Putrefactive pleural effusions as an alternative sample for drug quantification

In the investigation of drug-related deaths it is occasionally necessary to examine putrefied bodies. In such cases the availability of conventional body fluids for toxicologic analysis is usually limited, whereas blood-stained pleural effusion is often present in adequate quantity in the pleural cavity. Fifty-five cases involving numerous drugs are presented in which pleural effusion drug concentrations are compared with corresponding blood or liver concentrations. More than 90% of comparisons produced coincident interpretations of the role that drugs played in the deaths. In most instances pleural effusion analysis was shown to be a valid alternative to the analysis of blood or other conventional fluids or tissues in cases exhibiting advanced putrefaction.