Death Due to Apparent Intravenous Injection of Tapentadol

This case report describes a 34‐year‐old male who died as the result of tapentadol toxicity. This case apparently represents the first reported description of a death because of this drug. The toxicologic features of this case, namely concentrations of tapentadol in the femoral blood and heart blood, 1.05 and 3.20 mg/L, respectively, may assist other individuals in evaluating deaths where tapentadol concentration is a factor. Analysis of the blood based upon enzyme‐linked immunosorbent assays, liquid chromatography–mass spectrometry, and gas chromatography–mass spectrometry revealed no other substance of significance, only nicotine and cotinine, and the autopsy findings were consistent with an opiate‐type drug overdose, and indicated no competing cause of death.