CDI 104- SPECIAL IZED CRIME INVESTIGATION WITH LEGAL MEDICINE | Ma’am Odhezza F Fajilagmago, RCrim

FINALS: Week 1 AS TO MANNER OF INFLICTION

INJURIES AND WOUNDS 1. HIT- by the stroke of a bolo, axe and other blunt
instrument
PHYSICAL INJURY 2. THRUST/STAB- by the stroke of a knife, dagger,
• refers to the damage inflicted on “any part of the body ice pick, bayonet and spears
due to the deliberate or accidental application of 3. SLIDING/RUBBING
mechanical or other traumatic agent. 4. GUNPOWDER EXPLOSION BY PROJECTILE
• Impairment of the body structure or function caused by OR SHRAPNEL
the outside force 5. TEARING/ STRETCHING
WOUND
• is a disruption of the continuity of tissues and AS TO THE KIND OF INSTRUMENT USED
lining epithelium (layer of the skin) produced by LACERATED WOUNDS
external, mechanical force. • Produced by blunt instrument.
INJURY • Example: lead pipe, piece of wood, stones
• used synonymously with wound, but the former INCISED WOUND
can have a wider meaning, which encompasses
not only damage produced by physical force, but
• Wound produced by sharp edged instrument
STABBED WOUND
also damage produced by other means such as
heat, cold, chemicals, electricity, and radiation. • Wound produced by sharp edged and sharp pointed
instruments
THE ABDOMINOPELVIC QUADRANTS PUNCTURED WOUND
1. RIGHT UPPER QUADRANT (RUQ) • Wound produced by sharp pointed instrument
• Right portion of the liver, right kidney, small portion • Example: ice pick, screw driver, barbeque stick
of the stomach, portion of the ascending and traverse
colon as well as the parts of the small intestine. AS TO THE DEPTH OF WOUND
2. LEFT UPPER QUADRANT (LUQ) 1. SUPERFICIAL WOUNDS
• Left portion of the liver, the larger portion of the - Wound which involves the outer layer of the skin
stomach, the pancreas, left kidney, spleen, portions of 2. DEEP WOUND
the transverse and descending colon and parts of the - Wound which involves the outer as well as the inner
small intestine are located. structure of the body
3. RIGHT LOWER QUADRANT (RLQ) 2.1 PENETRATING WOUND
• Location of the cecum, appendix, part of the small - Wound wherein the instrument pierces a solid organ
intestines, the right reproductive organs, and the right or tissues
ureter; 2.2 PERFORATING WOUND
4. LEFT LOWER QUADRANT (LLQ) - Wound where there is communication between the
• Serves as the location of the most of the small outer and inner portions of the hallow organs.
intestines, some of the large intestine, the left
reproductive organs and the left ureter. AS TO THE RELATION OF THE SITE OF APPLICATION
OR FORCE AND THE LOCATION OF INJURY
COUP INJURY
• Injury which is found at the site of application of
force
CONTRE COUP INJURY
• injury which is found not at the site but opposite the
site of the application of force
COUP CONTRE COUP INJURY
• Injury which is found at the site and also opposite of
the application of force
LOCUS MINOR’S RESISTENCIA
• Injury which is found not at the site or opposite the
site of the application of force but in some areas
offering least resistance to the force applied.
EXTENSIVE INJURY
• Physical injury involving greater areas beyond the
site of application of force

AS TO THE TYPES OF WOUNDS

CLASSIFICATION OF WOUNDS
AS TO SEVERITY
MORTAL/ FATAL WOUNDS
• which when inflicted capable of causing death
• EXAMPLE: Injuries to the brain, spinal cord heat
and big blood vessels, internal abdominal organs
NON-MORTAL WOUNDS
• wound when inflicted will not endangers one’s life
PETECHIAE
• Minute pin-point circumscribed extravasations of
blood underneath the skin or mucous membrane
CONTUSION OR BRUISE
• Wound in the skin and subcutaneous tissues
characterized by swelling and discoloration of tissues
because of extravasation of blood.
