Investigation of Postmortem Absorption and Redistribution After the Application of a Fentanyl Patch |
| |
Authors: | Alan H B Wu PhD Rebecca Hamilton MD Robert Middleberg PhD Sherri Kacinko PhD Thomas Kearney PharmD |
| |
Institution: | 1. San Francisco General Hospital, San Francisco, CA 94110;2. , 705 Danley Dr., Ft. Myers FL 33907;3. , Willow Grove, PA 19090;4. University of California, San Francisco, San Francisco, CA 94143 |
| |
Abstract: | Fentanyl deaths have increased with availability of transdermal patches. Interpretation of postmortem fentanyl levels may be complicated by postmortem redistribution and absorption of fentanyl from a patch. We applied an unused 100‐μg/h fentanyl patch onto the lower abdomen of a decedent with no premortem fentanyl exposure. Ocular fluid, blood, and urine were collected prior to placement, and the decedent was refrigerated for 23 h. Prior to the autopsy, urine, subcutaneous tissue under the patch, and samples from the same anatomic sites were obtained. We observed no fentanyl in any postpatch placement samples (LOD: 0.1 ng/mL for blood and vitreous fluid, 1.0 ng/mL urine, 2.0 ng/g for tissues). Although we observed no postmortem absorption of fentanyl, this was only a single case; therefore, we recommend that patches be removed after receipt of a cadaver before initiation of an autopsy, with the location of removed patch documented. |
| |
Keywords: | forensic science fentanyl transdermal patch postmortem redistribution postmortem absorption liquid chromatography/mass spectrometry stratum corneum |
|
|