Table 4.
Summary of reported toxicology cases involving U-47700 and U-49900.
| Series/Case | U-Compound | Case Type | Brief History | Clinical Symptoms/Autopsy Findings | Drug Results (ng/mL unless Specified) | Reference |
|---|---|---|---|---|---|---|
| 1.1 | U-47700 | PM | 20 y/o M with hx of illicit drug use. Found with syringe still clutched in hand. | N/A | Peripheral Blood: U-47700 382, Amphetamine 12, caffeine | [25] |
| 1.2 | U-47700 | PM | 18 y/o M found unresponsive in bed. Had a hx of ADHD and illicit drug use. Paraphernalia was found on scene and presumptively identified to be butyrylfentanyl and U-47700. | N/A | Peripheral Blood: U-47700 17, EtOH 0.03 g/dL, butyrylfentanyl 26 Urine: carbamazepine, ibuprofen, iminostilbene, oxcarbazepine and suspected butyrylfentanyl Vitreous: EtOH 0.03 mg/dL |
[25] |
| 1.3 | U-47700 | PM | 39 y/o M found unresponsive by wife. A syringe was found on the floor. Individual had a hx of ordering supplements and designer drugs off the internet. | N/A | Femoral Blood: U-47700 217, Mephedrone 22, etizolam | [25] |
| 1.4 | U-47700 | PM | 25 y/o M with hx of poly-substance abuse. Decedent was recently released from a halfway house. White powder found at the scene chemically confirmed to be U-47700. | Evidence of pulmonary edema—on scene. | Peripheral blood: U-47700 334 | [25] |
| 1.5 | U-47700 | PM | 23 y/o M was found in the bathroom of a rehabilitation center with a ligature around his arm and a needle/syringe found on floor near decedent. A packet was found nearby containing a powdery substance labeled “U-47700”. | N/A | Peripheral blood: U-47700 252, Citalopram 43 Urine: cotinine, caffeine, nicotine, citalopram |
[25] |
| 1.6 | U-47700 | PM | 29 y/o M was complaining of a headache and collapsed suddenly. EMS was called and resuscitation was unsuccessful. | Cerebral and pulmonary edema. | Blood: U-47700 453 Urine: cannabinoids, mitragynine |
[25] |
| 1.7 | U-47700 | PM | 29 y/o M with a hx of drug abuse was released from a rehabilitation facility. Individual was found unresponsive with drug paraphernalia present: Rolled up 10-dollar bill and packets of white powders. | Evidence of pulmonary edema—on scene. | Peripheral blood: U-47700 242, THC-COOH 5.3 | [25] |
| 1.8 | U-47700 | PM | 26 y/o M with hx of illicit substance use was found deceased at home. Paraphernalia was found on scene including: 5 syringes, 3 blue glass dropper bottles with liquid, 15 diphenhydramine tablets, and etizolam and Benadryl® pills. | N/A | Blood: U-47700 103, Diphenhydramine 694 Urine: Diphenhydramine metabolites, 3-MeO-PCP Gastric Contents: Diphenhydramine and metabolites |
[25] |
| 1.9 | U-47700 | PM | 21 y/o M with hx of drug abuse and convictions. Found with needle still penetrating injection site. | N/A | Aorta Blood: U-47700 299, tramadol < 250, alprazolam 47, lorazepam 11, 3-MeO-PCP 180 Urine: alprazolam, amphetamine, tramadol |
[25] |
| 1.10 | U-47700 | PM | 32 y/o M was found deceased sitting in a chair. | N/A | Aorta Blood: U-47700 311, Oxycodone 11, venlafaxine 2600, O-desmethylvenlafaxine 380 Liver: Venlafaxine 7.5 mg/kg, O-Desmethylvenlafaxine 0.87 mg/kg |
[25] |
| 1.11 | U-47700 | PM | 24 y/o M was reported to be using U-47700 that was obtained over the internet. | N/A | Aorta Blood: U-47700 487, etizolam 86, chlorpheniramine < 250, diphenhydramine 250 | [25] |
| 1.12 | U-47700 | PM | 24 y/o M with a hx of substance abuse was found unresponsive. | N/A | Aorta Blood: U-47700 59, 4-ANPP, quinine, furanylfentanyl | [25] |
| 1.13 | U-47700 | PM | 36 y/o M was found unresponsive in a bathroom with a syringe cap in his mouth. | N/A | Aorta Blood: U-47700 135, furanylfentanyl 26, EtOH, 4-ANPP, and quinine | [25] |
| 1.14 | U-47700 | PM | 33 y/o M with hx of cocaine and heroin use. | N/A | Aorta Blood: U-47700 167, furanylfentanyl 56, morphine 48, 4-ANPP, 6-MAM, and quinine | [25] |
| 1.15 | U-47700 | PM | 29 y/o M found unresponsive of a suspected heroin overdose. | N/A | Aorta Blood: U-47700 490, furanylfentanyl 76, 4-ANPP and quinine | [25] |
