Use of Hair Testing to Determine Methadone Exposure in Pediatric Deaths
Corresponding Author
Gilles Tournel M.D., Ph.D.
Forensic Institute, School of Medicine, CHRU of Lille, rue André Verhaeghe, 59037 Lille, France
Laboratory of Forensic Toxicology, Center of Biology and Pathology, CHRU of Lille, 59037 Lille, France
Additional information and reprint requests:
Dr. Gilles Tournel, M.D., Ph.D.
Maître de Conférences
Institut de Médecine Légale de Lille
Rue André Verhaeghe
CHRU de Lille
59037 Lille Cédex
France
E-mail: [email protected]
Search for more papers by this authorJocelyn Pollard M.D.
Forensic Institute, School of Medicine, CHRU of Lille, rue André Verhaeghe, 59037 Lille, France
Search for more papers by this authorLuc Humbert M.Sc.
Laboratory of Forensic Toxicology, Center of Biology and Pathology, CHRU of Lille, 59037 Lille, France
Search for more papers by this authorJean-François Wiart M.Sc.
Laboratory of Forensic Toxicology, Center of Biology and Pathology, CHRU of Lille, 59037 Lille, France
Search for more papers by this authorValéry Hédouin M.D., Ph.D.
Forensic Institute, School of Medicine, CHRU of Lille, rue André Verhaeghe, 59037 Lille, France
Search for more papers by this authorDelphine Allorge Pharm.D., Ph.D.
Laboratory of Forensic Toxicology, Center of Biology and Pathology, CHRU of Lille, 59037 Lille, France
Search for more papers by this authorCorresponding Author
Gilles Tournel M.D., Ph.D.
Forensic Institute, School of Medicine, CHRU of Lille, rue André Verhaeghe, 59037 Lille, France
Laboratory of Forensic Toxicology, Center of Biology and Pathology, CHRU of Lille, 59037 Lille, France
Additional information and reprint requests:
Dr. Gilles Tournel, M.D., Ph.D.
Maître de Conférences
Institut de Médecine Légale de Lille
Rue André Verhaeghe
CHRU de Lille
59037 Lille Cédex
France
E-mail: [email protected]
Search for more papers by this authorJocelyn Pollard M.D.
Forensic Institute, School of Medicine, CHRU of Lille, rue André Verhaeghe, 59037 Lille, France
Search for more papers by this authorLuc Humbert M.Sc.
Laboratory of Forensic Toxicology, Center of Biology and Pathology, CHRU of Lille, 59037 Lille, France
Search for more papers by this authorJean-François Wiart M.Sc.
Laboratory of Forensic Toxicology, Center of Biology and Pathology, CHRU of Lille, 59037 Lille, France
Search for more papers by this authorValéry Hédouin M.D., Ph.D.
Forensic Institute, School of Medicine, CHRU of Lille, rue André Verhaeghe, 59037 Lille, France
Search for more papers by this authorDelphine Allorge Pharm.D., Ph.D.
Laboratory of Forensic Toxicology, Center of Biology and Pathology, CHRU of Lille, 59037 Lille, France
Search for more papers by this authorAbstract
A case of death attributed to methadone acute poisoning in an infant aged 11 months is reported. A sudden infant death syndrome (SIDS) was suspected, whereas a traumatic cause of death was excluded regarding autopsy findings. Specimens were submitted to a large toxicological analysis, which included ethanol measurement by HS-GC-FID, a targeted screening for drugs of abuse and various prescription drug classes followed by quantification using UPLC-MS/MS methods. Methadone and its metabolite (EDDP) were detected in all the tested fluids, as well as in hair, with a blood concentration of methadone considered as lethal for children (73 ng/mL). The cause of death was determined to be acute “methadone poisoning”, and the manner of death was “accidental”. A discussion of the case circumstances, the difficulties with the interpretation of toxicological findings in children (blood concentration and hair testing), and the origin of exposure are discussed.
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