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An Acute Acetyl Fentanyl Fatality: A Case Report With Postmortem Concentrations
Iain M McIntyre1, Amber Trochta2, Ray D Gary2
1County of San Diego Medical Examiner's Office, 5570 Overland Ave., Suite 101, San Diego, CA 92123, USA iain.mcintyre@sdcounty.ca.gov.
Journal of Analytical Toxicology
|April 29, 2015
Summary
This case report details a fatal acetyl fentanyl (a potent synthetic opioid) overdose. Postmortem toxicology revealed high concentrations of acetyl fentanyl in blood and tissues, confirming it as the cause of death.
Area of Science:
- Forensic Toxicology
- Clinical Chemistry
- Pharmacology
Background:
- Acetyl fentanyl is a potent synthetic opioid analogue of fentanyl.
- Illicit drug use, particularly of synthetic opioids, poses a significant public health challenge.
- Accurate postmortem toxicological analysis is crucial for determining cause and manner of death.
Observation:
- A young male with a history of heroin abuse was found deceased.
- Initial screening detected fentanyl; subsequent GC-MS SIM analysis confirmed acetyl fentanyl.
- No other drugs or medications were identified in the toxicological analysis.
Findings:
- Quantified postmortem concentrations: peripheral blood 260 ng/mL, central blood 250 ng/mL, liver 1,000 ng/kg, vitreous 240 ng/mL, urine 2,600 ng/mL.
- The cause of death was certified as acute acetyl fentanyl intoxication.
- The manner of death was certified as accidental.
Implications:
- This case highlights the critical need for specific analytical methods to differentiate fentanyl analogues.
- Understanding the distribution of postmortem concentrations can aid in interpreting toxicological findings in similar cases.
- The data contributes to the forensic science knowledge base regarding acetyl fentanyl toxicity and its role in fatal overdoses.
