Methadone-related deaths in Montpellier and Region, from 2000 to 2010.

PURPOSE: The objectives of this analysis were to assess the role of methadone and related substances in death occurring, discussing methadone blood concentrations and the contribution of the autopsy to the accountability of methadone in the death process. METHOD: We retrospectively analyzed all forensic cases positive for methadone from January 2000 to December 2010, in Montpellier and the region served by our laboratory. RESULTS: During the study period, 64 cases of deaths (11 women, 53 men) with methadone detection were recorded. A progressive increase between 2001 (2 cases) and 2010 (8 cases) was observed. The median age was 33 years old. An autopsy was available in 56.3% of cases. The most frequent finding at the autopsy was non-specific asphyxia death signs (67.6%). Tolerance to opioids was documented in 21 cases. The methadone blood concentrations ranged from 1 to 2 800 ng/mL (59 cases, median value 330 ng/mL). Most of the cases (88%) were polydrug intoxications. The most commonly associated drugs were benzodiazepines (61%), cannabinoids (28%), opioids (19%) and cocaine (12.5%). CONCLUSION: During a 11-year period, toxicological analyses related to 1991 death cases were performed at the Toxicology Laboratory of Montpellier University Hospital. Of these patients, 64 deaths were possibly related to methadone. Several relevant elements (biological analysis and autopsy) were used to attribute the deaths to the sole methadone (12 cases) or to methadone and associated substances (8 cases).

Evaluation of the ABX Pentra 400: a newly available clinical chemistry analyser.

The performance of the ABX Pentra 400, a new multiparametric analyser available for routine and specialised clinical chemistry analyses, was evaluated according to the National Committee for Clinical Laboratory Standards (NCCLS) and Valtec protocols. Substrate concentrations and enzyme activities were determined by spectrophotometric measurement after coloured reaction or UV detection-based reactions; electrolyte concentrations were determined with ion-selective electrodes, and specific protein concentrations were assayed by immunoturbidimetry. In total, 32 of the most common clinical chemistry parameters were evaluated under simulated routine conditions. The analytical performance of the system and the quality of the ABX Pentra reagent line were both examined in a single-site study. The ABX Pentra 400 was compared with the Olympus AU640, Konelab-Konepro, Beckman Coulter-Immage and Beckman Coulter-Access 2, depending on the tests available on these analysers. The coefficient of variation (CV) values were within expected values. Coefficients of correlation showed high correlation between the analysers compared. The influence of interfering substances was moderate. The practicability of the system was good. We conclude that good reliability and practicability make the ABX Pentra 400 system suitable for laboratories with various needs.