Consultor Pericial

Five Case Studies in Forensic Toxicology

Judy Melinek

As a practicing forensic pathologist in a busy urban office, I’m confronted every week with a stack of toxicology reports from my cases. Most are simple to interpret: the multiple GSW with (inconsequential) trace cocaine, or the slam-dunk OD with a needle in his arm and sky high 6-MAM from heroin. Then there are the challenges. I might get a case with no apparent anatomic cause of death. I pend it, confident that tox will turn something up. But instead the toxicology report shows only prescription drugs in therapeutic levels, or—worse!—it’s completely negative. Interpreting the laboratory findings, deciding whether to pursue additional testing, and coming to a reasonable conclusion in these cases can be difficult. Though I can always call a toxicologist for advice, ultimately I am the one to make the call on cause and manner of death, and I have to be able to defend my determination in court.

So, now that we’ve established the stakes, let’s take a look at five case studies that illustrate the most common errors forensic pathologists make related to toxicology.

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