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Postmortem blood ketamine distribution in two fatalities.

Brendon R Lalonde1, H Rachelle Wallage

  • 1Centre of Forensic Sciences, Toxicology Section, 25 Grosvenor Street, 5th Floor, Toronto, Ontario, Canada, M7A 2G8.

Journal of Analytical Toxicology
|February 28, 2004
PubMed
Summary

Few ketamine poisoning fatalities are documented. This study details two cases, noting significant differences in ketamine blood levels between heart and femoral samples, suggesting distribution or redistribution issues.

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Area of Science:

  • Forensic Toxicology
  • Pharmacology

Background:

  • Ketamine is increasingly used recreationally, yet documented fatalities from ketamine poisoning remain rare.
  • This study investigates two recent fatalities where ketamine was detected, comparing findings with existing literature.

Observation:

  • Ketamine concentrations were measured in heart and femoral blood samples using gas chromatography with nitrogen phosphorus detection.
  • Case 1: A 26-year-old man with death attributed to ketamine intoxication showed heart blood levels of 6.9 mg/L and femoral of 1.8 mg/L.
  • Case 2: A 20-year-old man with death attributed to asthma (ketamine incidental) had heart blood levels of 1.6 mg/L and femoral of 0.6 mg/L.

Findings:

  • Ketamine concentrations in heart blood (6.9 mg/L) in the intoxication case align with the lowest reported lethal levels when no other drugs are present.

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  • Significant discrepancies between heart and femoral blood ketamine concentrations were observed in both cases.

    • Implications:

    • These concentration differences may indicate incomplete drug distribution before death or postmortem redistribution.
    • Understanding ketamine distribution is crucial for accurate toxicological interpretation in forensic investigations.