An Acute Acetyl Fentanyl Fatality: A Case Report With Postmortem Concentrations

J Anal Toxicol. Jul-Aug 2015;39(6):490-4. doi: 10.1093/jat/bkv043. Epub 2015 Apr 26.


In this case report, we present an evaluation of the distribution of postmortem concentrations of acetyl fentanyl in a fatality attributed to the drug. A young man who had a history of heroin abuse was found deceased at his parents' home. Toxicology testing, which initially screened positive for fentanyl by ELISA, subsequently confirmed acetyl fentanyl by gas chromatography-mass spectrometry specific ion monitoring (GC-MS SIM) analysis following liquid-liquid extraction. No other drugs or medications, including fentanyl, were detected. The acetyl fentanyl peripheral blood concentration was quantified at 260 ng/mL compared with the central blood concentration of 250 ng/mL. The liver concentration was 1,000 ng/kg, the vitreous was 240 ng/mL and the urine was 2,600 ng/mL. The cause of death was certified due to acute acetyl fentanyl intoxication, and the manner of death was certified as an accident.

Publication types

  • Case Reports
  • Comparative Study

MeSH terms

  • Accidents
  • Administration, Cutaneous
  • Adult
  • Analgesics, Opioid / blood*
  • Autopsy
  • California
  • Cause of Death
  • Fentanyl / analogs & derivatives*
  • Fentanyl / blood
  • Fentanyl / toxicity
  • Fentanyl / urine
  • Forensic Toxicology / methods*
  • Gas Chromatography-Mass Spectrometry
  • Humans
  • Liquid-Liquid Extraction
  • Liver / chemistry*
  • Male
  • Substance Abuse Detection / methods*
  • Vitreous Body / chemistry*
  • Young Adult


  • Analgesics, Opioid
  • N-(1-phenethylpiperidin-4-yl)-N-phenylacetamide
  • Fentanyl