Combining LC-MS/MS Product-Ion Scan Technology with GC-MS Analysis to Identify Drugs and Poisons in Postmortem Fluids and Tissues, Florida, 2019-2022

The Miami-Dade County Medical Examiner Department (MDME) successfully conducted preliminary studies that evaluated the effectiveness of fast scanning liquid chromatography-tandem mass spectrometry (LC/MS/MS) which created a detailed merged-product ion scan spectra with library search capabilities to identify substances more accurately. The project intent was to establish its effectiveness in replacing more traditional immunoassay testing procedures that are costly, of limited scope, non-specific, and can only provide presumptive results. The goal was to develop a superior screening protocol that combines fast scanning LC/MS/MS technology with the currently utilized gas chromatography mass spectrometry (GC/MS) screening technique. By merging these two analytical tools, GC/MS and LC/MS/MS, a broader range of drugs can be identified more efficiently and at appropriate drug concentrations for postmortem analysis.