HEMATOMA
• Large extravasation in a newly formed cavity
secondary to trauma characterized by swelling,
discoloration of tissues and effusion of blood
underneath the tissues
MUSCULO SKELETAL INJURIES
• Example; sprain, dislocation, strain, fracture
 CDI 104- SPECIAL IZED CRIME INVESTIGATION WITH LEGAL MEDICINE | Ma’am Odhezza F Fajilagmago, RCrim

• Characterized by removal of the superficial layer of

OPEN WOUND the skin brought about by friction against a hard
• There is a breach of the continents of the skin rough object
• EXAMPLE: ABRASIONS
INCISED WOUNDS FORMS OF ABRASION
• STAB WOUNDS LINEAR ABRASION
• There is single line which may be curve or straight
LACERATED WOUNDS MULTI-LINEAR ABRASION
• SHRAPNEL WOUNDS • Several lines of injury which are parallel to one
another
SPECIAL TYPE OF WOUNDS CONFLUENT ABRASION
PATTERNED WOUND • The lines of injury are arranged in haphazardly of the
• Wound produced by the shape of the instrument or body
object reflected in the body. MULTIPLE ABRASIONS
• Example: imprint of the radiator in the chest, tire • Abrasion In the body surface located in different
marks on the body parts of the body
DEFENSE WOUNDS
• Refers to injuries sustained by victims attempting to TYPES OF ABRASION
defend themselves from attack. SCRATCHES
• The wounds are often from victim’s fingers, hands, • Abrasion brought about by the stroke of sharp
forearms, and upper arms. Defensive injuries may pointed instrument over the skin
include not only sharp force injuries, but also blunt GRAZES
injuries and gunshot wounds. • Due to forcible contact with a rough, hard object
• May also be present in the legs of victims attacked on resulting to irregular removal of the skin surface
the ground kicking away an assailant. IMPACT OR IMPRINT ABRASION
CHOP WOUNDS • An abrasion due to contact with a rough, hard object
• Caused by objects with relative sharp edges e.g., in which the structural form of the object is reflected
hatchet, axe, boat propeller or lawn mower blade) over the skin
possessing a reasonable weight resulting in a PRESSURE OR FRICTION ABRASION
combination of sharp blunt force injuries • An abrasion due to pressure applied and with
• Tend to have incised appearance on the skin surface accompany movement over the skin
with associated bruises, abrasions, and significant INCISED WOUND
underlying blunt trauma • An open wound produced by forcible contact with
SELF-INFLICTED WOUNDS sharp edged instrument characterized by gaping of
• Shallow cuts as a form of self-harm, which falls short the wound with smooth edges and causing of profuse
of attempted suicide, are parallel, shallowly incised bleeding
wounds that heal and leave multiple, fine, horizontal, LACERATED WOUND
linear white scars. • Wound produced by blunt instrument characterized
• They are often located in reasonably accessible areas by ill-defined or irregular edges
such as forearms, upper thighs, abdomen, and the • EXAMPLE: blow by piece of wood, lead pipe, stone,
front of the chest. butt of fire arm and fist blow
PUNCTURED WOUND
CLOSED WOUNDS • An open wound produced by round bodied and
PETECHIAE pointed instrument characterized by small opening.
• Circumscribed extravasation of blood in the STABBED WOUNDS
subcutaneous tissues, pinhead size like mosquito • Wound produced by sharp pointed and sharp-edged
bites instrument. The edges of the wound are clean-cut,
HEMATOMA smooth and distinct
• Effusion of blood in the newly formed cavity PENETRATING STAB WOUND
CONTUSION “PASA”  Involves solid interval organs
• Effusion of blood into the tissues underneath the skin PERFORATING STAB WOUND
on account of the rupture of the blood vessels as a  Involves hallow interval organs
result of the application of blunt force. FIREARM INJURIES
• refers to those caused by projectiles (missiles or
MUSCULO-SKELETAL INJURIES bullets) fired from guns.
SPRAIN • Wound characteristics are influenced by the calibre
• Partial or incomplete disruption in the continuity of of the weapon and the distance from the gun to the
muscle ligaments victim
FRACTURE PENETRATING
• It is a break or solution the continuity of the bone • when a projectile has entered but not exited the body
tissues PERFORATING
DISLOCATION • if the projectile has passed completely through the
• Displacement of the articular surface of the bones body
INTERNAL HEMORRHAGE
• Rupture of blood vessels causing hemorrhage WOUND BALLISTICS
• Refers to the study of the effects of penetrating
OPEN WOUNDS projectiles on the body.
