Citation

Paul AB, Simms L, Mahesan AM. J. Forensic Sci. 2017; 62(5): 1414-1417.

Affiliation

Eastern Virginia Medical School, Jones Institute for Reproductive Medicine, Norfolk, VA, 23507.

Copyright

(Copyright © 2017, American Society for Testing and Materials, Publisher John Wiley and Sons)

DOI

10.1111/1556-4029.13410

PMID

28133719

Abstract

Methadone-related fatalities occur rarely in infants under 1 year, with five confirmed cases in the literature. The interpretation of pediatric postmortem toxicology relies on adult data; however, infants have crucial physiological differences that may impact interpretation of results. Retrospective case review included scene investigation, interviews, autopsy, and NIH/CDC Sudden Unexplained Infant Death Investigation Reporting Form. Methadone levels were confirmed by liquid chromatography/tandem mass spectrometry (LC-MS/MS). The fatal blood methadone levels in this case series ranged from 69 to 700 ng/mL. This review of the literature adds toxicological findings of three methadone-related infant fatalities and reviews the current literature on methadone-related death in infants under 1 year. With opioid use on the rise in today's society, forensic experts should have a high index of suspicion for the possibility of intentional or unintentional poisoning in infants.

© 2017 American Academy of Forensic Sciences.

Language: en

Keywords

forensic science; homicide; infant mortality; methadone; toxicology