| Autor: |
Andreasen, Mette Findal, Hardlei, Tore Forsingdal, Rosendal, Ingrid, Thomsen, Asser Hedegaard, Johannsen, Mogens, Sædder, Eva Aggerholm |
| Jazyk: |
angličtina |
| Rok vydání: |
2018 |
| Předmět: |
|
| Zdroj: |
Andreasen, M F, Hardlei, T F, Rosendal, I, Thomsen, A H, Johannsen, M & Sædder, E A 2018, ' A fatal poisoning involving 2-fluorofentanyl : Poster P5 ', 2017 Joint meeting of the Society og Forensic Toxicologists and The International Association of Forensic Toxicologists, Boca Raton, United States, 07/01/2018-11/01/2018 . |
| Popis: |
Background/introduction: A fatal intoxication involving 2-fluorofentanyl, a potent synthetic opioid analgesic, is reported. This is the first serious case associated with 2-fluorofentanyl that to our knowledge have been reported. 2-fluorofentanyl is the common name for N-(2-fluorophenyl)-N-[1-(2-phenylethyl)-4-piperidinyl]propanamide (InChIKey: BKUWDIVZCJNXRA-UHFFFAOYSA-N). Structurally it is an ortho-fluoro derivative of fentanyl. It is a new illegal substance on the drug scene, as the first reports on this drug in Europe appeared in 2016; First in Denmark in March, then in Ireland and Sweden in April [European information system and database on new drugs, EDND]. In the present case from Denmark, a 23-year-old male was found dead in his apartment on March 16th 2016, approximately 3 days after being seen alive. A small plastic bag with approx. 1 g of white powder was found in the waist of his pants. Objective: To determine the cause of death by analyzing postmortem samples from the deceased and to identify the seizure found at the scene of death. Methods: Medico-legal autopsy was performed on the deceased, during which time peripheral whole blood, bile, liver tissue, muscle tissue and gastric content samples were submitted for toxicological examination; all samples were screened by ultra-performance liquid chromatography high-resolution time-of-flight mass spectrometry (UPLC-HR-TOFMS) and quantified by specific UPLC-MS/MS methods. Powder recovered from the scene of death was identified using gas chromatography–mass spectrometry (GC-MS), UPLC-HR-TOFMS and Nuclear Magnetic Resonance (NMR) (1H, 19F and 13C). Results: The powder was unambiguously identified to be 2-fluorofentanyl. 2-fluorofentanyl was detected by UPLC-HR-TOFMS in all matrices collected from the autopsy. Post-mortem femoral blood concentrations found were: 2-fluorofentanyl 0.012 mg/kg (UPLC-MS/MS); alcohol < 0.2 ‰ (w/w) (GC-FID) likely post-mortem production as the body was moderate decomposed; buprenorphine 0.0004 mg/kg (UPLC-MS/MS) prescribed; quetiapine 0.088 mg/kg (UPLC-MS/MS) prescribed; venlafaxine 0.089 mg/kg (UPLC-MS/MS) prescribed; o-desmethylvenlafaxine 0.31 mg/kg (LC-MS/MS), metabolite of prescribed drug. The autopsy findings were consistent with acute poisoning. The decedent had a history of drug abuse. The route of administration of 2-fluorofentanyl was unknown. However, we presume the drug was snorted as no syringe was found at the scene of death. Conclusion/discussion: Based on the toxicological findings, the cause of death was determined to be a fatal overdose with 2-fluorofentanyl. 2-fluorofentanyl is a very potent and dangerous drug. The purity of the powder found at the scene of death was high, thus making it easy to cause a fatal intoxication. Further, a fatal blood concentration of this potent drug is difficult to detect even when using highly sensitive methods like UPLC-HR-TOFMS. To our knowledge, the present abstract reports the first quantification of 2-fluorofentanyl in biological specimens in a fatal intoxication. |
| Databáze: |
OpenAIRE |
| Externí odkaz: |
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