PMID- 30497048
OWN - NLM
STAT- In-Process
LR  - 20190106
IS  - 1872-6283 (Electronic)
IS  - 0379-0738 (Linking)
VI  - 294
DP  - 2019 Jan
TI  - Fatal poisoning involving cyclopropylfentanyl - Investigation of time-dependent
      postmortem redistribution.
PG  - 80-85
LID - S0379-0738(18)30777-1 [pii]
LID - 10.1016/j.forsciint.2018.11.007 [doi]
AB  - A growing number of fatal overdoses involving opioid drugs, in particular
      involving fentanyl and its analogues, pose an immense threat to public health.
      Postmortem casework of forensic toxicologists in such cases is challenging, as
      data on pharmacodynamic and pharmacokinetic properties as well as reference
      values for acute toxicities and data on potential postmortem redistribution (PMR)
      mechanisms often do not exist. A fatal case involving cyclopropylfentanyl was
      investigated at the Zurich Institute of Forensic Medicine and the Zurich Forensic
      Science Institute; an unknown powder found at the scene was reliably identified
      as cyclopropylfentanyl by gas chromatography-infrared spectroscopy (GC-IR).
      Femoral blood samples were collected at two time points after death; 11h
      postmortem (t1) and during the medico-legal autopsy 29h after death (t2). At the 
      autopsy, additional samples from the heart blood, urine and gastric content were 
      collected. Cyclopropylfentanyl was quantified using a validated liquid
      chromatography-tandem mass spectrometric (LC-MS/MS) method. Femoral blood
      concentration of cyclopropylfentanyl at autopsy was 19.8ng/mL (t1=15.7ng/mL;
      heart blood concentration at autopsy=52.4ng/mL). In the light of the current
      literature and under the exclusion that no other morphological findings could
      explain the cause of death, contribution of cyclopropylfentanyl to death was
      proposed (polydrug use). Significant postmortem concentration increases of
      cyclopropylfentanyl in femoral blood during 18h after the first sampling were
      observed, thus indicating a relevant potential to undergo PMR. A
      central-to-peripheral blood concentration ratio of 2.6 supports this.
      Consequently, the current case suggests that postmortem cyclopropylfentanyl
      concentration should always be interpreted with care.
CI  - Copyright (c) 2018 Elsevier B.V. All rights reserved.
FAU - Brockbals, Lana
AU  - Brockbals L
AD  - Department of Forensic Pharmacology and Toxicology, Zurich Institute of Forensic 
      Medicine, University of Zurich, Switzerland.
FAU - Staeheli, Sandra N
AU  - Staeheli SN
AD  - Department of Forensic Pharmacology and Toxicology, Zurich Institute of Forensic 
      Medicine, University of Zurich, Switzerland.
FAU - Gentile, Simon
AU  - Gentile S
AD  - Department of Forensic Medicine & Imaging, Zurich Institute of Forensic Medicine,
      University of Zurich, Switzerland.
FAU - Schlaepfer, Markus
AU  - Schlaepfer M
AD  - Zurich Forensic Science Institute, Zurich, Switzerland.
FAU - Bissig, Christian
AU  - Bissig C
AD  - Zurich Forensic Science Institute, Zurich, Switzerland.
FAU - Bolliger, Stephan A
AU  - Bolliger SA
AD  - Department of Forensic Medicine & Imaging, Zurich Institute of Forensic Medicine,
      University of Zurich, Switzerland.
FAU - Kraemer, Thomas
AU  - Kraemer T
AD  - Department of Forensic Pharmacology and Toxicology, Zurich Institute of Forensic 
      Medicine, University of Zurich, Switzerland.
FAU - Steuer, Andrea E
AU  - Steuer AE
AD  - Department of Forensic Pharmacology and Toxicology, Zurich Institute of Forensic 
      Medicine, University of Zurich, Switzerland. Electronic address:
      andrea.steuer@irm.uzh.ch.
LA  - eng
PT  - Journal Article
DEP - 20181116
PL  - Ireland
TA  - Forensic Sci Int
JT  - Forensic science international
JID - 7902034
OTO - NOTNLM
OT  - Alternative matrices
OT  - Cyclopropylfentanyl
OT  - Fentanyl analogue
OT  - LC-MS/MS
OT  - Time-dependent postmortem redistribution
EDAT- 2018/11/30 06:00
MHDA- 2018/11/30 06:00
CRDT- 2018/11/30 06:00
PHST- 2018/09/20 00:00 [received]
PHST- 2018/11/07 00:00 [revised]
PHST- 2018/11/12 00:00 [accepted]
PHST- 2018/11/30 06:00 [pubmed]
PHST- 2018/11/30 06:00 [medline]
PHST- 2018/11/30 06:00 [entrez]
AID - S0379-0738(18)30777-1 [pii]
AID - 10.1016/j.forsciint.2018.11.007 [doi]
PST - ppublish
SO  - Forensic Sci Int. 2019 Jan;294:80-85. doi: 10.1016/j.forsciint.2018.11.007. Epub 
      2018 Nov 16.