Pitfalls in forensic toxicology

Abstract

This article was prepared under the auspices of the Analytical Investigations Standing Committee of the Scienti®c Committee of the Association of Clinical Biochemists.

Postmortem toxicology

“…For example, even without restoration of the heart action during resuscitation, high concentrations of lidocaine may be present in the left side of the heart as intubation-related lidocaine may be absorbed by the trachea during cardiac massage. Interpretative problems involving alcohol and drug findings may also arise from lengthy treatment with intravenous fluids, from devices which automatically deliver medication by the parenteral route, or from transdermal patches that have been left on the body [10]. All these factors may affect drug concentrations in the body after death.…”

“…Tables of drug levels determined from plasma or serum previously reported in therapeutic or toxic conditions can serve as a reference point. But only after weighing all possible influences and-if availablereferring to postmortem values established from femoral blood samples can postmortem results be reliably interpreted [5,8,10]. Many drugs also do not evenly distribute between the cellular and fluid constituents of blood.…”

Determination of Biological Sample and Analytical Method in Forensic Toxicology Analysis

“…(1) genel tarama testleri (6,12,13,25). Valide edilmeyen yöntemlerle çalışıl-ması durumunda düşük kalitede kantitatif sonuçların elde edilmesi de olası bir risktir.…”

Editorial: Key Role of the Rational Laboratory Strategy in Diagnostic, Analytical and Forensic Toxicology

“…In Analytical Toxicology the limiting step is the "time", while in Forensic toxicology it is crucial to achieve incontestable laboratory data, and in this setting it is also crucial to define properly what Quality of Toxicological results [1][2][3][4].…”

“…The medical examiner and the forensic toxicologist should be aware that Clinical Pharmacology assumptions could be largely invalid in post mortem, because a lot of conditions as tissue distribution of xenobiotics, post mortem changes (i.e. putrefaction) and pH variations can affect most sophisticated results too [2][3][4][5]. The relationship between concentrations measured before and after death challenges the importance of quantitative analyses, for these reasons any deduction from post mortem concentration should be critically checked.…”