FORENSIC MEDICAL MANAGEMENT SERVICES OF TEXAS, P.A. Beaumonwefferson County PO Box 20097 Beaumont, Texas 77720 Case Number: 13-0814 County: SABINE AUTOPSY REPORT NAME OF DECEDENT: Wright, Alfred RACE: SEX: AGE: 28 years DATE AND TIME OF DEATH: November 25, 2013 at 7:00 p.m. DATE AND TIME OF AUTOPSY: November 26, 2013 at 3:45 p.m. FORENSIC PATHOLOGIST: John W. Ralston, M.D. PATHOLOGIC DIAGNOSES 1. Combined drug intoxication, including cocaine, methamphetamine and amphetamine (see toxicology report). 2. Shallow puncture wounds to the abdomen, left thigh, left lower leg, and palm of the left hand. 3. Decompositional changes and evidence of animal activity. 4. No evidence of severe trauma. CAUSE OF DEATH: Combined drug intoxication. MANNER OF DEATH: Accident. I hereby certify that I, John W. Ralston, M.D. have performed an autopsy on the body of Alfred Wright on the 26"' day of November 2013 at 3:45 p.m. at the Forensic Medical Management IDENTIFICATION: Identification is provided by the Justice of the Peace. CIRCUMSTANCESIHISTORY: Reportedly, the decedent was discovered in a wooded area in rural Sabine County after having been missing for approximately two weeks. AUTHORIZATION: The Honorable James Brasher, Justice of the Peace, Precinct 2, Sabine County, Texas has given written authorization to perform an autopsy on the decedent. ATTENDEES: FORENSIC TECHNICIANS: John Edwards and Jodi Simon LAW ENFORCEMENTIOTHER: Daniel Young, Texas Rangers, Company 13-0814 WRIGHT, ALFRED PAGE 2 OF 4 IDENTIFYING SCARS, MARKS 8: TATTOOS: On the left and right upper back is a design tattoo, 17.0 9.0 inches. On the back of the left upper arm is a picture tattoo of a shield with flames and writing 8.5 6.0 inches. On the back of the right upper arm is a writing tattoo CAN DO ALL THINGS THROUGH CHRIST WHO STRENGTHENS ME PHILLIPIANS 4:13", 5.0 4.0 inches. On the back of the right upper arm is a writing tattoo 7.0 2.0 inches. On the back of the right upper arm is a picture tattoo of hands with writing SAM 5.0 5.0 inches. EVIDENCE OF INJURY: On the palm of the left hand is a round puncture wound, 0.2 inches. On the right lower abdomen, 42.0 inches above the bottom of the foot and 1.0 inches right of the anterior midline, is a round puncture wound, 0.2 inches. On the left lower abdomen, 42.0 inches above the bottom of the foot and 3.0 inches left of the anterior midline, is a round 'puncture wound, 0.2 inches. On the front of the left thigh, 25.5 inches above the bottom of the foot, are two round puncture wounds, separated by a distance of 0.7 inches, measuring 0.2 inches each. On the front of the left lower leg, 15.0 inches above the bottom of the foot, is a round puncture wound, 0.2 inches. On the front of the left lower leg, at 13.0 inches above the bottom of the foot, is a vertical incised wound, 1.2 0.2 inches. On the bottom of the left foot is a red impressionlabrasion, 2.0 1.0 inches. The above injuries, having once been described, will not be referred to below. EXTERNAL EXAMINATION: The body is received clothed in a pair of black undershorts, a pair of black shoes, and one black sock on the left foot. Accompanying the body is a white metal ring, a cell phone, and a key chain. 'I3he4eedy--is- that ef--a--well-develeped-, and well-nourished Black male,- length, weighing 125 pounds, and appearing the recorded age of 28 years. A yellow plastic identification bracelet encircles the right ankle and reads "Alfred Wright" and "13-0814". The body is not embalmed. Rigor mortis is not evident. Purple fixed livor mortis is noted on the anterior surfaces of the body, with the exception of the pressure points. Extensive decornpositional changes are noted with skin slippage over all body surfaces, insect activity over the head, chest, and abdomen, and