FORENSIC TOXICOLOGY - Bio Medical Forensics

determination of methamphetamine from urine has been achieved prior
to this study, significant sample cleanup and/or derivatization techniques
have resulted in time consuming and challenging methodologies.
Concentrations of methamphetamine in urine can vary significantly
depending on the dose and whether or not the subject is a regular abuser.
As a result there is often a need for sample extraction/pre-concentration
from complex matrices. Solid-phase extraction (SPE) followed by precolumn
derivatization has proven to be a successful preparative
technique for the separation of methamphetamine isomers in urine using
GC/MS; however there is a need for more convenient, time efficient
techniques. The current methodology describes the stereoselective
quantification of methamphetamine isomers in urine samples while
reducing the degree of sample preparation. Rapid pre-column
derivatization allowed for the subsequent extraction and preconcentration
of the diastereoisomers using dynamic headspace
sampling followed by GC/MS.
Methamphetamine, Stereoselective, GC/MS
K45 Tissue Distribution of Drug
Intoxication in Pediatric Fatalities
Nancy B. Wu Chen, PhD, Edmund R. Donoghue, MD, Clare H.
Cunliffe, MD, Mitra B. Kalelkar, MD*, Jennifer L. Jakalski, BS, Devon
J. Johnson, BS, Kathleen A. Mittel, BS, and Khaled Ragab, BS, Office
of the Medical Examiner, Cook County, 2121 West Harrison Street,
Chicago, IL 60612
After attending this presentation, attendees will have learned about
the tissue distribution of lidocaine in a pediatric fatality as well as the
tissue distribution of methadone in four pediatric fatalities.
This presentation will impact the forensic community and/or
humanity by demonstrating the importance of obtaining multiple tissue
samples for analysis in pediatric fatalities involving drugs as well as the
need for co-operation between pathology staff and the toxicology
laboratory.
Lidocaine is a local anesthetic. Case history and toxicological
findings from one pediatric fatality due to lidocaine intoxication is
presented. Methadone is an analgesic. Case histories and toxicological
findings from four pediatric fatalities are presented.
In the first case, a two year-old black female complained about a
sore in the mouth, was taken by her mother to a clinic. The subject was
given a prescription for lidocaine and was found unresponsive two days
later. The subject was transported to the hospital and expired on the
following day. Lidocaine was detected in a basic drug screening and
quantitated by Gas Chromatography, after solvent-solvent extraction
with internal standard methodology. The presence of lidocaine was
confirmed with full scan Gas Chromatography/Mass Spectrometry. The
tissue distribution of lidocaine for the first case was as follows: blood,
2.52 mg/L; bile, 1.98 mg/L; liver, 0.76mg/kg; brain, 0.52 mg/kg; spleen,
7.20 mg/kg; and kidney, 2.68 mg/kg. The cause of death was
bronchopneumonia due to lidocaine intoxication due to herpes
stomatitis. The manner of death was listed as accident.
In the second case, an eighteen month-old black male drank a glass
of orange juice with methadone on an end table and was found
unresponsive later. The subject was hospitalized and died five days later.
Methadone was detected in a basic drug screening and quantitated by
Gas Chromatography, after solvent-solvent extraction with internal
standard methodology. The presence of methadone was confirmed with
full scan Gas Chromatography/Mass Spectrometry. The tissue
distribution of methadone for the second case was as follows: blood,
0.10 mg/L; hospital blood (clotted, day two), 0.10 mg/kg; liver, 0.23
mg/kg; and brain, 0.23 mg/kg. The cause of death was methadone
intoxication. The manner of death was listed as undetermined.
* Presenting Author
In the third case, a two year-old black male was found choking and
gasping for air while in the bed. The subject was hospitalized and
expired three days later. The tissue distribution of methadone for the
third case was as follows: blood, negative; bile, 0.36 mg/L; and liver,
0.26 mg/kg. The cause of death was methadone intoxication. The
manner of death was listed as undetermined.
In the fourth case, a five year-old black female began to choke and
went into convulsions in the presence of her grandmother early morning.
The subject died in the emergency room. On the day before, the subject
might have drunk some of the orange juice with methadone, while riding
with her mother and one of her mother’s friends in her mother’s car. The
tissue distribution of methadone for the fourth case was as follows:
blood, 0.64 mg/L; urine, 3.31 mg/L; bile, 2.18 mg/L; liver, 2.22 mg/kg;
brain, 0.82 mg/kg; and spleen, 3.58 mg/kg. The cause of death was
methadone intoxication, with parental neglect as a contributing factor.
The manner of death was listed as undetermined.
In the fifth case, a fourteen year-old black male was playing in a
football game for his high school and later on that night, was
complaining to his parents of having a headache. Four days later, the
subject was vomiting, so his parents told him to stay home from school.
The subject was found unresponsive in bed when his father returned
home from work. The tissue distribution of methadone for the fifth case
was as follows: blood, 0.35 mg/L; liver, 2.70 mg/kg; spleen, 1.08 mg/kg;
and kidney, 1.48 mg/kg. The cause of death was methadone
intoxication. The manner of death was listed as accident.
In these pediatric fatalities, multiple tissue specimens were
submitted to the toxicology laboratory when the pathologist requested
testing. In the event, that a positive finding occurred, in one specimen
from the case, the toxicology staff was then able to analyze multiple
tissue specimens in order to provide a tissue distribution study. In
pediatric fatalities, a positive finding of a drug usually implied that
someone other than the deceased child/infant was involved with the
administration of the drug in question. A tissue distribution study
performed in this type of case will provide the toxicology findings as an
unequivocal litigation package. Toxicologists are only able to do tissue
distribution studies in cases such as these, with the full support of the
pathology staff.
Lidocaine Tissue Distribution, Methadone Tissue Distribution,
Pediatric Fatalities
K46 Sensitive Detection of Amphetamines
and Other Basic Drugs Using Eosin
Isothiocyanate
Carla E. Turner, BS*, and Bruce R. McCord, PhD, Florida
International University, 11200 SW 8th Street, CP-175, Miami, FL
33199; and Julien Noel, BS, and Roberto Panepucci, PhD, Florida
International University, 10555 West Flagler Street, EC-3955, Miami,
FL 33174
After attending this presentation, attendees will understand the
growing applications of microfluidic systems such as how they can be
used to solve crimes as well as diagnosis health issues.
This presentation will impact the forensic community and/or
humanity by demonstrating that microfluidic systems can perform
extremely rapid analyses of compounds utilized in crimes such as Drug
Facilitated Sexual Assaults and DUIs.
The application of microfluidic systems to toxicological screening
and clinical diagnostics is growing rapidly. Rapid analysis of small
molecules is essential in the detection of drugs for the prosecution of
crimes such as drug-facilitated sexual assault and DUIs. Detection of
biogenic amines for identifying health disorders and diseases is also of
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