ABRASIONS • Morphology, pathway, and exit of gunshot wound
from the body are dependent on several factors, such
 CDI 104- SPECIAL IZED CRIME INVESTIGATION WITH LEGAL MEDICINE | Ma’am Odhezza F Fajilagmago, RCrim
as the weapons used and the bullets size, shape and
weight.
• The nature of the wound can also be affected by the
angle of impact, the depth of penetration and the
character of the target tissue.
BALLISTICS - science of the motion of projectiles
GUNSHOT WOUNDS
GUNSHOT
• A penetrating wound that leaves a skin defect where
the projectile passes through the skin
WOUNDS
• As a general rule, a gunshot exit wound is larger and
more irregular than a gunshot entry wound due to the
effect of bullet tumbling and bullet deformation.
GUNSHOT WOUNDS
• Typically categorized by examining characteristics of
wound and looking for the presence of gunshot
residues.
• The presence of gunshot residue is used to determine
approximate muzzle to garment
GUNSHOT ENTRY WOUNDS
• A result of the forward motion of the bullet indenting
the skin and grazing it at a time of its entry.
• The abrasion ring appears reddish-brown but can
darken to almost black with post-mortem drying.
• Typically absent from exit wounds.
GUNPOWDER STIPPLING
• Refers to small bruises or punctuate wounds on the
skin
GUNPOWDER TATTOOING
• Occurs when particles of burned or unburned
gunpowder are embedded into the skin
GUNSHOT EXIT WOUNDS
• Exit bullet wounds to be larger than the
corresponding and usually consist of lacerations with
unbruised and unabraded margins.
• Exit wounds from low-velocity firearms tend to be
relatively small. The projectile traverses the body,
producing a laceration upon exit.
BURNS
• An injury caused by the application of heat or by a
chemical or physical agent having an effect similar to
heat.
• The nature of burns is affected by certain conditions
such as the intensity of the heat, the duration of
exposure, the extent of area involved, the site of the
injury in the body, the age and even the sex
classification of the victim.
FIRST DEGREE BURNS
• These injuries involve only the epidermis and are
characterized by erytherma, edema and pain.
• Produced by prolonged exposure to low intensity heat
or very brief exposure to light intensity and manifests
as red discoloration and superficial inflammation.
• Wound healing is completed in approximately 5- to
10 days with no residual scarring
SECOND DEGREE BURNS
• Also called partial thickness burns.
• The most superficial second degree burns totally
affect the epidermis as well as the upper third of the
dermis
• Such burns involve blister formation and are
extremely painful.
• Wound healing is completed in approximately 7 to 14
days with minimal scarring.
THIRD DEGREE BURNS
• Also called full thickness burns destroys the full
thickness of the epidermis and dermis.
•
Heat coagulation of dermal blood vessels leaves the
tissue avascular with a characteristic waxy white
appearance.
• These burns require skin grafting because skin
regeneration is not possible.
FOURTH DEGREE BURNS
• These burns are also described as charring injury due
to incineration of tissues.
• There is complete destruction of the skin and
subcutaneous tissues, as well as complete or partial
charring of the bone.
TYPES OF BURNS
SCALDS
• Produced by moist heat or steam or any heat hot
liquid such as water, oil or even molten rubber or
metal.
DRY BURNS
• Dry heat sources result in dry burns.
• Examples: ovens, stove, hot engines, mufflers
radiator grills.
CHEMICAL BURNS
• Burns that are produced through contact with
corrosive acid and alkalis.
• Most of these injuries involved direct tissue damage,
which causes drying and blistering, destruction of
proteins and fat
FIRE BURNS
• Burns that can be caused by the radiant heat energy
alone, from tissues being in contact with burning
clothes or beddings or from the victim actually being
on fire.
RADIANT BURNS
• Burns are caused by heat source close to the victim or
electromagnetic energy radiating out from an energy
source.
FINALS: Week 2
ASPHYXIA
• Greek derivation and means "without a pulse"
• refers to a condition of severely deficient supply of
oxygen to the body, which arises from being unable
to breathe normally.
• It may be described as interference with respiration
due to any cause like mechanical, environmental, or
toxic.
• Any death is Asphyxial in nature because all bodies
deoxygenate after death.
• means interference with the natural exchange of
oxygen and carbon dioxide in the body (modern
forensic medical practice)
• Mechanical Asphyxia- physical interference with
breathing and/or circulation
• When the respiratory function of lungs stops as a
result of lack of oxygen, it causes failure of heart and
brain due to oxygen deprivation.