animal activity noted over the face, eyes, and left ear, with skeletonization of the face. The scalp is covered with short black curly hair. The scalp is without evidence of injury. The eyes are absent due to animal activity. The skeleton of the nose is intact. The right earlobe is unremarkable. The lips, oral mucosa and frenula are bsent. The teeth are natural with the - oiInfill": 4- - acti activity. The neck is symmetrical with extensive animal 13-0814 WRIGHT, ALFRED PAGE 3 OF 4 The chest, abdomen, posterior neck, back, buttocks, anus and upper and lower extremities are symmetrical and normally developed with injuries as previously described. The abdomen is soft and flat. The extemal genitalia appear normal circumcised adult male with both testes present in the scrotum. Skin slippage is noted on the hands with the absence of the fingemail on the right index finger. The remaining fingemails are short with underlying dirt. The toenails are short and clean. The soles of the feet are clean. INTERNAL EXAMINATION: BODY CAVITIES: The body is entered by a Y--shaped incision. The head is entered through an intermastoid incision. All organs are within their usual anatomic positions and relationships without abnormal fluid accumulation. NECK ORGANS: The anterior muscles of the neck show extensive postmortem animal activity. The cartilages of the larynx and epiglottis are intact. The hyoid bone is intact. The mucosal surfaces are tanlgray and smooth with extensive insect activity. The trachea and proximal bronchi contain abundant insect larvae. The tongue is absent. RESPIRATORY SYSTEM: The right lung weighs 450 g; the left lung weighs 315 g. The lungs are not hyperinflated. The pleural surfaces are dark redlpurple. Cut sections show diffuse dark red congestion. There is no fibrosis, or infiltrate. The pulmonary vasculature is intact and free of thromboemboli. CARDIOVASCULAR SYSTEM: The heart weighs 400 and appears nonnally formed. The pericardium is intact. There is no fibrosis or effusion. The epicardium is unremarkable without petechiae. The coronary arteries are normally configured with minimal atherosclerosis. On cut sections, the myocardium is brown without fibrosis or discoloration. The left ventricular free wall is 1.4 cm thick, the interventricular septum is 1.5 cm thick, and the right ventricular wall is 0.4 cm thick. There is no atrial or ventricular dilation, hypertrophy, or endocardial fibrosis. The valves of the heart and great vessels are unremarkable. The aorta is intact with minimal atherosclerosis. HEPATOBILIARY SYSTEM: The liver weighs 1450 g. The extemal surface is smooth with sharp margins and brown. Cut sections show soft brown tissue without fibrosis or cirrhosis. The biliary tracts are unremarkable with approximately 5 cc of bile in the gallbladder without stones. GASTROINTESTINAL SYSTEM: The--esophagus is unremarkable. 'The stomach contains approximately 20 cc of tan fluid. The gastric mucosa is tan with flattened rugal folds. There is no ulceration or hemorrhage. The duodenum and small and large intestines are unremarkable. The appendix is present. SYSTEM: The spleen weighs 125 g. The extemal surface is soft, gray/purple and wrinkled. Cut sections show unremarkable red pulp and unremarkable follicles. There is no GENITOURINARY SYSTEM: The right kidney weighs 125 g; the left kidney weighs 125 g. The extemal surfaces are smooth and redlbrown. Cut sections show unremarkable cortices and unremarkable medullae. The renal pelves, ureters and urinary bladder are unremarkable. The I II: I . 