Chemical toxicology for the coroner

Area of Science:

• Forensic Toxicology
• Clinical Chemistry

Background:

• Toxicology analysis is crucial in determining cause of death in coroner's cases.
• Beaumont Hospital's supraregional unit analyzed cases from December 1987 to November 1988.

Purpose of the Study:

• To detail toxicology findings in 302 consecutive coroner-referred cases.
• To categorize findings based on clinical information and identify common substances involved.

Main Methods:

• Retrospective analysis of toxicology results from coroner's cases.
• Categorization into road traffic accidents, suicides, possible suicides, and possible carbon monoxide poisonings.
• Alcohol, drug screens, and carboxyhemoglobin (COHb) measurements were performed.

Main Results:

• Alcohol detected in 44% of cases; drug screens positive in 30%. Overall, 61.9% had at least one positive finding.
• In road traffic accident victims, 60.4% had alcohol, with a median level of 117 mg/dl.
• Suicide cases involved various agents including paraquat, cyanide, and amitriptyline; suspected suicides showed high rates of poly-substance use (45.4%).

Conclusions:

• Toxicology plays a significant role in coronial investigations, with frequent detection of alcohol and drugs.
• High alcohol levels were noted in road traffic fatalities, and poly-substance use was prevalent in suspected suicides.
• Further investigation into the role of substances in accidental and intentional deaths is warranted.