Forensic Toxicology Scope of Testing and Detection Limits

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Forensic Toxicology Scope of Testing and Detection Limits Table of Contents QUALITATIVE ANALYSES... 2 Volatile Screen by GC/FID... 2 Carbon Monoxide by Microdiffusion... 2 Ethylene Glycol by GC/MS... 2 ELISA Buprenorphine by IA for Blood... 2 ELISA by IA for Blood... 3 ELISA by IA for Urine... 4 Gamma Hydroxybutyrate (GHB) by GC/MS... 4 Gabapentin, Pregabalin by GC/MS... 5 Alkaline Drug Screen by GC/MS... 5 Acid Neutral Drug Screen by GCMS... 8 Salicylates by CT... 8 QUANTITATION/CONFIRMATION... 9 Volatiles by HS GC/FID... 9 Carbon Monoxide by UV/Vis... 9 Alkaline Drugs by GC/MS... 9 Alkaline Drugs by LC/MS/MS... 10 Bupropion, Hydroxybupropion by GC/MS... 10 Acid Neutral Drugs by GC/MS... 11 Benzodiazepines by LC/MS... 11 Benzodiazepines by GC/MS... 12 Cocaine/metabolites by GC/MS... 12 Cannabinoids by GC/MS... 12 Opiates by GC/MS... 13 6-acetylmorphine by GC/MS... 13 Oxycodone, Oxymorphone by GC/MS... 13 Amphetamines by GC/MS... 14 Phencyclidine (PCP) by GC/MS... 14 Revision History:... 14 Revision 2 Page 1

Qualitative analyses Volatile Screen by GC/FID Limit of detection Acetaldehyde 10 mg% Acetone 10 mg% 1 mg% Ethanol 0.01 g% 0.003 g% Isopropanol 10 mg% 1 mg% Methanol 10 mg% 6 mg% Carbon Monoxide by Microdiffusion Carbon monoxide Approximate Limit of Detection 15% carboxyhemoglobin Ethylene Glycol by GC/MS Ethylene glycol 50 mg/l (5 mg%) ELISA Buprenorphine by IA for Blood /Class Calibrant Cut-Off Concentration (ng/ml) Buprenorphine/metabolite buprenorphine 1 Detects buprenorphine, norbuprenorphine Revision 2 Page 2

ELISA by IA for Blood /Class Calibrant Blood Cut-Off Concentration (ng/ml) Detects Amphetamines amphetamine 10 amphetamine, methylenedioxyamphetamine (MDA), phentermine Barbiturates secobarbital 100 butalbital, butabarbital, pentobarbital, secobarbital Benzodiazepines lorazepam 25 alprazolam, bromazepam, chlordiazepoxide, clonazepam and metabolite (7-aminoclonazepam), diazepam, nordiazepam, estazolam, flurazepam metabolite (N-desalkylflurazepam) lorazepam, midazolam, oxazepam, temazepam Cannabinoids delta-9 carboxy- THC 10 THC, delta-9 carboxy-thc Cocaine/metabolite benzoylecgonine 25 benzoylecgonine, cocaethylene, cocaine Fentanyl fentanyl 1 fentanyl, acetylfentanyl Methadone methadone 25 methadone Methamphetamine methamphetamine 10 methamphetamine, methylenedioxymethamphetamine (MDMA) Opiates morphine 10 6-acetylmorphine, codeine, hydrocodone, hydromorphone, morphine, morphine 3-glucuronide Oxycodone/ oxymorphone oxycodone 12.5 oxycodone, oxymorphone Phencyclidine phencyclidine 5 phencyclidine Note: Dextromethorphan/metabolites may exhibit cross-reactivity for the ELISA PCP immunoassay. Revision 2 Page 3

ELISA by IA for Urine /Class Amphetamines Class Calibrant Urine Cut-Off Concentration (ng/ml) Detects amphetamine 500 amphetamine, methylenedioxyamphetamine (MDA), phentermine Barbiturates secobarbital 200 butalbital, butabarbital, pentobarbital, secobarbital Benzodiazepines lorazepam 250 alprazolam, bromazepam, chlordiazepoxide, clonazepam and metabolite (7-aminoclonazepam), diazepam, nordiazepam, estazolam, flurazepam metabolite (Ndesalkylflurazepam), lorazepam, midazolam, oxazepam, temazepam Cannabinoids delta-9 carboxy- THC 50 THC, delta-9 carboxy-thc Cocaine/metabolite benzoylecgonine 150 cocaine, benzoylecgonine, cocaethylene Fentanyl fentanyl 1 fentanyl, acetylfentanyl Methadone methadone 300 methadone Methamphetamine methamphetamine 500 methamphetamine, methylenedioxymethamphetamine (MDMA) Opiates morphine 300 6-acetylmorphine, codeine, hydrocodone, hydromorphone, morphine, morphine 3-glucuronide Oxycodone/ oxymorphone oxycodone 300 oxycodone, oxymorphone Phencyclidine (PCP) phencyclidine 25 phencyclidine Note: Dextromethorphan/metabolites may exhibit cross-reactivity for the ELISA PCP immunoassay. Gamma Hydroxybutyrate (GHB) by GC/MS in in postmortem urine ante-mortem urine Gamma hydroxybutyrate (GHB) 50 mg/l 10 mg/l Revision 2 Page 4

