| Elevated morphine concentrations determined during infant death investigations: artifacts of withdrawal of care. | |
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MedLine Citation:
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PMID: 18547355 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Three cases are reported of elevated postmortem blood morphine concentrations (189-3036 ng/mL) that were observed during the course of death investigations involving three children ranging in age from 1 week to 2 years, all of whom underwent withdrawal of life support. In all three cases, the presence of opiates in postmortem blood was indicated by immunoassay (ELISA) and quantitative confirmatory analysis of free morphine concentrations in postmortem blood was performed by solid-phase extraction followed by gas chromatography/mass spectrometry (GC/MS) in the selected ion monitoring mode. While the practice of withdrawing life support from terminally ill patients, with the accompanying administration of narcotics/analgesics has been reported in the medical literature, it has not been adequately described in the forensic literature. The implications of this practice on the forensic toxicological interpretation of morphine findings are discussed. To our knowledge, this is the first report of postmortem morphine concentrations arising directly from administration in conjunction with withdrawal of care in pediatric patients. |
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Authors:
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James Watterson; Amy Peaire; Justin Hinman |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Journal of forensic sciences Volume: 53 ISSN: 1556-4029 ISO Abbreviation: J. Forensic Sci. Publication Date: 2008 Jul |
Date Detail:
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Created Date: 2008-07-21 Completed Date: 2008-11-04 Revised Date: 2009-04-16 |
Medline Journal Info:
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Nlm Unique ID: 0375370 Medline TA: J Forensic Sci Country: United States |
Other Details:
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Languages: eng Pagination: 1001-4 Citation Subset: IM |
Affiliation:
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Department of Forensic Science, Laurentian University, 935 Ramsey Lake Rd., Sudbury, ON P3E 2C6, Canada. jwatterson@laurentian.ca |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Analgesics, Opioid
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blood*,
therapeutic use Enzyme-Linked Immunosorbent Assay Euthanasia, Passive* Forensic Toxicology Gas Chromatography-Mass Spectrometry Humans Infant Infant, Newborn Morphine / blood*, therapeutic use Terminally Ill |
| Chemical | |
Reg. No./Substance:
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0/Analgesics, Opioid; 57-27-2/Morphine |
| Comments/Corrections | |
Comment In:
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J Forensic Sci. 2009 Jan;54(1):241; author reply 242
[PMID:
19120839
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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