To Test or Not To Test?: The Value of Toxicology in a Delayed Overdose Death

A case demonstrating the necessity of thorough death investigation processes where toxicology plays an active role is presented. A 33‐year‐old white man presented to the emergency room in respiratory distress after an overdose episode where he was revived on the scene by fire rescue. His condition c...

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Bibliographic Details
Published inJournal of forensic sciences Vol. 64; no. 1; pp. 314 - 317
Main Authors Walsh, Erin E., Shoff, Elisa N., Elizabeth Zaney, Mary, Hime, George W., Garavan, Fintan, Boland, Diane M.
Format Journal Article
LanguageEnglish
Published United States Wiley Subscription Services, Inc 01.01.2019
Subjects
Acute Kidney Injury - chemically induced
Adult
antemortem specimens
delayed death
Drug overdose
Drug Overdose - diagnosis
drug paraphernalia
forensic science
Forensic Toxicology
Humans
investigative forensic toxicology
Laboratories
Male
mitragynine
overdose
postmortem
Respiratory Distress Syndrome, Adult - chemically induced
Street Drugs - analysis
Street Drugs - pharmacokinetics
Substance-Related Disorders - complications
Substance-Related Disorders - diagnosis
Time Factors
Tissue Distribution
Toxicology
U‐47700
overdose
drug paraphernalia
postmortem
investigative forensic toxicology
delayed death
forensic science
antemortem specimens
U-47700
mitragynine
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Summary:A case demonstrating the necessity of thorough death investigation processes where toxicology plays an active role is presented. A 33‐year‐old white man presented to the emergency room in respiratory distress after an overdose episode where he was revived on the scene by fire rescue. His condition continued to deteriorate and he expired 6 days after the initial incident. No admission specimens were available for testing; however, there were specimens drawn 4 and 5 days after the incident. Drug paraphernalia from the scene was obtained by the laboratory through collaboration with local law enforcement. Drug paraphernalia was initially tested in the laboratory and after obtaining the results, the antemortem and postmortem specimens were tested identifying mitragynine and U‐47700, among other drugs. These results indicate the value in obtaining and testing drug paraphernalia, and the value of testing antemortem specimens even in the event of a delay.
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ISSN:0022-1198
1556-4029
1556-4029
DOI:10.1111/1556-4029.13822