Acute Benztropine Intoxication and Fatality |
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Authors: | Iain M McIntyre PhD Phyllis Mallett BS Christopher G Burton Jacquelyn Morhaime MD |
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Institution: | County of San Diego Medical Examiner's Office, , San Diego, CA, 92123 |
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Abstract: | A woman was found unresponsive with an empty bottle of Cogentin® prescribed to another. Admitted to an area hospital, her condition steadily declined until death 29 h after admission. Following toxicological screening on hospital (admission) whole blood, the only significant compound detected was benztropine. Benztropine was confirmed at 0.28 mg/L – the highest antemortem blood concentration recorded in a case of toxicity or fatality uniquely associated with benztropine. A second serum antemortem specimen showed a benztropine concentration of 0.19 mg/L. Despite over 24 h in the hospital, benztropine was also found in the postmortem specimens collected at autopsy. Peripheral blood, central blood, liver, and gastric concentrations were 0.47 mg/L, 0.36 mg/L, 9.6 mg/kg, and 44 mg, respectively. These results indicate that benztropine exhibited a potential difference between whole‐blood and serum (plasma) concentrations. Additionally, in consideration of literature data, benztropine was found indicative of a compound prone to at least some postmortem redistribution. |
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Keywords: | forensic science benztropine fatality antemortem and postmortem concentrations postmortem redistribution |
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