Forensic toxicologists and pathologists are often faced with the challenge of interpreting the analytical results from toxicological analyses of embalmed tissues. The question that arises is "Does the measured concentration in the embalmed tissues reflect the concentration at death or does the embalming process artificially increase or decrease the measured concentration of drug?" One would generally think that any process that adds solution to a sample may cause a dilutional effect, thus

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... ng the measured concentration. Furthermore, the addition of embalming fluid, which is organic in nature, may lower the recovery (extractability) and/or chemically react (1) with the target compound, both of which could potentially lower the measured concentration of drug. In the case of drug metabolites (e.g., tricyclic antidepressants), which are formed via oxidative demethylation, these may be converted back to their parent compounds and thus give an artificial rise in the parent concentration and a lowering of the metabolite concentration (2) . A MedLine search did not reveal any cases that reported drug concentrations before and after the embalming process and burial. Recently, I had the opportunity to investigate a death case in which toxicological analyses were performed before embalming and after embalming and burial. This case involved a 43-year-old Caucasian female who died during a surgical procedure. A complete toxicological examination and autopsy were performed. A number of medications were detected (Table I) and determined to be within expected concentrations, including fentanyl. The body was subsequently released, embalmed, and interred. Approximately two years later, the body was exhumed pursuant to a court order and reautopsied. During the second autopsy, additional tissues were collected and analyzed. The second examination revealed essentially the same drug profile, including fentanyl. The liver fentanyl concentration decreased by approximately 26% over the two-year period. The initial drug concentrations for the other medications were not initially quantitated, but they were considered to be well within expected concentrations for the reported administered doses. The embalmed tissue concentrations were also within their expected concentrations. Although quantitative data for embalmed and unembalmed liver tissue were only available for fentanyl, this case does support the hypothesis that, with the few exceptions noted here, tissue concentrations will not increase because of the embalming and burial process. If there is a change in tissue concentration, the measured concentration will decrease, and a therapeutic administration of drug will not be misinterpreted as toxic because of an artifactual increase in the measured concentration.