Related Experiment Videos
Duragesic transdermal patch: postmortem tissue distribution of fentanyl in 25 cases
1Los Angeles County Department of Coroner, Los Angeles, California 90033, USA.
Journal of Analytical Toxicology
|October 24, 2000
Summary
Fentanyl (Duragesic) patches were found in 25 Los Angeles County fatalities over three years. This study presents postmortem tissue distribution data to help forensic toxicologists interpret fentanyl levels in casework.
Area of Science:
- Forensic Toxicology
- Analytical Chemistry
- Pharmacology
Background:
- Fentanyl is a potent analgesic commonly delivered via transdermal patches (Duragesic) due to its lipophilicity and low molecular weight.
- Understanding fentanyl's postmortem distribution is crucial for accurate toxicological interpretation in death investigations.
- The Los Angeles County Coroner's Toxicology Laboratory has observed an increase in cases involving fentanyl patches.
Purpose of the Study:
- To document the prevalence of fentanyl transdermal patches in 25 postmortem cases within Los Angeles County.
- To present comprehensive postmortem tissue distribution data for fentanyl.
- To provide a resource for forensic toxicologists to aid in the interpretation of fentanyl concentrations in various biological samples.
Main Methods:
- Fentanyl extraction from postmortem specimens using an n-butyl chloride basic extraction.
- Identification and quantitation performed using gas chromatography-mass spectrometry (GC-MS) in selected ion monitoring (SIM) mode.
- Specific ions monitored for fentanyl (m/z 245, 146, 189) and fentanyl-d5 (m/z 250, 151, 194) with a validated linear range and limit of quantitation (1.67 µg/L).
Main Results:
- Fentanyl was detected in various postmortem matrices, including heart blood (1.8–139 µg/L), liver (5.8–613 µg/kg), and urine (2.9–895 µg/L).
- Gastric contents showed the highest potential concentration range (0–1200 µg total).
- The 25 decedents ranged from 19 to 84 years old (average 46), with deaths attributed to accidents (15), natural causes (5), suicide (3), and undetermined (2).
Conclusions:
- This study highlights the presence of fentanyl patches in a significant number of postmortem cases in the Los Angeles area.
- The provided tissue distribution data offers valuable reference ranges for forensic toxicologists.
- Accurate interpretation of postmortem fentanyl levels is essential for determining cause and manner of death.