Illicit fentanyl occurrence in Los Angeles, California has increased along with the emergence of several fentanyl analogues (fentalogs). The following two case studies address the original identification of cyclopropyl fentanyl in cases investigated by the Los Angeles County Department of Medical Examiner-Coroner in the summer of 2017. In the first case study, cyclopropyl fentanyl was the only drug detected in the decedent's system and was also identified in medical evidence collected at the death scene. Medical evidence is classified as any medical device, prescription(s), drug(s) and/or paraphernalia collected by the Los Angeles Medical Examiner-Coroner. The decedent in the second case study had multiple drugs present in combination with 14 ng/mL of cyclopropyl fentanyl. However, cyclopropyl fentanyl was not identified in any of the collected medical evidence. Both deaths were classified as Accidental due to Effects of cyclopropyl fentanyl (and/or other drugs). Due to limitations in screening methodology, it is possible to overlook fentalogs. Therefore, it is important to be hyper vigilant when assessing negative toxicology results or when many other drugs are also found. Maintaining adequate and up-to-date library databases, along with constant drug monitoring, and validation of new methodologies can help identify Novel Psychoactive Substances (NPS) as they emerge. However, many of the fentalogs are only prevalent for a short amount of time as they are constantly changing to avoid detection and criminality. No other fatal cyclopropyl fentanyl cases have been identified in Los Angeles County Medical Examiner-Coroner cases since the fall 2017.

中文翻译：

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洛杉矶的两个环丙基芬太尼案例研究。

随着几种芬太尼类似物的出现，非法的芬太尼在加利福尼亚州洛杉矶的出现有所增加。以下两个案例研究解决了洛杉矶县医学检验师-Coroner在2017年夏天调查的案例中环丙基芬太尼的原始标识。在第一个案例研究中，环丙基芬太尼是死者系统中唯一检测到的药物，在死亡现场收集的医学证据中也发现了该病。医学证据被分类为由Los Angeles Medical Examiner-Coroner收集的任何医疗器械，处方，药物和/或用具。第二个案例研究中的死者有多种药物与14 ng / mL的环丙基芬太尼组合使用。然而，在任何收集的医学证据中均未鉴定出环丙基芬太尼。由于环丙基芬太尼（和/或其他药物）的影响，这两例死亡均被归为意外死亡。由于筛选方法的局限性，有可能会忽略fentalog。因此，在评估毒理学阴性结果或同时发现许多其他药物时，务必保持高度警惕。保持足够的和最新的图书馆数据库，以及持续的药物监测和新方法的验证，可以帮助识别出现的新型精神活性物质（NPS）。但是，许多通俗小说只在很短的时间内流行，因为它们不断变化以避免被发现和犯罪。