| 1.16 | U-47700 | PM | 40 y/o M with hx of heroin/opioid abuse. | N/A | Aorta Blood: U-47700 105, furanylfentanyl 2.5, 4-ANPP and quinine | [25] |
| 2.1 | U-47700 | PM | 27 y/o M was found dead at home. It was believed that the individual snorted mirtazapine (prescribed) and had a hx of use of cannabis, ketamine, MCAT, and “legal highs”. | No natural disease or cause of death was found. | Femoral blood: U-47700 1460, quetiapine < 50 Amphetamine < 100 Naproxen < 0.8 mg/L Urine: quetiapine, amphetamine, amitriptyline, mexedrone, ketamine |
[91] |
| 3.1 | U-47700 | PM | 30 y/o M found deceased in his home after inhaling fumes of a powder burned on aluminum foil. A recently delivered envelope from China containing 36 g of a white powder, a digital scale and a spoon were also found in the room. Individual did have a hx of drug abuse and experimenting with drugs purchased over the internet. Powder found on scene was determined to be fentanyl and U-47700. | No injection sites or traumatic injuries were found Pulmonary edema observed Only external body examination was ordered. |
Subclavian blood: U-47700 13.8, fentanyl 10.9, sertraline 180 Urine: U-47700 71 |
[92] |
| 4.1 | U-47700 | PM | 46 y/o M had a hx of ingesting substances he purchased through the mail. Individual had ingested the substance previously and passed out on the floor but was able to be awaken with no need for medical assistance. Individual was then found unresponsive the next morning in his bedroom. EMS was called and the individual was declared deceased on scene. An envelope labeled “U-47700” and a straw were found in the bedroom. The compound was obtained through the mail 3 days prior to incident. | No needle puncture sites identified Enlarged heart (570 g) with Dilation of the right ventricle Lungs were mildly edematous and congested (right 500 g, left 640 g)–microscopically lungs showed edema, congestion and expanded alveoli with terminal clubbing of septa Liver and spleen were enlarged (2310 and 300 g, respectively). |
Peripheral Blood: U-47700 190, alprazolam 120, nordiazepam < 50, doxylamine 300, diphenhydramine 140, ibuprofen 2.4 mg/L, salicylic acid < 20 mg/L and THC-COOH 2.4 Central Blood: U-47700 340 Liver: U-47700 1700 ng/g Vitreous: U-47700 170 Urine: U-47700 360 Gastric Contents: U-47700 < 1 mg |
[80] |
| 5.1 | U-47700 | PM | Individual found dead in bed. | Cerebral/lung edema. | Femoral Blood: U-47700 525, diphenidine ~1.7, methoxphenidine ~26, ibuprofen 1.8 mcg/mL, naloxone 1.9 Heart Blood: U-47700 1347 Urine: U-47700 1393 Kidney: U-47700 2.7 ng/mg Liver: U-47700 4.3 ng/mg Lung: U-47700 3.2 ng/mg Brain: U-47700 0.97 ng/mg |
[93] |
| 5.2 | U-47700 | PM | Individual found dead in bed. | Cerebral/lung edema. | Femoral Blood: U-47700 819, diphenhydramine 45, methylphenidate 2.5 Heart Blood: U-47700 1043 Urine: U-47700 1848 Kidney: U-47700 1.4 ng/mg Liver: U-47700 3.1 ng/mg Lung: U-47700 2.4 ng/mg Brain: U-47700 1.1 ng/mg |
[93] |
| 6.1 | U-47700 | PM | A 28 y/o M was found deceased at home with dried froth on his mouth and nose. Several plastic baggies labeled as “U-47700”, “etizolam”, “butyrylfentanyl” and “4-2CO-MET” were found in the room with other drug paraphernalia. | Pulmonary edema, hypertensive-type cardiomegaly, and chronic active hepatitis with steatosis. | Femoral Blood: U-47700 189, oxycodone 67, dextro/levomethorphan 17 |
[94] |
| 6.2 | U-47700 | PM | An 18 y/o M was found deceased on his bedroom floor. He had bloody fluid emanating from his nose. Baggies labeled as “U-47700” and “etizolam” were found at the scene with other drug paraphernalia. | Pulmonary edema, cerebral edema, asthma, and focal subgaleal hemorrhage consistent with a terminal fall. | Femoral Blood: U-47700 547, etizolam | [94] |
| 7.1 | U-47700 | PM | 34 y/o M with history of Illicit drug use, as well as depression and bipolar disorder, found unresponsive in a bathroom. Drug paraphernalia, including needles and an empty plastic bag labeled “3-FPM”, were located near the decedent. |