101'" ll-"ll I mucosa. The prostate is unremarkable externally and on sectioning 13-0814 WRIGHT, ALFRED PAGE 4 OF 4 ENDOCRINE SYSTEM: Examination of the pituitary, pancreas, thyroid and adrenal glands is unremarkable extemally and on sectioning. MUSCULOSKELETAL SYSTEM: The general musculature is brown with insect and animal activity noted as previously described. No fractures are identified. CENTRAL NERVOUS SYSTEM: The brain weighs 490 g. The scalp is without laceration or hematoma. Upon reflection of the scalp, there is no subgaleal hemorrhage. The calvarium and skull base are intact. Upon entering the cranial cavity, there is no epidural, subdural or subarachnoid hemorrhage. Extensive insect activity is noted with abundant larvae. The remaining cerebral tissue is friable with loss of architectural landmarks. The vessels at the base of the brain are unremarkable. The cervical spinal cord, viewed in the foramen magnum, and internal palpation of the neck is unremarkable. X-RAY EXAMINATION: Postmortem radiographs reveal no skeletal fractures or foreign objects. ADDITIONAL STUDIES AND PROCEDURES: 1. SAMPLES SUBMITTED FOR TOXICOLOGY: Samples of central blood and urine are submitted for analysis. Samples of kidney, liver, and bile are held for future testing as needed. Samples will be held for a period of one year from date of autopsy. Tissue samples are placed in a formalin stock bottle. Tissue samples will be held for a period of five years from date of autopsy. Documentation photographs are obtained. Fingerprints are obtained. Pulled head hair samples are obtained. Blood card standards are obtained. The subject's clothing is submitted to the Texas Rangers. TOXICOLOGY RESULTS: Toxicology testing is positive for cocaine and metabolites, within lethal range, as well as methamphetamine, amphetamine, nicotine metabolites and alprazolam. Please see toxicology report for full details. SUMMARY OF CASEIOPINION: Circumstances and history are reviewed above. Toxicology opinion, the cause of death of this 28 year old Black male, Alfred Wright, is due to combined drug intoxication. The manner of death is accident gm W. Ralston, MD. Date hief Forensic Pathologist . - -.- . . --. . NMS Labs CONFIDENTIAL 3701 Welsh Road, PO Box 433A, Vlfillow Grove. PA 19090-0437 Phone: (215) 657-4900 Fax: (215) 657-2972 A 5 e-mail: nms@nmslabs.com RobertA. Middleberg. DABFT. DABCC-TC, Laboratory Director Toxicology Report Patient Name WRIGHT, ALFRED Patient ID 13-0814 Report Issued 01/07/2014 11.00 I chain 11680489 Last Report Issued 12/17/2013 13.54 Age 28 Gender Male To: 10240 Forensic Medical Management Services - 1'33" 5 5" 5030 Highway 69 South. Ste.700 Page 1 of 7 Beaumont, TX 77705 Positive Findings: Compound Result Unit; Mggrix Benzoylecgonine Positive ng/ml. Cardiac Blood Ecgonine Methyl Ester 530 ng/mL Cardiac Blood Ethanol 36 mg/dL Cardiac Blood Blood Alcohol Concentration (BAC) 0.036 g/100 mL Cardiac Blood Acetone 6.5 mgIdL cardiac Blood cotinine Positive ng/ml. Cardiac Blood Alprazolam 36 ng/mL Cardiac Blood Benzoylocgonine 1800 ng/mL Cardiac Blood Amphetamine 30 ng/mL Cardiac Blood 140 ng/mL Cardiac Blood Cocaine 2700 ngImL Urine Benzoylecgonine 000O ng/m_L Urine See Detailed Findings section for additional information Testing Requested: Analysis Code Description 1300U Cocaine and Metabolites, Urine Cocaine and Products Panel Blood 7757SA Special Request: Fonnic Acid in blood 8052B Postmortem Toxicology -- Expanded, Blood (Forensic) 8756B Bath Salts and Stimulants Designer Drugs -- Expanded, Blood 9560B Cannabinoids Screen, Blood (Forensic) Tests Not Performed: Part or all of the requested testing was unable to be performed. Refer to the Analysis Summary and Reporting Limits section for details. Specimens Received: ID Tube/Container Volume! Collection Matrix Source Miscellaneous Mass Date/Time Information 001 Gray Top Tube 9 mL 11/26/2013 15145 Cardiac Blood 002 Gray Top Tube 9 mL 11/26/2013 15:45 Cardiac Blood 003 Red Top Tube 8.6 mL 11/26/2013 15:45 