The case history and toxicological findings of a fatal fentanyl intoxication due to ingestion of a transdermal patch are presented. A 1-year-old otherwise healthy girl was put to bed and 2 h later she was found dead. The autopsy revealed a 25-microg/h (4.2 mg) transdermal fentanyl patch in the stomach. Toxicological analysis by liquid chromatography-tandem mass spectrometry with positive electrospray ionization yielded fentanyl and norfentanyl concentrations in the peripheral blood of 5.6 and 5.9 ng/ml, heart blood 19.0 and 8.9 ng/ml, and liver 235 and 26 ng/g, respectively. The cause of death was determined to be a fentanyl overdose. The investigation established that the child has unintentionally swallowed the patch, which had been lying on the floor.
Cannabinoids were extracted from serum with C18 SPE cartridges and analyzed as their trimethylsilyl (TMS) derivatives. A benchtop gas chromatography-tandem mass spectrometry (GC-MS-MS) system based on an ion trap with external ionization was used. Quantitation was done in relation to trideuterated internal standards in dual MS-MS mode. Confirmation of the identity for the three compounds of interest, delta9-tetrahydrocannabinol (THC), 11-hydroxy-delta9-tetrahydrocannabinol (11-OH-THC), and 11-nor-9-carboxy-delta9-tetrahydrocannabinol (THCCOOH), was achieved by registering the daughter spectra in full scan mode. It was possible to identify the three compounds at concentrations down to 0.25 microg/L for THC, 0.5 microg/L for 11-OH-THC, and < 2.5 microg/L for THCCOOH by comparison with reference spectra. The limits of quantitation are better than 2 microg/L for THC, 5 microg/L for 11-OH-THC, and 8 microg/L for THCCOOH. The within-run and day-to-day precision for the three analytes were very similar and ranged from 4.2 to 10.4%.
To avoid the detection of small fragmentation products of γ-hydroxybutyrate (GHB), a liquid chromatography-tandem mass spectrometry GHB quantification method in human serum supported by adduct formation was developed and validated. The continuous infusion of GHB/GHB-D6 made the identification of two adducts possible and GHB/GHB-D6 sodium acetate adduct fragmentation was used as target mass transition. A Luna 5 μm C18 (2) 100 A, 150 mm × 2 mm analytical column and elution with a programmed flow of the mobile phase consisting of 10% A (H2O/methanol = 95/5, v/v) and 90% B (H2O/methanol = 3/97, v/v), both with 10 mM ammonium acetate and 0.1% acetic acid (pH = 3.2), were used. Protein precipitation with 1 mL of the mobile phase B was used as the sample preparation. The calculated limit of detection/quantification was 1 μg/mL. The presented study shows that the fragmentation of GHB sodium acetate adducts is an effective way of quantification of this small molecule and is an interesting alternative to other methods based on the detection of ions smaller than 85 Da. This fact together with the short analysis time of 3 min and the fast sample preparation make this method very attractive for forensic/clinical application.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.