Abstract
Forty‐three fatalities involving the potent synthetic cannabinoid, 5‐Fluoro‐ADB, are summarized. For each case, a description of the terminal event, autopsy findings, cause of death, qualitative identification of 5‐Fluoro‐ADB and its ester hydrolysis metabolite, 5‐Fluoro‐ADB metabolite 7, in urine, and the quantitative values obtained in the blood specimens are outlined. Central blood concentrations ranged from 0.010 to 2.2 ng/mL for 5‐Fluoro‐ADB and 2.0 to 166 ng/mL for 5‐Fluoro‐ADB metabolite 7. Peripheral blood concentrations ranged from 0.010 to 0.77 ng/mL and 2.0 to 110 ng/mL for 5‐Fluoro‐ADB and 5‐Fluoro‐ADB metabolite 7, respectively. The majority of cases resulted in central to peripheral blood concentration ratios greater than 1 for 5‐Fluoro‐ADB (58%) and 5‐Fluoro‐ADB metabolite 7 (71%) suggesting that postmortem redistribution occurs to some extent. Combining the increased cardiac weight and/or gastric volume and toxicology data identifying 5‐Fluoro‐ADB, it is hypothesized that abuse of this substance may precipitate a dysrhythmia and cause sudden death.