Urine v.10 CONFIDENTIAL Workorder 1 3294894 Chain 11680489 Patient lD 13-0814 LABS Page 2 of 7 ID Tubelcontainer Volurnel Collection Matrix Source Miscellaneous Mass DateITlme information All sample volumeslweights are approximations. Specimens received on 12l05I2013. Detailed Findings: Rpt. Analysis and Comments Result Units Limit Specimen Source Analysis By Benzoylecgonine Positive ngImL 50 002 - Cardiac Blood Reconfirmed in tube -002 by Ecgonine Methyl Ester 530 ng/mL 20 002 - Cardiac Blood Special Request Finding(s) TNP 001 - Cardiac Blood [Depending on request} Ethanol 36 10 001 - Cardiac Blood Headspace GC Blood Alcohol 0.036 9/100 mi. 0.010 001 -- Cardiac Blood Headspace GC Concentration (BAC) Acetone 6.5 5.0 001 -- Cardiac Blood Headspace GC Colinine Positive ngImL 1000 001 - Cardiac Blood LCITOF-MS Alprazolam 36 ngImL 5.0 001 - Cardiac Blood Benzoylecgonine 1800 nglmi_ 50 001 - Cardiac Blood Ethanol Continned 10 001 -- Cardiac Blood Headspace GC Acetone Confirmed 5._0 001 - Cardiac Blood Headspace GC Amphetamine 30 ngImL 5.0 001 -- Cardiac Blood "Methamphetamine 140 5.0 001 -- Cardiac Blood Cocaine 2700 ngImL 200 003 - Urine Benzoylecgonine >50000 ngImL 150 003 - Urine Otller than the above examination of the specimen(s) submitted did not reveal any positive findings of toxicological significance by procedures outlined in the accompanying Analysis summary. 1. Acetone - Cardiac Blood: Acetone is a solvent used for chemicals, paints, etc. it is also a product of diabetic and fasting-induced ketoacidosis as well as a metabolite following isopropanol ingestion. in high concentrations. acetone can have CNS-depressing effects. include lethargy, ataxia, headadle, nausea and lightheadedness. Stupor and coma appear in severe cases. Acetone produced in the body as a result of uncontrolled diabetes can also be converted to isopropanol. Repoited normal endogenous acetone levels in blood are up to 3 Levels associated with diabetic or fasting ketoacidosis range from 10 - 70 mg/dl_. Alter exposure to 100 and 500 acetone for 2 hr, reported blood acetone concentrations peaked at 2 and 10 respectively. A blood level of 250 was reported in an individual who became lethargic following ingestion of acetone. 2. Alprazolam (Xanax(R)) - Cardiac Blood: Alprazolam is a DEA Schedule lV second-generation benzodiazepine, which is effective at very low doses. It shares the ions othr belaze ithanaement of anxie disorde and- rm relief of .ae assocra - - wl epresslve oms. roxya prazo am an active meta te oi alprazolam. Common CNS-depressant side effects of alprazolam include drowsiness and fatigue. For anxiety, daily doses of 0.8 to 4 mg are effective whereas for phobic and panic disorders, 6 to 9 mg daily is recommended. v.10 CONFIDENTIAL Workorder 13294894 5 Chain 11680489 Patient ID 13-0814 LABS Page 3 of 7 Reference Comments: Reported therapeutic plasma concentrations of alprazolam are proportional to dose given: 3 mg/day produced steady-state levels of 30 ng/mL; 6 mg/day, 60 and 9 mg/day, 100 in reported cases involving driving under the influence, alprazolam concentrations ranged from 8 - 640 L. Alcohol greatly enhances the activity of benzodiazepines. Reported blood concentrations of alprazolam in alprazolam-related fatalities ranged from 100 - 400 (mean, 200 In combination with other ce_ntral nervous system depressants such as ethyl alcohol, alprazolam can become toxic at low concentrations. 