Site-, Technique-, and Time-Related Aspects of the Postmortem Redistribution of Diazepam, Methadone, Morphine, and their Metabolites: Interest of Popliteal Vein Blood Sampling

J Forensic Sci. 2017 Nov;62(6):1559-1574. doi: 10.1111/1556-4029.13404. Epub 2017 Jan 20.

Abstract

Sampling site, technique, and time influence postmortem drug concentrations. In 57 cases, we studied drug concentration differences as follows: subclavian vein-dissection/clamping versus blind stick, femoral vein-dissection/clamping versus blind stick, right cardiac chamber, and popliteal vein-dissection and clamping only. Cases were distributed in group #1 (all cases with both techniques), group #2 (dissection/clamping), and group #3 (blind stick). Sampled drugs were diazepam, methadone, morphine, and their metabolites. To assess PMR, mean concentrations and ratios were calculated for each group. Time-dependent variations of blood concentrations and ratios were also assessed. Results indicate that site, method, and time may influence postmortem distribution interpretation in different ways. Popliteal blood seems less subject to PMR. In conclusion, our study is the first to evaluate concurrently three main aspects of PMR and confirms that the popliteal vein may represent a site that is more resistant to the changes seen as a result of PMR.

Keywords: blind stick; dissection/clamping; forensic science; forensic toxicology; popliteal blood; postmortem interval; postmortem redistribution; sampling site; sampling technique.

MeSH terms

  • Adult
  • Blood Specimen Collection / instrumentation
  • Blood Specimen Collection / methods*
  • Chromatography, Liquid
  • Diazepam / blood*
  • Diazepam / pharmacokinetics
  • Female
  • Femoral Vein
  • Forensic Toxicology
  • Humans
  • Male
  • Methadone / blood*
  • Methadone / pharmacokinetics
  • Middle Aged
  • Morphine / blood*
  • Morphine / pharmacokinetics
  • Morphine Derivatives / blood
  • Morphine Derivatives / pharmacokinetics
  • Nordazepam / blood
  • Nordazepam / pharmacokinetics
  • Oxazepam / blood
  • Oxazepam / pharmacokinetics
  • Popliteal Vein
  • Postmortem Changes
  • Subclavian Vein
  • Young Adult

Substances

  • Morphine Derivatives
  • morphine-6-glucuronide
  • Nordazepam
  • Oxazepam
  • Morphine
  • morphine-3-glucuronide
  • Diazepam
  • Methadone