Gabapentin, Pregabalin by GC/MS Gabapentin Pregabalin in Blood 0.5 ug/ml 0.5 ug/ml Alkaline Drug Screen by GC/MS Amantadine Approximate Detectable Concentration (ng/ml)* Amitriptyline 10 Amoxapine Atropine Benztropine Brompheniramine Bupivacaine Bupropion 10 Chlorpheniramine 25 Chlorpromazine 25 Citalopram/escitalopram** 10 Clomipramine 10 Clozapine Cyclobenzaprine 10 Desipramine 25 Desmethylcitalopram 50 Dextromethorphan 10 Diphenhydramine 10 Doxepin 25 Doxylamine 10 Duloxetine 150 Etomidate Fluoxetine not detected at 100 ng/ml Imipramine 10 Ketamine 10 Lidocaine Loxapine Revision 2 Page 5

Alkaline Drug Screen by GC/MS Continued Meperidine Approximate Detectable Concentration (ng/ml)* Methadone 10 Metoclopramide Mirtazapine 50 Norquetiapine 250 Norsertraline 50 Nortripyline 50 O-desmethyltramadol 100 O-desmethylvenlafaxine 50 Orphenadrine Paroxetine 50 Pentazocine 50 Propoxyphene 25 Pseudoephedrine/ephedrine 100 Quinine/quinidine*** Sertaline 25 Strychnine 14 Thioridazine 25 Tramadol 50 Trazodone 50 Trimipramine Venlafaxine 50 Verapamil 25 Zolpidem 25 *Due to the nature of certain specimens (e.g., decompositional fluid, spleen, and liver), detectable concentrations may be elevated. **Differentiation between citalopram and escitalopram cannot be determined by this laboratory. *** Differentiation between quinine and quinidine cannot be determined by this laboratory. Alkaline drug screening for gastric contents is conducted on a 1:25 dilution. Revision 2 Page 6

Alkaline Drug Screen by GC/MS Continued Bath Salts Detectable s Butylone Dibutylone Ethcathinone Ethylone Mephedrone Methylenedioxypyrovalerone (MDPV) 4-methylethcathinone Methylone N-ethylpentylone Pentylone 2-pyrrolidinovalerone (alpha-pvp) Fentanyl analogs Detectable s Acetyl fentanyl Acryl fentanyl 4-ANPP (despropionyl fentanyl) Butyryl fentanyl Fluorobutyryl fentanyl** Furanyl fentanyl 4-methoxybutyryl fentanyl **Differentiation between isomers of fluorobutryl fentanyl cannot be determined by this laboratory. Revision 2 Page 7

Acid Neutral Drug Screen by GCMS Approximate Detectable Concentration (ug/ml)* acetaminophen 0.5 butalbital 0.05 caffeine carbamazepine 0.25 carisoprodol 0.25 celecoxib ibuprofen 2 lamotrigine 0.25 levetiracetam 0.25 meprobamate 0.25 metaxalone naproxen 1 phenobarbital 0.25 phenytoin 0.25 primidone theophylline topiramate 0.25 trimethoprim valproic acid 25 warfarin zonisamide *Due to the nature of certain specimens (e.g., decompositional fluid, spleen, and liver), detectable concentrations may be elevated. Acid neutral screening for gastric contents is conducted on a 1:25 dilution. Salicylates by CT Salicylates Limit of Detection 100 ug/ml Revision 2 Page 8

Volatiles by HS GC/FID Quantitation/Confirmation Limit of detection Acetaldehyde 10 mg% Acetone 10 mg% 1 mg% Ethanol 0.01 g% 0.003 g% Isopropanol 10 mg% 1 mg% Methanol 10 mg% 6 mg% Carbon Monoxide by UV/Vis Carbon monoxide 10% carboxyhemoglobin Alkaline Drugs by GC/MS in blood in liver Chlorpheniramine 5 ng/ml 50 ng/g Citalopram/escitalopram** 5 ng/ml 50 ng/g Dextromethorphan 5 ng/ml 50 ng/g Diphenhydramine 5 ng/ml 50 ng/g Doxylamine 5 ng/ml 50 ng/g Fentanyl 0.125 ng/ml 5 ng/g Ketamine 5 ng/ml 50 ng/g Methadone 5 ng/ml 50 ng/g Mirtazapine 5 ng/ml 50 ng/g Zolpidem 5 ng/ml 50 ng/g Only analytes listed on the report underwent alkaline drug quantitation by GC/MS. **Differentiation between citalopram and escitalopram cannot be determined by this laboratory. Revision 2 Page 9

