A Death due to Self-Administered Fentanyl

A fatality resulting from the self-admln]stration of fentanyl [s descrlbed. The deceased was a hea]th care professlonal with a known history of drug abuse. At the scene, a syringe partly filled with red fluid was found. Pathologlcal findings dlsclosed pulmonary congestion, hemorrhage, and aspiration of gastrlc contents and passive congestion In the Iiver and kldneys. Initlal drug screening revealed the presence of fentanyl in the fluid from the syringe and diazepam/ oxazepam in the urine. Fentanyl, diazepam, nordiazepam, and oxazepam in the submitted samples were simultaneously quantitated using a gas chromatograph equipped with a nitrogen-phosphorus detector. The fentanyl concentratlons (~g/L or/~g/kg) In serum, blood, urlne, blle, Iiver, kidney, braln, lung, and stomach tissue were 17.7, 27.5, 92.7, 58.2, 77.5, 41.5, 30.2, 83.4, and 31.6, respectively. The tlssue levels of dtazepam and Its metabol|tes were lower than the reported lethal concentrat[ons. The fentanyl concentrat[on In the syrlnge contents was 2,800 vg/L. The toxlcological findlngs and circumstantial evidence of the case indicate that the death resulted primarily from fentanyl overdose.