Accidental death from hydromorphone ingestion.
Author(s): Meatherall R, Lee C, Phillips S
Affiliation(s): St Boniface General Hospital, Winnipeg, MB, Canada. email@example.com
Publication date & source: 2011-01, J Forensic Sci., 56 Suppl 1:S271-4. Epub 2010 Nov 15.
Publication type: Case Reports
A 15-year-old male orally consumed an unknown but fatal amount of sustained release hydromorphone. He was naive to opioid use. No other drugs or alcohol were involved. The cause of death was acute aspiration-related bronchopneumonia, secondary to hydromorphone ingestion; the manner of death was accidental. Hydromorphone and hydromorphone-3-glucuronide were quantified in postmortem fluids by tandem liquid chromatography-mass spectrometry. The hydromorphone concentrations in the peripheral blood, urine, and vitreous humor were 57, 4460, and 31 ng/mL, respectively. The hydromorphone-3-glucuronide concentrations in the corresponding three fluids were 459, 36,400, and 40 ng/mL. Hydromorphone-3-glucuronide accumulation probably did not contribute significantly to the opiate toxicity. The proposed minimum lethal hydromorphone blood concentration in the nontolerant user is in the vicinity of 60 ng/mL. (c) 2010 American Academy of Forensic Sciences.