Pulmonary edema and congestion. | Femoral blood: U-47700 360, 3-fluorophenmetrazine 2400, amitriptyline 440, nortriptyline 290 methamphetamine < 40, amphetamine 70, diazepam 200, nordiazepam 180, temazepam 11, flubromazolam, delorazepam |
[95] |
| 8.1 | U-47700 | PM | 51 y/o M was found unresponsive in a hotel bathroom. Paraphernalia was found on scene: a spoon, white powder and a syringe. | Brain swelling (1570 g), lung hyperhydration (right lung 905 g and left lung 665 g) and hyperemia of the inner organs (heart 375 g, spleen 185 g, liver 1635 g, right kidney 145 g, left kidney 210 g). Injections site were observed on the right and white crumbs in the gastric contents. | Femoral Blood: U-47700 290, oxycodone 50, noroxycodone 40 Heart Blood: U-47700 1290 Liver: U-47700 9.9 ug/g Urine: U-47700 240 Gastric Contents: U-47700 570 Bile Fluid: U-47700 2300 Cerebrospinal fluid: U-47700 400 Hair: U-47700 0.14 ng/mg |
[96] |
| 9.1 | U-47700 | PM | A 26 y/o M with history of illicit drug use found deceased in his bedroom. A foam cone was noted. A box containing drug paraphernalia was located at the scene. | Moderate congested and edematous lungs and urine retention. | Femoral blood: U-47700 400 Heart blood: U-47700 260 Vitreous Fluid: 90 Brain: U-47700 0.38 ng/mg Liver: U-47700 0.28 Urine: U-47700 4600 |
[26] |
| 10.1 | U-47700 | PM | A 28 y/o M with history of illicit drug use was found deceased at home. Decedent was known to use methamphetamine and had told a friend at times he took a “benzo” believed to be etizolam. | N/A | Peripheral blood: U-47700 330, Diclazepam 70, flubromazepam 10, methamphetamine 290, amphetamine 150, DOC | [97] |
| 11.1 | U-47700 | PM | A 63 y/o M with a history of drug abuse was found deceased at home by girlfriend. | Autopsy findings included cirrhosis, arterionephrosclerosis, intact artificial aortic and mitral values, pleural and pericardial adhesions, and cardiomegaly with left ventricular hypertrophy. | Peripheral blood: U-47700 24, Cyclopropylfentanyl 31.5, EtOH 0.025 g/dL, cocaine 25, BZE 58 | [98] |
| 11.2 | U-47700 | PM | A 57 y/o M with a history of drug abuse became unresponsive in a vehicle. The decedent was transferred to a hospital via EMS but pronounced dead on arrival. | Autopsy findings included pulmonary edema. | Postmortem blood: U-47700 7.8, Cyclopropylfentanyl 18.5 cocaine 130, BZE 910, fentanyl 6.2, norfentanyl 5.5 |
[98] |
| 12.1 | U-47700 | PM | The M decedent, who had a history of drug addiction, was found deceased in his apartment. Two amber glass bottles of nasal spray containing a transparent liquid and a plastic bag containing a white powder were located at the scene, in addition naloxone. | General pulmonary edema noted at autopsy. | Blood: U-47700 380 Urine: U-47700 10400 |
[78] |
| 13.1 | U-47700 | PM | A 24 y/o M suffered apnea after the consumption of U-47700 and flubromazepam. After hospital admission, hypoxic cerebral damage and severe brain edema were stated. After six days in the hospital, mechanical ventilation was discontinued. | N/A | Admission Serum: U-47700 370, Flubromazepam 830, hydroxyflubromazepam 160, pregabalin 1.7 mcg/mL Serum + 9 hrs: U-47700 37, Flubromazepam 370, hydroxyflubromazepam 87 pregabalin 1.3 mcg/mL Serum + 24 hrs: U-47700 6.3, Flubromazepam 530, hydroxyflubromazepam 120 pregabalin 0.29 mcg/mL |
[48] |
| 14.1 | U-47700 | PM | A 19 y/o M was found deceased at home. Paroxetine tablets were located at the scene. | Autopsy findings were not specific. | Peripheral Blood: U-47700 3040, acetaminophen 700 oxazepam 30, dextromethorphan 20, paroxetine 170, alpha-PHP |
[46] |
| 15.1 | U-47700 | Intoxication | 29 y/o M found unresponsive after intravenous injection of U-47700. Regained consciousness before being transferred to the ED. Individual admitted to purchasing U-47700 and phenazepam over the dark net, and the phenazepam was ingested a few days prior to the ED visit. | At ED: no complaints other than feeling thirst BP 157/105 mmHg HR 112 bpm Creatinine 1.4 mg/dL Was discharged after 3 h. |