3. Amphetamine (Benzphetamine Metabolite) - Cardiac Blood: Amphetamine (Adderall, Dexedrine) is a Schedule ll phenethylamine CNS-stimulant. it is used therapeutically. in the treatment of narcolepsy and obesity and also in the treatment of hyperactivity in children. Amphetamine has a high potential for abuse. When used in therapy, initial doses should be small and increased gradually. in the treatment of narcolepsy, amphetamine is administered in daily divided doses of 5 to 60 mg. For obesity and children with attention deficits, usual dosage is 5 or 10 mg daily. Following a single oral dose of 10 mg amphetamine sulfate, a reported peak blood concentration of 40 was reached at 2 hr. Following a single 30 mg dose to adults, an average peak plasma level of 100 was reported at 2.5 hr. A steady-state blood level of 2000 - 3000 was reported in an addict who consumed approximately 1000 mg daily. Overdose with amphetamine can produce restlessness, hyperthermia, convulsions, hallucinations, respiratory andlor cardiac failure. Reported blood concentrations in amphetamine-related fatalities ranged from 500 - 41000 9000 Amphetamine is also a metabolite of methamphetamine, benzphetamine and selegiline. 4. Benzoylecgonine (Cocaine Degradation Product) - Cardiac Blood: Benzoylecgonine is an inactive metabolite and chemical breakdown product of cocaine. Cocaine is a DEA Schedule ll controlled central nervous stimulant drug. Effects following cocaine use can include euphoria, excitement, restlessness, risk taking, sleep disturbance, and aggression. Aperioci of mental and physical fatigue and somnolence follow the use of cocaine after me excitant-stimulantefiects wear off. Benzoylecgonine has a half-life of 6 to 10 hours. The average blood benzoylecgonine concentration in 906 impaired drivers was 1260 (range 5 - 17600 Benzoylecgonine blood concentrations in patients admitted to an emergency room for cocaine related medical complaints were 1280 (SD 1290 Benzoylecgonine concentrations in plasma following oral administration of 2 glday of cocaine over 6 days, averaged 4900 L. The average blood benzoylecgonine concentration in 37 cocaine related fatalities was 7900 (range 700 - 31000 5. Benzoylecgonine (Cocaine Degradation Product) - Urine: Benzoylecgoninejsan inactivemetabolite and chemicaLb1aakdown Schedule ll controlled central nervous stimulant drug. Effects following cocaine use can include euphoria, excitement, restlessness, risk taking, sleep disturbance and aggression. A period of mental and physical fatigue and somnolence follow the use of cocaine after the excltant-stimulant effects wear off. It has a half-life of 6 to 10 hours. 6. Cocaine - Urine: Cocaine is a DEA Schedule ll controlled central nervous stimulant drug. Effects following cocaine use can include euphoria, excitement, restlessness, risk taking. sleep disturbance, and aggression. A period of mental and physical fatigue and somnolence follow the use of cocaine alter the excitant-stimulant effects wear off. Cocaine is metabolized to the inactive compounds benzoyleogonine, eogonine methyl ester, and eogonine. Benzoylecgonine and eogonine methyl ester can form from cocaine breakdown after death and even after sample collection. (See also Benzoylecgonine). v.10 CONFIDENTIAL Workorder 13294894 5 Chain 11680489 Patient ID 13-0814 Page 4 of 7 Reference Comments: 7. Cotinine (Nicotine Metabolite) - Cardiac Blood: Cotinine is a metaboiite of nicotine and may be encountered in the fluids and tissues of an individual as a result of tobacco exposure. Anabasine is a natural product occurring in tobacco, but not in pharmaceutical nicotine and a separate test for anabasine in urine can be used to distinguish tobacco from pharmaceutical nicotine use. The reported qualitative result for this substance was based upon a singie analysis only. if confirmation testing is required please contact the laboratory. 8. Eogonine Methyl Ester (Cocaine Metabolite) -- Cardiac Blood: Eogonine methyl ester is formed enzymatically by plasma and liver cholinesterases, and is an inactive metaboiite. Eogonine methyl ester concentrations appear to be higher following oral administration than via other routes. 