A 24-year-old woman presents to a Mumbai tertiary hospital reporting a suspected drug-facilitated sexual assault from the previous night. The standard DFC kit is collected within the 24-hour window. The case is referred to the state FSL toxicology unit for benzodiazepine and Z-drug confirmation.
The bench runs the urine through mixed-mode cation-exchange SPE, with d5-alprazolam spiked at 10 ng/mL into 1 mL of urine before extraction. The extract is reconstituted in 200 microlitres and injected on an Agilent 6470 LC-MS/MS triple-quad. The method is a 6-minute methanol-water gradient with 0.1 percent formic acid on a C18 column at 0.4 mL/min.
The MRM monitors alprazolam at 309 to 281 (quantifier, 28 eV) and 309 to 205 (qualifier, 38 eV), with d5-alprazolam at 314 to 286 (28 eV). Dwell 30 ms per transition, scheduled to a 1-minute window centred on retention time 4.2 minutes.
The calibration is built at 0.5, 1, 2, 5, 10, 25 and 50 ng/mL alprazolam in matrix-matched blank urine, each spiked with 10 ng/mL d5-alprazolam. The analyte/IS ratio versus concentration line gives R-squared of 0.9996. LOD is 0.1 ng/mL and LOQ is 0.5 ng/mL.
The case sample reads at 12 ng/mL alprazolam. Retention time 4.18 minutes (within 1 percent of the standard). Quantifier-to-qualifier ratio 100 to 78 against a reference ratio of 100 to 75 (within tolerance). The d5-alprazolam IS area is 92 percent of the calibrator IS area, indicating modest matrix suppression the IS correction handles. The Cerilliant alprazolam CRM run with the batch reads 9.7 ng/mL against a certified 10.0 ng/mL.
The certificate issued under BSA 2023 Section 63 reports alprazolam at 12 plus or minus 1.5 ng/mL in urine, with the method, both transitions, the d5-alprazolam IS, retention time, ratio with tolerance, R-squared, LOD, LOQ, the CRM result and the relevant clinical context (a single 0.5 mg therapeutic dose produces urine concentrations of 5 to 50 ng/mL at 12 to 24 hours post-ingestion). The result is consistent with covert administration in the time window before the alleged assault.
The instructive point is that no single number on its own carries the case. Two transitions, the IS, the retention time, the ratio, the CRM and the calibration line together make the 12 ng/mL court-defensible. Drop any leg and the report falls back to a screening result.