical Examiner System, 115 Purple Heart Drive, Dover AFB, DE 19902, USA eric.t.shimomura.civ@mail.mil.
authors.forename: Eric T
authors.initials: ET
authors.lastname: Shimomura
authors.affiliation: Office of the Armed Forces Medical Examiner, Armed Forces Medical Examiner System, 115 Purple Heart Drive, Dover AFB, DE 19902, USA.
authors.forename: Alice J
authors.initials: AJ
authors.lastname: Briones
authors.affiliation: Office of the Armed Forces Medical Examiner, Armed Forces Medical Examiner System, 115 Purple Heart Drive, Dover AFB, DE 19902, USA.
authors.forename: Wendy S
authors.initials: WS
authors.lastname: Warren
authors.affiliation: Division of Forensic Toxicology, Armed Forces Medical Examiner System, 115 Purple Heart Drive, Dover AFB, DE 19902, USA.
authors.forename: Joseph W
authors.initials: JW
authors.lastname: Addison
authors.affiliation: Division of Forensic Toxicology, Armed Forces Medical Examiner System, 115 Purple Heart Drive, Dover AFB, DE 19902, USA.
authors.forename: Jessica L
authors.initials: JL
authors.lastname: Knittel
authors.affiliation: Division of Forensic Toxicology, Armed Forces Medical Examiner System, 115 Purple Heart Drive, Dover AFB, DE 19902, USA.
authors.forename: Sarah A
authors.initials: SA
authors.lastname: Shoemaker
authors.affiliation: Navy Drug Screening Laboratory, PO Box 113/Building H-2033 Adams Avenue, Jacksonville, FL 32212-0113, USA.
authors.forename: Taj D
authors.initials: TD
authors.lastname: King
authors.affiliation: Division of Forensic Toxicology, Armed Forces Medical Examiner System, 115 Purple Heart Drive, Dover AFB, DE 19902, USA.
authors.forename: Thomas Z
authors.initials: TZ
authors.lastname: Bosy
mesh_terms: D000328:Adult; D062787:Drug Overdose / Q000175:diagnosis*; D000431:Ethanol / Q000097:blood / Q000378:metabolism* / Q000652:urine; D017809:Fatal Outcome; D053593:Forensic Toxicology; D006801:Humans; D008297:Male; D008694:Methamphetamine / Q000031:analogs & derivatives* / Q000097:blood / Q000378:metabolism / Q000652:urine; D010111:Oxymorphone / Q000097:blood / Q000378:metabolism* / Q000652:urine; D011654:Pulmonary Edema / Q000175:diagnosis
chemical_list: D000431:Ethanol; D008694:Methamphetamine; D010111:Oxymorphone; C400939:methylone