Fatal Fentanyl Patch Misuse in a Hospitalized Patient with a Postmortem Increase in Fentanyl Blood Concentration
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- Philip W. Moore
- Department of Internal Medicine PinnacleHealth Hospitalists 111 S. Front St Harrisburg PA 17101
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- Robert B. Palmer
- Toxicology Associates PLLC 2555 South Downing, Suite 260 Denver CO 80210
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- Joseph Ward Donovan
- Department of Internal Medicine PinnacleHealth Toxicology Center 111 S. Front St Harrisburg PA 17101
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説明
<jats:title>Abstract</jats:title><jats:p>Opioid‐related mortality happens, even in healthcare settings. We describe serial postmortem fentanyl blood concentrations in a hospital inpatient who fatally abused transdermal fentanyl. This is a single‐patient case report. A 42‐year‐old man with lymphoma was started on transdermal fentanyl therapy while hospitalized for chronic abdominal pain. The patient was last seen awake 1.3 h prior to being found apneic and cyanotic. During the resuscitation attempt, a small square‐shaped film was removed from the patient's oropharynx. Femoral blood was collected 0.5 and 2 h postmortem, and the measured fentanyl concentration increased from 1.6 to 14 ng/mL. Study limitations include potential laboratory or collection errors and missing data. (i) Providers must be vigilant for signs of fentanyl patch abuse. (ii) Postmortem blood concentrations are not static postmortem, likely secondary to decreasing <jats:styled-content style="fixed-case">pH</jats:styled-content>, increased aqueous solubility, and tissue redistribution, and are therefore unlikely to accurately represent antemortem blood concentrations.</jats:p>
収録刊行物
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- Journal of Forensic Sciences
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Journal of Forensic Sciences 60 (1), 243-246, 2014-07-17
Wiley
