|SOFT - TIAFT 1998||Poster Session 3||Thursday October 8, 1998|
COCAINE AND COCAINE METABOLITE CONCENTRATIONS IN POSTMORTEM FLUIDS|
Michael E. Frontz, Gary W. Kunsman, Paola Rodriguez, and Randall E. Frost
Bexar County Medical Examiner's Office, San Antonio, TX 78229, USA
|Elevated concentrations of cocaine, benzoylecgonine, and other cocaine metabolites were identified in the postmortem fluids of an individual found dead in the rural West Texas town of Alpine. No drug paraphernalia was found at the scene and no intravenous injection sites were noted at autopsy. An ongoing police investigation, subsequent to the autopsy and initial toxi-cological evaluation, suggested that the decedent had a history of "body-packing". No direct evidence for this conclusion was determined by investigation or at autopsy. Body packing is the procedure by which illegal drugs are concealed in the body by swallowing drug-filled balloons, condoms, etc. for the purpose of transporting the drugs while avoiding detection.
Femoral blood (preserved and unpreserved), bile, urine, vitreous humor, and stomach contents were submitted for routine toxicological testing including analysis for alcohols, basic drugs, cocaine, and opiates. The urine was screened for cocaine and opiates using the Abbott TDx FPIA assays. The positive cocaine metabolite result was confirmed using a combined cocaine, benzoylecgonine, cocaethylene, ecgonine methyl ester, morphine, codeine, and 6-monoacetylmorphine gas chromatography/mass spectrometry assay using solid phase extraction. All samples were also subjected to an alkaline drug screen using gas chromatography with a flame ionization detector (FID) followed by mass spectrometry for the confirmation of positive results. Cocaine and benzoylecgonine concentrations in the femoral blood were measured as high as 38.1 mg/L and 26.1 mg/L, respectively, with a benzoylecgonine concentration in the stomach contents of 673.5 mg/L. A significant loss of cocaine was noted in those blood samples that were not preserved with sodium fluoride.
The cause of death was ruled as cocaine intoxication and the manner was accidental. The cocaine concentrations reported here are the highest determined in any recent case submitted to this office. An additional interesting finding in this case was the identification of benzoyl-ecgonine in the alkaline blood extract by GC/FID with subsequent full scan mass spectral confirmation.