Alkaline Drugs by LC/MS/MS in blood limit in liver Amitriptyline 5 ng/ml 50 ng/g Nortryptyline 5 ng/ml 50 ng/g Citalopram/escitalopram** 5 ng/ml 50 ng/g Desmethylcitalopram 5 ng/ml 50 ng/g Cyclobenzaprine 5 ng/ml 50 ng/g Fluoxetine 5 ng/ml 50 ng/g Norfluoxetine 50 ng/g Mirtazapine 5 ng/ml 50 ng/g Paroxetine 5 ng/ml 50 ng/g Sertraline 5 ng/ml 50 ng/g Norsertraline NA Tramadol 5 ng/ml 50 ng/g O-desmethyltramadol 5 ng/ml 50 ng/g Venlafaxine 5 ng/ml 50 ng/g O-desmethylvenlafaxine 5 ng/ml 50 ng/g Zolpidem 5 ng/ml 50 ng/g Only analytes listed on the report underwent alkaline drug quantitation by LC/MS/MS. **Differentiation between citalopram and escitalopram cannot be determined by this laboratory. Bupropion, Hydroxybupropion by GC/MS Bupropion Hydroxybupropion in blood 5 ng/ml Revision 2 Page 10

Acid Neutral Drugs by GC/MS in blood limit in liver Butalbital 0.025 ug/ml 0.05 ug/g Carbamazepine 1 ug/ml 2 ug/g Carisoprodol 0.25 ug/ml 0.5 ug/g Meprobamate 0.25 ug/ml 0.5 ug/g Phenobarbital 0.25 ug/ml 0.5 ug/g Phenytoin 0.25 ug/ml 0.5 ug/g Only analytes listed on the report underwent acid neutral drug quantitation by GC/MS. Benzodiazepines by LC/MS Alprazolam 7-aminoclonazepam Chlordiazepoxide Clonazepam Diazepam Lorazepam Midazolam N-desalkylflurazepam Nordiazepam Oxazepam Temazepam in blood 5 ng/ml 5 ng/ml 5 ng/ml Revision 2 Page 11

Benzodiazepines by GC/MS in blood/spleen limit in liver Alprazolam 5 ng/ml 50 ng/g Diazepam 50 ng/g Lorazepam 5 ng/ml 50 ng/g Nordiazepam 50 ng/g Oxazepam 50 ng/g Temazepam N/A Only analytes listed on the report underwent benzodiazepine quantitation by GC/MS. Cocaine/metabolites by GC/MS for blood/spleen limit for urine^ limit for liver Cocaine 5 ng/ml N/A 50 ng/g Benzoylecgonine 5 ng/ml 50 ng/ml 50 ng/g Cocaethylene 5 ng/ml N/A 50 ng/g ^Report urine qualitatively only. Cannabinoids by GC/MS 11-Hydroxy Delta-9 THC Delta-9 Carboxy THC in blood 1 ng/ml 3 ng/ml Revision 2 Page 12

Opiates by GC/MS in blood, vitreous, spleen in urine^ limit in liver Codeine 5 ng/ml 25 ng/ml 50 ng/g Morphine 5 ng/ml 25 ng/ml 50 ng/g Hydrocodone 5 ng/ml 25 ng/ml 50 ng/g Hydromorphone 2.5 ng/ml 25 ng/ml 50 ng/g 6-acetylmorphine 0.625 ng/ml 2.5 ng/ml 50 ng/g ^Report urine qualitatively only. 6-acetylmorphine by GC/MS in blood, vitreous, spleen limit in urine^ in liver 6-acetylmorphine 0.625 ng/ml 2.5 ng/ml 50 ng/g ^Report urine qualitatively only. Oxycodone, Oxymorphone by GC/MS in blood, vitreous, spleen limit in urine^ in liver Oxycodone 2.5 ng/ml 25 ng/ml 50 ng/g Oxymorphone 2.5 ng/ml 25 ng/ml 50 ng/g ^Report urine qualitatively only. Revision 2 Page 13

Amphetamines by GC/MS for blood/spleen Report limit for urine^ Report limit for liver Amphetamine 50 ng/ml 50 ng/g Ephedrine 50 ng/ml 50 ng/g Methamphetamine 50 ng/ml 50 ng/g Methylenedioxyamphetamine(MDA) 50 ng/ml 50 ng/g Methylenedioxymethamphetamine (MDMA) 50 ng/ml 50 ng/g Phentermine^^ 50 ng/ml 50 ng/g Phenylpropanolamine 20 ng/ml 50 ng/ml 50 ng/g Pseudoephedrine 20 ng/ml 50 ng/ml 50 ng/g Note: Ephedrine's report limit is raised to 100 ng/ml or 100 ng/g when pseudoephedrine is also positive. ^Report urine qualitatively only. ^^Report phentermine qualitatively only. Phencyclidine (PCP) by GC/MS Phencyclidine (PCP) in blood 0.5 ng/ml Revision History: Revision Number Date Reason for Revision 0 March 1, 2016 Initial version 1 April 15, 2016 Updated test names, added comment to ELISA 2 February 17, 2017 phentermine qualitatively only, liver temazepam quantitation no longer available, Carbamazepine report limit updated, added additional bath salts and removed special request, added fentanyl analogs Revision 2 Page 14

Revision 2 Page 15