ABSTRACT
Postmortem toenail samples were used for the detection of cocaine (COC), benzoylecgonine (BZE), norcocaine (NCOC), cocaethylene (CE), morphine (MOR), 6-monoacetylmorphine (6-MAM), codeine (COD), and hydrocodone (HDC). After the toenail clippings were washed with methanol, they were solubilized in 0.1 M potassium phosphate (pH 5.0). The drugs of interest, along with internal standards, were isolated by solid-phase extraction followed by derivatization with N-methyl-N-trimethylsilyl-trifluoroacetamide. The derivatized products were analyzed by gas chromatography-mass spectrometry operated in the selective ion monitoring (SIM) mode. The limit of quantitation for all analytes was 0.3 ng on column. The quantities of drugs found in toenails of each of 46 decedents were compared with those of their corresponding postmortem fluids. The toenails of the 46 decedents were tested for COC, BZE, NCOC, and CE, and 34 of the collected samples were also tested for opiates. COC and BZE concentrations ranged from 0.20 to 140.17 (n = 20) and 0.30 to 315.44 ng/mg (n = 21), respectively. NCOC concentrations of 6.78 and 0.66 ng/mg and CE concentrations of 2.60 and 0.73 ng/mg were detected in two of the decedents' toenails. MOR and 6-MAM were detected in three sets of toenails at average concentrations of 0.37 and 0.89 ng/mg, respectively. COD was detected in two sets of specimens at concentrations of 3.07 and 1.02 ng/mg. HDC (0.62 ng/mg) was found in only one set of specimens.
Subject(s)
Nails/chemistry , Narcotics/analysis , Substance-Related Disorders/diagnosis , Gas Chromatography-Mass Spectrometry , HumansABSTRACT
A case in which the death of a 2-year-old male child was the result of an acute intoxication with chloral hydrate, lidocaine, and nitrous oxide is presented. Trichloroethanol (TCE), the primary metabolite of chloral hydrate, was qualitatively detected by the Fujiwara reaction. Quantitation of TCE was carried out by gas chromatography-mass spectrometry (GC-MS) with the following results: plasma, 79.0 mg/L; urine, 31.0 mg/L; gastric contents, 454.0 mg/L; bile, 111.0 mg/L; vitreous, 40.2 mg/L; cerebrospinal fluid (CSF), 68.3 mg/L; and liver, 164 mg/kg. Lidocaine was quantitated by GC analysis using nitrogen-phosphorus detection with the following results: plasma, 11.9 mg/L; urine, 3.7 mg/L; gastric contents, 15.3 mg/L; bile, 19.0 mg/L; vitreous, 17.8 mg/L; CSF, 9.4 mg/L; and liver, 19.0 mg/kg. Nitrous oxide was quantitated in the blood with a value of 4.4 mL/L.
Subject(s)
Anesthetics, Inhalation/poisoning , Anesthetics, Local/poisoning , Chloral Hydrate/poisoning , Hypnotics and Sedatives/poisoning , Lidocaine/poisoning , Nitrous Oxide/poisoning , Anesthetics, Local/metabolism , Child, Preschool , Chromatography, Gas , Drug Combinations , Drug Overdose , Ethylene Chlorohydrin/analogs & derivatives , Ethylene Chlorohydrin/metabolism , Fatal Outcome , Gas Chromatography-Mass Spectrometry , Humans , Lidocaine/metabolism , MaleSubject(s)
Morphine Derivatives/cerebrospinal fluid , Substance Abuse Detection/methods , Substance-Related Disorders/cerebrospinal fluid , Cause of Death , Forensic Medicine , Humans , Injections, Intravenous , Morphine Derivatives/blood , Morphine Derivatives/poisoning , Substance-Related Disorders/mortalityABSTRACT
A 78-year-old woman was found dead in her basement. Qualitative screening of available postmortem specimens detected the presence of diltiazem and pentoxifylline. Quantitations were carried out by gas chromatography using nitrogen-phosphorus detection and confirmed by gas chromatography-mass spectrometry with the following results: blood, 0.59 mg/dL diltiazem and 0.63 mg/dL pentoxifylline; urine, 1.17 mg/dL diltiazem and 0.08 mg/dL pentoxifylline; bile, 0.40 mg/dL diltiazem and 0.22 mg/dL pentoxifylline; gastric contents, 0.28 mg/dL diltiazem and 0.02 mg/dL pentoxifylline. Both drugs were found qualitatively in formaline-fixed tissues.
