Abstract
An 85-year-old man died after 20 days in an hospital. In order to investigate the unclear circumstances surrounding her father's death, his daughter asked our laboratory to analyse his hair for possible negligence. We received a strand of hair measuring approximately 3 cm in length, which we divided into two parts: 0 to 1 cm (1 month prior to hospitalisation) and 1 to 3 cm (2 months prior to the period of deterioration of the subject's state of health). Metformin was investigated on a GC-MS/MS system after derivatisation with MBTFA. Drug screening was performed using an LC-HRMS system. Analyses confirmed the presence in both segments (0-1 and 1-3 cm) of: metformin (117 and 215 pg/mg), metoprolol (1574 and 1550 pg/mg), apixaban (182 and 218 pg/mg) and amiodarone (2393 and 205 pg/mg). The concentration of metformin found in the segment corresponding to the month preceding hospitalisation (period covering the aggravation of the subject's state of health) seems compatible with a reduction in the dosage of the treatment. In the case of amiodarone, the concentration in the 0-1 cm segment was 10 times higher than in the previous segments. Analysis of the hair specimen, after segmentation, revealed reduced exposure to metformin with deterioration in the state of diabetes and acute exposure of the subject to amiodarone in the period preceding his death.
Published Version
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