9. Ethanol (Ethyl Alcohol) - Cardiac Blood: Ethyl alcohol (ethanol, drinking alcohol) is a centrai nervous system depressant and can cause effects such as impaired judgment, reduced alertness and impaired muscular coordination. Ethanol can also be a product of decomposition or degradation of biological samples. The blood alcohol concentrations (BAC) can be expressed as a whole number with the units of or as a decimal number with units of 91100 mL which is equivalent to wlv. For example, a BAC of 85 equals 0.085 gl100 mL or 0.085% of ethanol. 10. Methamphetamine (_Benzphetamine Metaboiite) - Cardiac Blood: d~methamphetamine is a DEA schedule ll stimulant capable of causing hallucinations, aggressive behavior and irrational reactions. Chemically, there are two fonns (isomers) of methamphetamine: l- and methamphetamine. The l-isomer is used in non-prescription inhalers as a decongestant and has weak CNS- stimulatory activity. The d-isomer has been used therapeutically as an anorexigenic agent in the treatment of obesity and has potent CNS-, cardiac- and circulatory-stimulatory activity. Amphetamine and norephedrine are metaboiites of methamphetamine. d-methamphetamine is an abused substance because of its -stimulatory effects and is also addictive. A peak blood concentration of methamphetamine of 20 ng/mL was reported at 2.5 hr after an oral dosage of 12.5 mg. Blood levels of 200 - 600 have been reported in methamphetamine abusers who _exhibited violent and irrationai behavior. High doses of methamphetamine can also elicit restlessness, confusion, haliucinations, circulatory coilapse and convulsions. *In this case, the level of methamphetamine determined has not been differentiated according to its isomeric forms. Differentiation of the isomers of methamphetamine is available upon request Sample Comment; 001 PhysicianlPathologist Name: JOHN RALSTON, MD Unless altemate arrangements are made by you, the remainder of the submitted specimens will be discarded one (1) year from the date of this report; and generated data will be discarded five (5) years from the date the analyses were performed. Workorder 13294894 was electronically signed on 01/07/2014 10:19 by: Daniel S. D-ABFT Forensic Toxicologist v.10 CONFIDENTIAL Workorder 13294894 5 Chain 11680489 Patient ID 1 3-08-14 Page 5 of 7 Analysis Summary and Reporting Limits: Ail of the following tests were performed for this case. For each test, the compounds listed were included in the scope. Please refer to the Positive Findings section of the report for those compounds that were identified as being present. Aoode 1300U - Cocaine and Metaboiites, Urine -Analysis by Gas Chromatography/Mass Spectrometry (GCIMS) for. Comgound R91. Limit Commund Benzoyiecgonine 150 Cocaine 200 Cocaethylene 200 Acode 1303B -- Cocaineand Products Panel, Blood -- Cardiac Blood -Analysis by Gas ChromatographyIMass Spectrometry (GCIMS) for". Comgognd Rgt. Limit Compound Rot Limit Benzoyiecgonine 50 ng/mL Cocaine 20 Cocaethylene 20 Ecgonine Methyl Ester 20 Aoode 500123 - Benzodiazepines Confirmation, Blood (Forensic) - Cardiac Blood -Analysis by High Performance Liquid Mass Spectrometry fon Comggund Rgt. Limit Comgoung Rgt. Limit 7-Amino Clonazepam 5.0 Flurazepam 2.0 Aipha-Hydroxyalprazolam 5.0 5.0 ng/mL Alprazolam 5.0 Hydroxytriazolam 5.0 Chlordiazepoxide 20 ng/mL Lorazepam 5.0 ng/mL Clobazam 20 Midazolam 5.0 Clonazepam 2.0 Nordiazepam 20 ng/mL 5.0 Oxazepam 20 Diazepam 20 Temazepam 20 ngimL Estazolam 5.