A Death from Fentanyl Overdose

A case of death from self-injection of fentanyl and a method for its detection in autopsy specimens are reported. Fentanyl was measured by extraction of biological samples with ethyl acetate, partitioning into 0.1N HCl, then reextracting into ethyl acetate after alkalinization of the acid phase. After reducing to a residue, the fentanyl was measured by selective ion monitoring gas chromatography/mase spectrometry. Concentrations of 4.8, 6.3, and 4.7 µg/L were found in blood, urine, and bile, respectively.