Drug concentrations in post-mortem specimens

Area of Science:

• Forensic Toxicology
• Analytical Chemistry

Background:

• Accurate interpretation of post-mortem drug concentrations is crucial for forensic investigations.
• Femoral blood is a standard specimen, but its availability can be compromised in post-mortem cases.

Purpose of the Study:

• To systematically analyze drug concentrations across various post-mortem specimens.
• To establish reliable ratios of drug concentrations in different tissues relative to femoral blood.
• To provide a framework for selecting alternative biological specimens for toxicological analysis when femoral blood is absent.

Main Methods:

• Meta-analysis of 10,993 analytical results from 5,375 post-mortem cases across 388 studies.
• Inclusion of data from a laboratory's own database (2000-2018).
• Calculation of drug concentration ratios between various tissues (e.g., vitreous humor, liver, bile) and femoral blood.

Main Results:

• Significant variation in drug concentration ratios between post-mortem specimens and femoral blood, highly dependent on the specific compound.
• Vitreous humor, muscle, and other blood (e.g., cardiac blood) showed concentrations similar to femoral blood.
• Liver and bile generally exhibited the highest drug concentrations.

Conclusions:

• A ranked order of preferred biological specimens for quantitative toxicological analysis is proposed when femoral blood is unavailable: other blood, muscle, vitreous humor, brain, heart, spleen, kidney, liver, and bile.
• This data-driven approach aids toxicologists in interpreting drug levels from alternative specimens.
• The findings enhance the reliability of post-mortem drug analysis in challenging cases.