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Open Access 01-07-2020 | Cannabinoid | Original Article

Four cases of death involving the novel synthetic cannabinoid 5F-Cumyl-PEGACLONE

Authors: Arianna Giorgetti, Lukas Mogler, Sebastian Halter, Belal Haschimi, Andreas Alt, Daniel Rentsch, Bea Schmidt, Vanessa Thoma, Susanne Vogt, Volker Auwärter

Published in: Forensic Toxicology | Issue 2/2020

Abstract

Purpose

Cumyl-PEGACLONE was the first synthetic cannabinoid (SC) with a γ-carbolinone core structure detected in forensic casework and, since then, it has dominated the German SC-market. Here the first four cases of death involving its fluorinated analog, 5F-Cumyl-PEGACLONE, a recently emerged γ-carbolinone derived SC, are reported.

Methods

Complete postmortem examinations were performed. Postmortem samples were screened by immunoassay, gas chromatography mass spectrometry (GC–MS) or liquid chromatography tandem mass spectrometry. For quantification of SCs, the standard addition method was employed. Herbal blends were analyzed by GC–MS. In each case of death, the Toxicological Significance Score (TSS) was assigned to the compound.

Results

5F-Cumyl-PEGACLONE was identified at concentrations ranging 0.09–0.45 ng/mL in postmortem femoral blood. In case 1, signs of hypothermia and kidney bleedings were noted. Despite a possible tolerance due to long term SC use, a TSS of 3 was assigned. In case 2, an acute heroin intoxication occurred and a contributory role (TSS = 1) of 5F-Cumyl-PEGACLONE was suggested. In case 3, a prisoner was found dead. GC–MS analysis of herbal blends, retrieved in his cell together with paraphernalia, confirmed the presence of 5F-Cumyl-PEGACLONE and a causative role was deemed probable (TSS = 2). In case 4, the aspiration of gastric content due to a SC-induced coma was observed (TSS = 3).

Conclusions

5F-Cumyl-PEGACLONE is an emerging and extremely potent SC which raises serious public health concerns. A comprehensive analysis of circumstantial, clinical, and postmortem findings, as well as an in-depth toxicological analysis is necessary for a valid interpretation and for the assessment of the toxicological significance.

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Title: Four cases of death involving the novel synthetic cannabinoid 5F-Cumyl-PEGACLONE
Authors: Arianna Giorgetti
Lukas Mogler
Sebastian Halter
Belal Haschimi
Andreas Alt
Daniel Rentsch
Bea Schmidt
Vanessa Thoma
Susanne Vogt
Volker Auwärter
Publication date: 01-07-2020
Publisher: Springer Singapore
Keyword: Cannabinoid
Published in: Forensic Toxicology / Issue 2/2020
Print ISSN: 1860-8965
Electronic ISSN: 1860-8973
DOI: https://doi.org/10.1007/s11419-019-00514-w

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Four cases of death involving the novel synthetic cannabinoid 5F-Cumyl-PEGACLONE

Abstract

Purpose

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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