Citation

Nara A, Yamada C, Saka K, Kodama T, Yoshida M, Iwahara K, Takagi T. J. Forensic Sci. 2019; ePub(ePub): ePub.

Affiliation

Center of Legal Medicine of Dentistry, The Nippon Dental University School of Dentistry at Tokyo, 1-9-20 Fujimi, Chiyoda-ku, Tokyo, 102-8159, Japan.

Copyright

(Copyright © 2019, American Society for Testing and Materials, Publisher John Wiley and Sons)

DOI

10.1111/1556-4029.14127

PMID

31340064

Abstract

Fentanyl transdermal patches have been used to treat cancer- and noncancer-related chronic pain. However, its inappropriate or illegal application may cause fatal poisoning. We herein present the case of a Japanese woman in her 40s who was found dead with seven 25-μg/h fentanyl transdermal patches on her body. We established a detailed toxicological analysis procedure to quantify fentanyl, and its metabolite norfentanyl, and other drugs (acetaminophen, allylisopropylacetylurea, celecoxib, estazolam, promethazine, and sertraline) in human whole blood by ultra-high-performance liquid chromatography-tandem mass spectrometry. The measured fentanyl and norfentanyl concentrations in the femoral and cardiac blood were 0.051 and 0.072 μg/mL and 0.033 and 0.076 μg/mL, respectively. The decedent's fentanyl concentrations were consistent with previously reported postmortem blood levels for fatal cases of poisoning by fentanyl transdermal patches. Based on the decedent's case history, autopsy findings, and toxicological analyses, the cause of death was identified as intoxication with transdermal fentanyl.

© 2019 American Academy of Forensic Sciences.

Language: en

Keywords

QuEChERS; fentanyl; forensic science; forensic toxicology; transdermal patch; ultra-high-performance liquid chromatography-tandem mass spectrometry; whole blood