Problems of Forensic Sciences 2008 Vol. 75 (LXXV) 308-313
METHADONE INTOXICATION IN A 3-WEEK OLD INFANT – A CASE PRESENTATION
Joanna KULIKOWSKA, Rafał CELIŃSKI, Joanna NOWICKA, Małgorzata ALBERT, Mariusz KOBEK, Kornelia DROZDZIOK
Chair and Department of Forensic Medicine, Silesian Medical University, Katowice, Poland
Streszczenie
The authors describe a case of lethal methadone intoxication of a 3-week-old infant – a child of a drug-addicted mother on methadone substitution therapy commenced during pregnancy. At birth, the neonate presented with withdrawal symptoms and was immediately admitted to a paediatric ward where it was treated for three weeks, without administration of methadone. The infant died suddenly during bottle-feeding within 24 hours following discharge. The autopsy demonstrated obstruction of the lower air passages by aspirated stomach contents along with classic features of asphyxia. The toxicological examinations showed methadone and its metabolite (EDDP) in the blood, liver, kidney and urine samples, as well as the presence of methadone in the stomach contents. The concentration of unchanged methadone in the blood was 0.24 μg/ml, in the urine – 0.31 μg/ml, in the liver – 0.09 μg/g, in the kidney – 0.07 μg/g and in the stomach contents – 0.63 μg/ml. The concentration of EDDP in the blood was 0.04 μg/ml, in the urine – 0.44 μg/ml and in the liver and kidney – 0.01 μg/g. Based on the results of the post-mortem examination, the laboratory tests and the police investigation, it was concluded that the drug was ingested with formula (milk) (DNA polymorphism analysis of the sex-specific amelogenin locus in stomach content yielded a negative result).
Słowa kluczowe
Newborn; Methadone intoxication; Cause of death.