FORENSIC TOXICOLOGY - Bio Medical Forensics

esterification of cocaine with ethyl alcohol when used simultaneously.
Anhydroecgonine methyl ester (AEME) is a unique metabolite of
smoked cocaine, and anhydroecgonine ethyl ester (AEEE) has been
identified in cocaine smokers who also use ethyl alcohol. A method has
been developed for the detection of and quantiation of COC, HOBE,
AEME, AEEE, NC, CE, and BE in urine at low concentrations.
Sixty-eight randomly selected previously confirmed BE positive by
GC-Ms were collected from May 19 th to 22 nd and June 20 th to 27 th .
Samples were extracted using SPE and 30uL of the reconstituted extract
was injected. Chromatographic separation was achieved using a gradient
consisting of Mobile phase A [20mM ammonium formate (pH = 2.7)]
and Mobile phase B [50%/50% methanol/acetonitrile], and an XDB-C8,
1.8micron, 2.1x50mm column, with a flow rate of 270 ul/min.
Concentrations were calculated by comparing the drug peak area with
the internal standard peak-area. The ratio was plotted against a standard
curve.
The assay displayed linearity from 1.0m- 1000 ng/mL for all
analytes. Between-run CVs were 1.0 ng/mL.
Standard surveys to determine methods of cocaine use rely on
individual responses to survey questions, and assumes that users
responses are honest. We report here on a sensitive method to identify
cocaine metabolites at concentrations as low as 1.0 ng/mL. Because of
the unique derivation of some of the metabolites, the pattern of the
metabolites makes it possible to determine the user’s method of cocaine
ingestion. This assay could be used to validate or challenge current
survey techniques.
Cocaine, Cocaine Metabolites, LC-MS/MS
K36 Opiate Withdrawal and Adulterated CNS
Depressant Drug Impaired Driving: Case
Interpretation and Overcoming Motions
to Suppress
Michael Wagner, PhD*, State Department of Toxicology, Indiana
University, 550 West Sixteenth Street, Indianapolis, IN 46202
After attending this presentation, attendees will understand the key
medical legal issues addressed when evaluating impaired driving
resulting from opiate addiction. Case history, self reporting, biological
samples, analytical test results, relevant case law, and strategies
challenging motions to suppress will be discussed. In addition, the
opposing conclusions from the expert witnesses will be presented.
This presentation will impact the forensic community by
interpreting DUID cases involving impairment when only trace
analytical test results are available.
On March 7th at 1445 hours, police are notified of a collision
involving two vehicles (vehicle #1 a 1998 Nissan Frontier (pickup truck)
and vehicle #2 a 1987 Volvo 740). The weather was clear and dry.
Vehicle #2 was traveling eastbound and made a left hand turn (northerly)
when it was struck broadside by vehicle #1 that was traveling
westbound. Vehicle #1 driven by a 47-year-old male had violated a red
traffic control device just prior to this collision. As a result of this
accident, two males ages 17 and 34 occupying vehicle #2 had been
fatally injured.
Scene evaluation of the driver for vehicle #1 reveals the subject
claims to have been reaching down for a water bottle and taking his
attention off the roadway. The subject made statements at the scene to
police officers and medical personnel that he was a heroin addict and had
ingested three Klonopin® prescription pills approximately 09:00 –
09:30. He crushed two of the pills and snorted them, and then he
ingested the third. Subject claimed to have eaten very little in the past
two days (two bowls of cereal the previous day) and nothing that day
(body height and weight were 6’1” and 135 pounds). In addition, the
subject claimed to be in withdrawal with his last use of Heroin having
been on March 5 th . The subject admitted to be in route to purchasing
more Heroin and having $2,500 dollars in cash. Multiple blood samples
were collected and indicated the presence of trace parent cocaine and
metabolite, trace clonazepam, while urine test results confirmed the
presence of morphine and oxycodone in addition to parent cocaine and
benzoylecognine.
DUID, Opiate Impairment, Benzodiazepines
K37 Prescription Drugs, Poor Driving, DRE
Evaluation…and a Surprising Verdict –
A DUID Case Study
Laura J. Liddicoat, BS*, Toxicology Section - WSLH, 2601 Agriculture
Drive, PO Box 7996, Madison, WI 53707-7996
After attending this presentation, attendees will have a greater
understanding of drug interpretation, prosecutor preparation, and
effective expert witness testimony for prescription drug impaired driving
cases.
This presentation will impact the forensic community by
influencing toxicologists who are involved with suspected DUID cases
by enhancing their understanding of the challenges to interpretive issues.
For drugs other than alcohol, interpretation of drug concentrations
and effects on safe driving ability is extremely complex. The
toxicologist must consider drug pharmacology, pharmacokinetics, drug
interactions, medical information, and research findings and apply them
to the individual case scenario. This information must then be presented
to the attorneys during preparation for the trial.
The case study that will be presented involves several drugs that can
severely affect driving abilities. The drugs include oxycodone (at a
potentially toxic concentration of 530 ng/mL), diazepam, nordiazepam,
cyclobenzaprine and citalopram. Poor driving was observed by a citizen
driver, reported to law enforcement, and documented by the arresting
State Patrol Officer. A Drug Recognition Expert (DRE) was called to the
scene and conducted an evaluation of the driver. The DRE concluded
that he was impaired and under the influence of a CNS Depressant and
Narcotic Analgesics.
At trial the driver alleged that he was able to ingest several
oxycodone pills while in custody and prior to the blood sample
collection. Even though this case had all the required elements for a
DUID conviction, the first hearing resulted in a mistrial and was
subsequently retried. The full case will be presented with emphasis
given to drug interpretation, pharmacokinetics, prosecutor preparation,
and effective expert witness testimony.
Drugs, Driving, Impairment
K38 Driving Under the Influence of
Methamphetamine in the City &
County of San Francisco, California
Nikolas P. Lemos, PhD*, and Ann M. Gordon, MA, San Francisco Office
of the Chief Medical Examiner, 850 Bryant Street, Hall of Justice, North
Terrace, San Francisco, CA 94103; and Preston J. Wong, BS, 5013
Hummingbird Lane, Plano, TX 75093
After attending this presentation, attendees will have a better
understanding of the signs and symptoms often observed in drivers
driving under the influence of methamphetamine, the measured
concentrations of the drug in the drivers’ blood specimens, and the
73 * Presenting Author