Samples Received
| Sample | Volume / Condition | Received |
|---|
| Femoral blood | 8 mL — preserved in sodium fluoride | 15 Feb 2025, 02:30 AM |
| Cardiac blood | 5 mL — preserved | 15 Feb 2025, 02:30 AM |
| Vitreous humour | 2 mL bilateral — clear | 15 Feb 2025, 02:30 AM |
| Gastric wash | 60 mL — amber coloured liquid | 15 Feb 2025, 02:30 AM |
| Urine | 15 mL — collected at autopsy | 15 Feb 2025, 02:30 AM |
Substances Detected
| Substance | Matrix | Concentration | Reference Range |
|---|
| Midazolam | Femoral blood | 82 ng/mL | Therapeutic: 40–200 ng/mL (IV sedation) |
| Midazolam | Gastric wash | Significant residue detected | — |
| 1-Hydroxymidazolam (metabolite) | Urine | Detected — consistent with recent ingestion | — |
| Ethanol | Vitreous | 0.08 g/100 mL | Low to moderate range |
| Ethanol | Gastric wash | High concentration — co-ingested with primary substance | — |
Pharmacokinetic Assessment
The blood Midazolam concentration of 82 ng/mL is within the sedative-hypnotic range for an adult male of estimated 78 kg body weight. At this concentration, clinical effects would include: significant drowsiness, impaired motor coordination, and inability to mount effective physical resistance. Onset of sedation following oral ingestion in ethanol solution: approximately 8–15 minutes. Duration of sedation at this dose: 30–60 minutes. The gastric residue indicates the dose was administered in liquid form, most likely dissolved in the co-ingested alcoholic beverage.
Analytical Method
LC-MS/MS (Liquid Chromatography — Mass Spectrometry). Confirmation by immunoassay. All standards calibrated. Chain of custody intact.
Remarks
The route of administration is consistent with dissolution of tablet form Midazolam in an alcoholic drink. Standard tablet strength available for legitimate medical use is 7.5 mg or 15 mg. Estimated dose administered: 10–15 mg. No other controlled substances detected. No prescription benzodiazepines in therapeutic range detected separately (i.e., not a pre-existing prescription). Carbon monoxide, cyanide, and heavy metals: not detected.