A fatality from an oral ingestion of methamphetamine

The case presented is of a 49-year-old white male decedent who admitted to oral ingestion of methamphetamine. He believed he was being followed by the police while walking his daughter to school in the morning and swallowed the "8-ball of meth," which is known to be one-eighth of an ounce or the equivalent of about 3 g. The following autopsy specimens were analyzed for the presence of methamphetamine and amphetamine by gas chromatography-mass spectrometry: femoral blood, urine, bile, vitreous fluid, brain, liver, and gastric contents. Blood drawn at the hospital approximately 12 h after ingestion was also analyzed. The methamphetamine concentration in the hospital blood was 3.0 mg/L, and the concentration in the femoral blood from autopsy was 30 mg/L. Other drugs confirmed included tramadol, lorazepam, and 11-carboxy-Delta(9)-tetrahydrocannabinol. The pathologist ruled the cause of death to be cardiac dysrhythmia due to excited delirium as a result of methamphetamine drug effects. Discussion of the timeline from ingestion to death and the clinical presentation of the decedent are included.