Serum: U-47700 240, phenazepam 1400 Urine: U-47700 Positive, phenazepam |
[99] |
| 16.1 | U-47700 | Intoxication | 28 y/o M found unconscious in the driver seat of a vehicle. A needle was observed in the individual’s lap and a further search of the car yielded two clear plastic baggies. Individual was then transported to the ED and eventually released. A blood sample was provided over 2 h after the incident. | Field sobriety tests and DRE evaluations were not performed due to individual being unconscious. | Antemortem Blood: U-47700 (>100 pg/mL), alprazolam 55, fentanyl < 0.5, carfentanil, furanylfentanyl, para-fluoroisobutyrylfentanyl, N-desmethyl U-47700 | [100] |
| 17.1 | U-47700 | Intoxication | A 23 y/o F presented to the ED after insufflating and injecting “U4”. She was cyanotic with respiratory depression and responded to naloxone in the field. | N/A | Serum: U-47700 394 Urine: U-47700 228 |
[101] |
| 18.1 | U-47700 | Intoxication | A 41 yr old woman who presented to the ED with pinpoint pupils, respiratory depression, and depressed consciousness after consuming three pills of street purchased “Norco”. | N/A | Serum: U-47700 7.6, fentanyl 15.2, acetaminophen 10 mg/L, BZE 46, gabapentin 350, hydrocodone 107, sertraline 15 |
[102] |
| 19.1 | U-47700 | Intoxication | A M in his 30s was found unresponsive in his residence and was transported to the ED in a comatose state with severe respiratory depression. U-47700 was chemically identified in a white powder found at the scene. | N/A | Admission blood: U-47700 94 Blood + 24 hrs: U-47700 3.0 Admission Urine: U-47700 5.2 Urine + 24 hrs: U-47700 5.4 Pubic hair: U-47700 3.02 ng/mg |
[51] |
| 20.1 | U-47700 | Intoxication | A 28 y/o M was found unresponsive by roommate after ingesting “Norco” he had purchased from a drug dealer. When EMS arrived, he was cyanotic with respiratory depression and did not respond to naloxone. | At ED, patient had systolic blood pressure of 95 mmHg, diastolic blood pressure of 70, oxygen saturation of 84%, and respiration rate of 10 breaths/min. Physical examination noted pinpoint pupils. | Serum: U-47700 18, acetaminophen < 10 mcg/mL Urine: U-47700 130 |
[103] |
| 21.1 | U-47700 | Intoxication | A 26 y/o M found unconscious at home. Individual was found with 3 bags containing white powder, with one labeled as MMB CHMINACA. | On scene: Depressed respiration noted, Score of 3 on the GCS ED: hemodynamically stable, bp 90/50 mmHg, pulse rate 50 bp/m, unconscious and required artificial ventilation for 12 h. Patient was discharged 40 h after admission. |
Serum: U-47700 351, U-47700-N,N-didesmethyl, U-47700-N-demethyl-hydroxy, U-47700-N,N-didesmethyl-hydroxy, THC 3.3, THC-COOH 121.6, clonazolam 6.8, citalopram < 5, midazolam < 10 Urine: U-47700, citalopram, midazolam, clonazolam, THC |
[52] |
| 22.1 | U-47700 | Intoxication | A 17 y/o M became apneic and unresponsive en route to school after insufflating a white substance he believed to be “crushed Xanax”. Naloxone was administered and the individual was transported to an ED with signs consistent with opioid toxidrome. | N/A | Blood: U-47700 282 | [104] |
| 23.1 | U-49900 | PM | A 31 y/o M was found vomiting and convulsing in his residence by a family member. The decedent has a history of schizophrenia, bipolar disorder, and illicit drug use. Emergency rescue personnel were called but resuscitation efforts were unsuccessful, despite use of naloxone. Drug paraphernalia was located on scene, including a needle and two baggies containing a suspected controlled substance; one baggie was marked as “THFF”. Chemical testing on the powder identified the presence a smaller amount of U-49900 in addition to the tetrahydrofuranylfentanyl. | Pulmonary congestion and edema, in addition to cerebral edema, noted at autopsy. | Postmortem blood: U-49900 1.5, Tetrahydrofuranylfentanyl 339, methoxyphencyclidine 1.0 | [105] |