An accidental death related to cocaine, cocaethylene, and caffeine.

Cocaethylene is often found in body fluids after concurrent use of alcohol and cocaine. Current research is showing that cocaethylene is more toxic than cocaine. The case presented here involves a death that is due to cocaine, cocaethylene, and caffeine. The cocaethylene concentrations found were 0.16 mg/L (blood) and 1.85 mg/L (gastric). Caffeine concentrations were 16.40 mg/L (blood) and 15.40 mg/L (gastric). Cocaine was found only in the gastric sample at a level of 0.45 mg/L. The blood alcohol of the subject was 10 mg/dL. From the case investigation it was determined that the death was accidental but related to the ingestion of cocaine and caffeine tablets. With the combination of alcohol and cocaine use rising, it is becoming evident that the routine screening of medical examiner cases for cocaethylene should be performed.