# 167

                            Toxicology reports for two deaths in Minnesota

The death of Prince on April 21, 2016 was determined to be caused by an "exceedingly high level of Fentanyl (report below in terms of micrograms per liter)."

George Floyd's official Hennepin County M.E. report cites a number of substances and Fentanyl (and its metabolite norfentanyl) are listed against a different standard of "ng per ml."  The report determined that Floyd's level of blood Fentanyl was found to be 11ng/ml.

Signs associated with fentanyl toxicity include severe respiratory depression, seizures, hypotension, coma and death. In fatalities from fentanyl, blood concentrations are variable and have been reported as low as 3 ng/mL (From Floyd's Toxicology Report).

Fentanyl (Duragesic®; Sublimaze®) - Hospital Blood: Fentanyl is a DEA Schedule II synthetic morphine substitute anesthetic/analgesic. It is reported to be 80 to 200 times as potent as morphine and has a rapid onset of action as well as addictive properties.
It is reported that patients lost consciousness at mean plasma levels of fentanyl of 34 ng/mL when infused with 75 mcg/Kg over a 15 min period; peak plasma levels averaged 50 ng/mL.
After application of a fentanyl transdermal preparation (patch), serum fentanyl concentrations are reported to be in the following ranges within 24 hours: 25 mcg/hour patch: 0.3 - 1.2 ng/mL 50 mcg/hour patch: 0.6 - 1.8 ng/mL 75 mcg/hour patch: 1.1 - 2.6 ng/mL 100 mcg/hour patch: 1.9 - 3.8 ng/mL
9.
NMS v.18.0
CONFIDENTIAL Workorder Chain Patient ID
20159963 NMSCP59310 2020-3700
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Reference Comments: Following removal of the patch, serum fentanyl concentrations are reported to decrease with a mean elimination half-life of 17 hours (range, 13 to 22 hours).
The mean peak plasma serum fentanyl concentration in adults given an 800 mcg oral transmucosal fentanyl preparation over 15 minutes is reported at 2.1 ng/mL (range, 1.4 - 3.0 ng/mL) at approximately 0.4 hours.
Signs associated with fentanyl toxicity include severe respiratory depression, seizures, hypotension, coma and death. In fatalities from fentanyl, blood concentrations are variable and have been reported as low as 3 ng/mL.
Substance(s) known to interfere with the identity and/or quantity of the reported result: 4-methylphenethyl acetyl fentanyl

https://www.hennepin.us/-/media/hennepinus/residents/public-safety/documents/Autopsy_2020-3700_Floyd.pdf

https://www.npr.org/sections/thetwo-way/2018/03/27/597249429/prince-died-with-exceedingly-high-level-of-fentanyl-report-states