Diagnostics of fatal poisoning with 4-hydroxybutyric acid, ethanol and cannabinoids
M. Wiergowski, J. S. Anand, K. Karnecki, I. Sołtyszewski, Z. Jankowski
Abstract: This work describes a case of acute mixed poisoning with 4-hydroxybutyric acid (GHB) and ethanol with a fatal
outcome, as well as the methodology of chemical toxicological analyses of ante-mortem and post-mortem biological material in the
form of blood and urine samples, as well as an exhibit: a syringe with transparent liquid.
In the course of chemical toxicological analyses of samples of biological material, toxic and fatal concentrations of the
psychotropic substance GHB were detected and determined in urine. The presence of ethyl alcohol in samples of blood serum (0.60
per mille) and urine (0.74 per mille) collected from a man at 09:08 a.m. on the day of his poisoning in December 2014 indicated a
possible strong combined depressive effect of GHB and ethanol on the central nervous system and the respiratory system.
The analyses additionally detected psychoactive delta-9-tetrahydrocannabinol (THC) and its inactive metabolite, 11-nor-9-
carboxy-delta 9-tetrahydrocannabinol acid (THCCOOH), in concentrations indicating previous ingestion of hashish or marijuana,
remaining without any significant impact on the cause of death. The transparent liquid from the syringe contained the psychotropic
substance GHB, which was identical with the GHB detected in the ante-mortem biological material. Keywords: atal poisoning, 4-hydroxybutyric acid, ethanol, delta-9-tetrahydrocannabinol, 11-nor-9-carboxy-delta
9-tetrahydrocannabinol acid, gas chromatography, mass spectrometry.