The Toxicology of Methadone‐Related Death in Infants Under 1 Year: Three Case Series and Review of the Literature |
| |
| Authors: | Anthea B Mahesan Paul MD Lary Simms DO MPH Arnold M Mahesan MD |
| |
| Institution: | 1. Nuffield Department of Obstetrics & Gynecology, University of Oxford, Oxford, U.K.;2. Office of the Medical Examiner, Clark County Coroner's Office, Las Vegas, NV;3. Eastern Virginia Medical School, Jones Institute for Reproductive Medicine, Norfolk, VA |
| |
| Abstract: | Methadone‐related fatalities occur rarely in infants under 1 year, with five confirmed cases in the literature. The interpretation of pediatric postmortem toxicology relies on adult data; however, infants have crucial physiological differences that may impact interpretation of results. Retrospective case review included scene investigation, interviews, autopsy, and NIH/CDC Sudden Unexplained Infant Death Investigation Reporting Form. Methadone levels were confirmed by liquid chromatography/tandem mass spectrometry (LC‐MS/MS). The fatal blood methadone levels in this case series ranged from 69 to 700 ng/mL. This review of the literature adds toxicological findings of three methadone‐related infant fatalities and reviews the current literature on methadone‐related death in infants under 1 year. With opioid use on the rise in today's society, forensic experts should have a high index of suspicion for the possibility of intentional or unintentional poisoning in infants. |
| |
| Keywords: | forensic science methadone infant mortality toxicology homicide |
|
|
