Annals of Emergency Medicine
Volume 52, Issue 5 , Pages 548-553, November 2008

A Descriptive Study of an Outbreak of Clenbuterol-Containing Heroin

  • Robert S. Hoffman, MD

      Affiliations

    • New York City Poison Center, New York University School of Medicine, New York, NY
    • Corresponding Author InformationAddress for correspondence: Robert S. Hoffman, MD, 455 First Avenue, Room 123, New York, NY, 10016; 212-447-8153, fax 212-447-8223
    • ,
  • Barbara M. Kirrane, MD

      Affiliations

    • Department of Surgery, Section of Emergency Medicine, Yale School of Medicine, New Haven, CT
    • ,
  • Steven M. Marcus, MD

      Affiliations

    • New Jersey Poison Information and Education System, New Jersey Medical School of University of Medicine and Dentistry of New Jersey, Newark, NJ
    • ,
  • Clenbuterol Study Investigators

      Affiliations

    • All members are listed in the Appendix.

Received 10 November 2007; received in revised form 29 February 2008 and 16 March 2008; accepted 22 April 2008. published online 27 May 2008.

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 Funding and support: By Annals policy, all authors are required to disclose any and all commercial, financial, and other relationships in any way related to the subject of this article that might create any potential conflict of interest. The authors have stated that no such relationships exist. See the Manuscript Submission Agreement in this issue for examples of specific conflicts covered by this statement.

 Supervising editor: Richard C. Dart, MD, PhD

 Author contributions: RSH helped define case criteria, coordinated case collection, and coordinated the editing of revisions. BMK collected, stored, and analyzed all clinical data. RSH and BMK drafted the article. RSH, SM, GMC, MF, BYG, IH, SHE, KJ-A, CM, LSN, WHR, RB, ES, and AFT provided clinical care. SM identified the outbreak, coordinated with law enforcement. SM, KB, GMC, MF, BYG, IH, SEH, KJ-A, CM, LSN, RHP, WHR, RB, ES, MS, and AFT reviewed the article. SM and KB defined the original case definitions. KB aided with specimen analysis. KB, GMC, MF, BYG, IH, SEH, KJ-A, CM, LSN, RHP, WHR, RB, ES, MS, and AFT edited the article. GMC, MF, BYG, IH, SEH, KJ-A, CM, LSN, WHR, RB, ES, and AFT collected patient data. RHP analyzed the first clinical specimen, provided confirmation of select clinical specimens, provided veterinary background, and helped develop the method for subsequent analysis. MS developed a methodology to provide mass screening of biological specimens for clenbuterol, consulted on all forensic analyses, and provided the majority of laboratory confirmations. RSH takes responsibility for the paper as a whole.

 Reprints not available from the authors.

 Publication date: Available online May 23, 2008.

PII: S0196-0644(08)00729-4

doi:10.1016/j.annemergmed.2008.04.026

Annals of Emergency Medicine
Volume 52, Issue 5 , Pages 548-553, November 2008

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