Abstract
An audit of toxicological analysis in Coronial autopsies performed at Forensic Science South Australia was conducted on the cases of three pathologists. Toxicological analysis had been performed in 555 (68 %) from a total of 815 autopsies. It was found that the proffered manner of death was changed from the provisional report (provided immediately after the post-mortem examination) in five cases (just under 1 %) as a consequence of the toxicological findings. This is a limited study as it is retrospective, not all cases had toxicological analysis and the findings are constrained by the range of the substances that could be detected. Nonetheless, the audit supports the application of toxicological analysis in medico-legal death investigation and suggests that an inclusive policy should be adopted.
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Acknowledgments
The authors would like to thank Forensic Science SA for permission to publish and acknowledge the toxicology staff of Forensic Science SA who performed the analyses.
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Appendix
Appendix
Drugs screened for:
Amphetamines | Amphetamine, chlorphentermine, diethylpropion, dimethylamphetamine, 2,5-dimethoxy-4-methylamphetamine (DOM), ephedrine, fenfluramine, mephentermine, methylamphetamine, 3,4-methylenedioxyamphetamine (MDA), 3,4-methylenedioxymethylamphetamine (MDMA), methylphenidate, paramethoxyamphetamine (PMA), pseudoephedrine, phentermine |
Analgesics/hypnotics | Diclofenac, glutethimide, methaqualone, paracetamol, salicylate (aspirin) |
Anti-convulsants/barbiturates | Amylobarbitone, barbitone, carbamazepine, ethosuximide, lamotrigine methylphenobarbitone, pentobarbitone, phenobarbitone, phenytoin, primidone, quinalbarbitone, sulthiame, thiopentone |
Anti-depressants | Amitriptyline/nortriptyline, bupropion, citalopram, clomipramine, dothiepin, doxepin, fluoxetine, fluvoxamine, imipramine/desipramine, mianserin, mirtazepine, moclobemide, nefazadone, paroxetine, sertraline, trimipramine, venlafaxine, reboxetine, duloxetine |
Anti-diabetics | Chlorpropamide, gliclazide, tolbutamide |
Anti-histamines | Brompheniramine, chlorpheniramine, doxylamine, diphenhydramine, pheniramine, promethazine. |
Anti-inflammatories | Celecoxib, diflunisal, ibuprofen, indomethacin, ketoprofen, mefenamic acid, naproxen, oxyphenbutazone, piroxicam, phenylbutazone. |
Anti-psychotics/tranquilizers | Olanzapine, quetiapine, fluphenazine, zuclopenthixol, droperidol, haloperidol, chlorpromazine, pericyazine, pimozide, risperidone, amisulpride, trifluoperazine, aripiprazole, flupenthixol, ziprasidone, clozapine, promazine, thioridazine, paliperidone, prochloperazine |
Benzodiazepines | Alprazolam, bromazepam, clobazam, clonazepam/7-aminoclonazepam, diazepam/nordiazepam, flunitrazepam/7-aminoflunitrazepam, lorazepam, midazolam, nitrazepam/7-aminonitrazepam, oxazepam, temazepam, triazolam |
Diuretics | Chlorothiazide, frusemide |
Narcotic analgesics | Codeine, dextromethorphan, dextromoramide, hydrocodone, methadone, oxycodone, pethidine, propoxyphene, buprenorphine, fentanyl, tramadol |
Miscellaneous | Anabasine, amlodipine, baclofen, benzocaine, benztropine, bupivacaine, chloroquine, diltiazem, hydroxyquinone, ketamine, lignocaine, metoclopramide, nicotine, nifedipine, omeprazole, orphenadrine, pantoprazole, pentazocine, phenindione, procaine, propranolol, quinidine, quinine, strychnine, theophylline, verapamil, warfarin, zolpidem, zopiclone |
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Langlois, N.E.I., Gilbert, J.D., Heath, K.J. et al. An audit of the toxicology findings in 555 medico-legal autopsies finds manner of death changed in 5 cases. Forensic Sci Med Pathol 9, 44–47 (2013). https://doi.org/10.1007/s12024-012-9388-0
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DOI: https://doi.org/10.1007/s12024-012-9388-0