Acute Benztropine Intoxication and Fatality

A woman was found unresponsive with an empty bottle of Cogentin® prescribed to another. Admitted to an area hospital, her condition steadily declined until death 29 h after admission. Following toxicological screening on hospital (admission) whole blood, the only significant compound detected was be...

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Bibliographic Details
Published in:Journal of forensic sciences 2014-11, Vol.59 (6), p.1675-1678
Main Authors: McIntyre, Iain M., Mallett, Phyllis, Burton, Christopher G., Morhaime, Jacquelyn
Format: Article
Language:English
Subjects:
antemortem and postmortem concentrations
Autopsies
benztropine
Benztropine - analysis
Benztropine - poisoning
Cholinergic Antagonists - analysis
Cholinergic Antagonists - poisoning
Drug overdose
fatality
Female
forensic science
Forensic sciences
Gastrointestinal Contents - chemistry
Humans
Liver - chemistry
Middle Aged
postmortem redistribution
Suicide
Toxicology
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Summary:A woman was found unresponsive with an empty bottle of Cogentin® prescribed to another. Admitted to an area hospital, her condition steadily declined until death 29 h after admission. Following toxicological screening on hospital (admission) whole blood, the only significant compound detected was benztropine. Benztropine was confirmed at 0.28 mg/L – the highest antemortem blood concentration recorded in a case of toxicity or fatality uniquely associated with benztropine. A second serum antemortem specimen showed a benztropine concentration of 0.19 mg/L. Despite over 24 h in the hospital, benztropine was also found in the postmortem specimens collected at autopsy. Peripheral blood, central blood, liver, and gastric concentrations were 0.47 mg/L, 0.36 mg/L, 9.6 mg/kg, and 44 mg, respectively. These results indicate that benztropine exhibited a potential difference between whole‐blood and serum (plasma) concentrations. Additionally, in consideration of literature data, benztropine was found indicative of a compound prone to at least some postmortem redistribution.
ISSN:0022-1198
1556-4029
DOI:10.1111/1556-4029.12489