Lehmann, S; Sczyslo, A; Froch-Cortis, J; Rothschild, MA; Thevis, M; Andresen-Streichert, H; Mercer-Chalmers-Bender, K; ,
The organ distribution of 3-fluorophenmetrazine (3-FPM), pyrazolam, diclazepam as well as its main metabolites delorazepam, lormetazepam and lorazepam, was investigated. A solid phase extraction (SPE) and a QuEChERS (acronym for quick, easy, cheap, effective, rugged and safe) - approach were used for the extraction of the analytes from human tissues, body fluids and stomach contents. The detection was performed on a liquid chromatography-tandem mass spectrometry system (LCMS/MS). The analytes of interest were detected in all body fluids and tissues. Results showed femoral blood concentrations of 10 mu g/L for 3-FPM, 28 mu g/L for pyrazolam, 1 mu g/L for diclazepam, 100 mu g/L for delorazepam, 6 mu g/L for lormetazepam, and 22 mu g/L for lorazepam. Tissues (muscle, kidney and liver) and bile exhibited higher concentrations of the mentioned analytes than in blood. Additional positive findings in femoral blood were for 2-fluoroamphetamine (2-FA, approx. 89 mu g/L), 2-flourometamphetamine (2-FMA, hint), methiopropamine (approx. 2.2 mu g/L), amphetamine (approx. 21 mu g/L) and caffeine (positive). Delorazepam showed the highest ratio of heart (C) and femoral blood (P) concentration (C/P ratio = 2.5), supported by the concentrations detected in psoas muscle (430 mu g/kg) and stomach content (approx. 210 mu g/L, absolute 84 mu g). The C/P ratio indicates that delorazepam displays susceptibility for postmortem redistribution (PMR), supported by the findings in muscle tissue. 3-FPM, pyrazolam, diclazepam, lorazepam and lormetazepam did apparently not exhibit any PMR. The cause of death, in conjunction with autopsy findings was concluded as a positional asphyxia promoted by poly-drug intoxication by arising from designer benzodiazepines and the presence of synthetic stimulants. (C) 2019 Elsevier B.V. All rights reserved.