Investigation Of Circumstances Of Poisoning

Frequently, medical examiner investigators or police detectives can use directed interview questions to elicit information

Table 2-2

Investigative Information Useful for Suspected Poisoning Casesa

Date deceased was last known to be in good health

Date and time last known to be alive

Date admitted to hospital

Date and time pronounced dead in hospital, or

Date and time found dead

Date, time, and content of last meal

Prescribed drugs (append medication record if indicated)

Known drugs of abuse

Suspected drug of ingestion

Symptoms: nausea, vomiting, diarrhea, constipation, thirst, loss of weight, jaundice, blindness, cyanosis, shivering, hallucinations, convulsions, pupillary dilatation or contraction, delirium, drunkenness, sweating, unconsciousness a Adapted with permission from ref. (19).

Fig. 2-1. Average time of death after ingestion or inhalation of fatal dose of poison. Solid regions indicate interval in which most deaths occur. Shaded regions indicate intervals in which death occurs occasionally but less commonly. Adapted with permission from ref. (21).

that is helpful to further a toxicologic investigation, once poisoning is suspected (see Table 2-2). Of particular interest is the time interval between the alleged intake of the poison and the death of the decedent (20). Figure 2-1 shows that this time interval may be too long or too short to make death from a specific poison likely.

CONTAINERS To prevent contamination of specimens by cleaning or embalming agents, previously unused polyethylene or glass containers are preferable in most situations. With time, highly volatile compounds such as the accelerants used by arsonists will diffuse through polyethylene and escape the container. Glass containers are susceptible to breakage during transport. If glass containers are to be used, they must be washed with dichromate. Dichromate can activate the glass surface and cause adsorptive loss or low concentrations of drugs and metabolites. In the laboratory, this type of adsorptive loss is reduced by silyzation, silanization, or siliconization of the glassware prior to use. The pathologist should always be present if a funeral director obtains tissues for toxicologic study.

The label for each specimen container should state the date the material was secured, the name of the decedent, the case number, and the name of the organ or liquid sample. Samples added to containers with preservatives should be inverted several times to disperse the preservative through the sample. Samples should be kept refrigerated before and during transport to the toxicology laboratory. After analysis, deep-freeze storage is preferable to refrigeration. In the future, weighing and freeze-drying may permit storage of specimens at room temperature.

Constipation Prescription

Constipation Prescription

Did you ever think feeling angry and irritable could be a symptom of constipation? A horrible fullness and pressing sharp pains against the bladders can’t help but affect your mood. Sometimes you just want everyone to leave you alone and sleep to escape the pain. It is virtually impossible to be constipated and keep a sunny disposition. Follow the steps in this guide to alleviate constipation and lead a happier healthy life.

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