-0 Triazolam 2.0 Acode 500143 - Cocaine and Metabolites Confirmation. Blood (Forensic) - Cardiac Blood -Anaiysis by Gas Spectrometry (GCIMS) for: Benzoyleogonine 50 ng/mL Cocaine 20 Cocaethylene 20 Aoode 522503 -Alcohols and Acetone Confirmation, Blood (Forensic) - Cardiac Blood -Analysis by Headspace Gas Chromatography (GC) for Comgound Rgt. Limit Comggund Acetone 5.0 lsopropanol 5.0 Ethanol mg/dL Methanol 5.0 mg/dL Aoode 524093 -Amphetamines Confirmation, Blood (Forensic) -- Cardiac Blood -Anaiysis by High Performance Liquid Chromatography/Tandem Mass Spectrometry (LC-MSIMS) for: Co un Bgt. Limit Comgound Rgt. Limit ine Eu TllEPl'5'FflE 5.0 ngfiil. Ephedrine 5.0 Norpseudoephedrine 5.0 MBA 5.0 ng/mL Phendimetrazine 10 ng/mL MDEA 10 Phenmetrazine 5.0 v.10 CONFIDENTIAL Workorder 13294894 Chain 11680489 Patient ID '1 3--O814 A Page 6 of 7 Analysis Summary and Reporting Limits: Compound Rpj. Limit Comggund lgimit Phentermine 10 Pseudoephedrine 5.0 5.0 Acode 52411 - GC Confirmation Set 2, Blood (Forensic) -- Cardiac Blood --Analysis by Gas Chromatography (GC) fon Rpt. Limit Comgound Rpt. Limit Cyciobenzapnne 5.0 Orphenadrine 50 Desipramine 10 Promethazine 30 ng/mL 10 Protriptyline 10 Fluphenazine Overdose 20 Pyrilamine 30 ng/mL imipramine 10 Thiondazine 100 Meperidine 0.020 mcg/mL 10 Mesoridazine 100 ng/ml. Trimipramine 10 Normeperidine 0.010 mcg/mL Triproiidine 30 Acode - Special Request: Formic Acid in blood -- Cardiac Blood --Analysis by [Depending on request] for. Rpt. Limit Compound Limit Special Request Finding(s) NIA Testing Not Perfonned: Test was canceled due to [Sample Matrix Problem]. Acode 8052B - Postmortem Toxicology -- Expanded, Blood (Forensic) - Cardiac Blood --Analysis by Enzyme--Linked lmmunosorbent Assay (ELISA) for. Rpt. Limit Compougd Rgt. Limit Barbiturates 0.040 mcg/mL Salicylates 120 Cannabinoids 10 n_g/mi. -Analysis by Headspace Gas Chromatography (GC) fon Compound RQL Limit Commund Limit Acetone 5:0 mg/ciL lsopropanoi -- 5:0 Ethanol 10 mg/cit. Methanol 5.0 -Analysis by High Performance Liquid Chromatographyfiime of Flight-Mass Spectrometry for: The following is a general list of compound classes included in this screen. The detection of any specific analyte is concentration-dependent. Note, not all known analytes in each specified compound class are included. Some specific analytes outside these classes are also included. For a detaiied list of all analytes and reporting limits, please contact NMS Labs. Amphetamines, Anticcnvulsants, Antidepressants, Antihistamines, Agents, Benzodiazepines, CNS Stimuiants, Cocaine and Metabolites, Haliucinogens, Hypnosedatives, Hypoglycemics, Muscle Relaxants, Non Steroidal Anti-Inflammatory Agents. Opiates and Opioids. Acode 8756B - Bath Salts and Stimulants Designer Drugs - Expanded, Blood - Cardiac Blood -Anaiysisgby Performance Liquid of for: _C_gg1my;1gi_ Bgt. Limit Qflmund Rgt. Limit 2C-B 10 ng/mL 2C-E 10 2C-C 10 2C-H 10 LABS Comgound 2C-I 2C-P 2C-T-2 2C-T--7 3-FMC 4-MEC 7--Hydroxymitragynine Amphetamine BZP Buphedrone Butylone Cathinone DBZP DMAA DOB DOM Ethylone Flephedrone MBZP Compound A-796260 248 AM--2233 AM-694 JWH--01 8 JWH-018 5-chioropentyl JWH-01 9 JWH-022 JVVH-073 CONFIDENTIAL Analysis Summary and Reporting Limits: Limit ng/ng/mL 10 ng/mL Rgt. Limit 0.20 0.10 0.10 0.10 0.10 0.10 0.10 0.10 0.10 ng/mL 0.10 Workorder Chain Patient ID 1 3294894 11680489 13-0814 Page 7 of 7 Comgound MDA MDEA MDMA MDPV Mephedrone Methamphetamine Methcathinone Methedrone Methoxetamine Methylone Mitragynine Naphyrone 0--DesmethyitramadoI PMA Pentedrone Pentyione Phenazepam Pyrovalerone alpha-PVP Acode 9560B - Cannabinoids Screen, Blood (Forensic) - Cardiac Blood --Analysis by High Performance Liquid Mass Spectrometry (LC--MSIMS) for". Comgund JWH--O81 JWH-122 JWH-200 JWH-203 JWH-21 0 JWH-250 RCS-4 RCS--8 UR-144 XLR--11 Rgt. Limit ng/mL 2.0 10 ng/mL 10 ng/ml. 10 10 10 nglmi. 2.0 10 ng/mi. 10 10 10 2.0 10 ngImL Rgt. Limit 0.10 0.10 ng/mL 0.10 0.10 0.10 0.10 ng/mL 0.10 0.10 ng/mL 0.10 v.10