Was it poisoning?

Area of Science:

• Forensic Toxicology
• Analytical Chemistry
• Pathology

Background:

• Post-mortem toxicology aids in determining the role of drugs or poisons in deaths.
• Accurate toxicological analysis is crucial when the cause of death is not immediately apparent.

Purpose of the Study:

• To outline best practices for post-mortem toxicology sampling and interpretation.
• To highlight potential challenges and considerations in analyzing post-mortem samples.

Main Methods:

• Collecting blood samples before autopsy to minimize contamination.
• Analyzing various specimens including blood, stomach contents, urine, liver, and vitreous humor.
• Considering clinical pharmacology, pharmacokinetics, and exposure circumstances during interpretation.

Main Results:

• Post-mortem changes in body fluid composition can affect drug concentrations, especially for centrally-acting drugs.
• Prompt body refrigeration and rapid autopsy can minimize post-mortem alterations.
• Quantitative results alone can be misleading, particularly for drugs like opioids and clozapine.

Conclusions:

• Interpretation requires a holistic approach, integrating analytical data with clinical and circumstantial information.
• Improved training in analytical toxicology is needed for forensic professionals.
• Focus should be on identifying poisoning or overdose, rather than solely on 'fatal levels'.