Mode of Death Causes:
1. Mechanical obstruction to air passage (e.g.,
impaction of foreign bodies, bronchospasm,
suffocation, drowning) or external pressure to close
air passages (e.g., hanging strangulation,
smothering);
2. Being at a higher altitude where oxygen is deficient;
3. Poisoning (e.g., cyanide) resulting in the interference
in the utilization of oxygen at cellular level;
4. Penetrating injuries of the chest causing the collapse
of lungs or chest muscles;
5. Pulmonary embolism, tetanus and cold that lead to
asphyxia; and
6. Ingestion of poisons, such as strychnine, barbiturates
and opium
 CDI 104- SPECIAL IZED CRIME INVESTIGATION WITH LEGAL MEDICINE | Ma’am Odhezza F Fajilagmago, RCrim
The transfer of oxygen that can be compromised in
asphyxia in separated into the following four phases:
1. Decreased amounts of oxygen in the environment:
2. Reduced transfer from the air to the blood:
3. Reduced transport from the lungs to the tissues; and are
encountered.
4. Reduced transfer across cell membranes.
DEATHS CAUSED BY ASPHYXIA
1. Suffocation
- deprivation of oxygen, either from a lack of
oxygen in the surrounding environment or
obstruction of the upper airway
- refers to the exclusion of air from the lungs by
means other than compression of neck, such as
through entrapment in an airtight enclosure with
inadequate oxygen in the environment
- It is the most common term used for deaths
associated with reduced availability of oxygen as
well as in cases where other nontoxic irrespirable
gases are encountered.
- This could happen to a homicide victim who is
left to die while tied up in a confined space
- term suffocation can also broadly refer to cases
of entrapment, suffocating gases, smothering,
choking, mechanical asphyxia, and traumatic
asphyxia.
2. Smothering
- mechanical obstruction of the flow of air from
the environment into the mouth and nose
- mechanical obstruction of the external airways
(mouth and/or nostrils) by an object such as
pillow, duct tape, or plastic bag.
- This requires at least partial obstruction of both
the nasal cavities and the mouth or the upper
way.
- May be difficult to diagnose smothering as
mechanism of death, especially when the victims
are very young children, the elderly, or the
infirmed who cannot resist and will show no sign
of struggle, such as bruises and abrasions to the
face, lips or inside the mouth.
3. Strangulation
- may occur by ligature, or by manual pressure
using one or both hands when the term throttling
may be used
- is a violent form of death that occurs when
mechanical pressure is applied to the neck by
means of the ligature (ligature strangulation) or
by utilizing only the hands (manual
strangulation).
- Manual Strangulation- sometimes associated
by with sexual attack and is often used by a man
against a woman or a child. Common injuries
sustained include abrasions and bruises on the
front and sides of the neck at each side of the
laryngeal prominence and just below the jaw line
- Ligature Strangulation- a constricting band
(e.g., a rope, wire, string, electric cable,
telephone cable, scarf stockings or a piece of
cloth is tightened around the neck. The mark on
the neck is a vital piece of evidence that can
reflect the material used for the ligature.
Scratches and bruises on the neck may have
been caused by the victim trying to pull off the
ligature.
4. Choking
- usually occurs when a foreign object becomes
lodged in the throat or windpipe blocking the
flow of air
- involves the obstruction of the larynx by food,
vomit, blood, or other foreign bodies.
- This sometimes happens when a large bolus of
food material becomes lodged in the opening of
the pharynx or larynx, making the victim gag and
unable to inhale or exhale
- Choking is usually accidental and often involves
intoxicated people with no dentition or with
dentures, eating inappropriate foods or eating too
quickly.
- It can also be homicidal, such as when a gag is
placed in the mouth and/or pharynx.
5. Garroting - to achieve the strangulation of a person
where an iron collar is being placed around the neck
and tightened by a screw driver
6. Chest compression
- due to fixation of the external chest wall as a
result of crushing
- mechanical limitation of expansion of the lungs
by compressing the torso, hence interfering with
breathing.
- Compressive asphyxia occurs when the chest or
abdomen is compressed posteriorly, thereby
preventing cardiorespiratory function.
- Form: phenomenon of crush or traumatic
asphyxia wherein the chest is compressed, either
by individuals or from solid objects.
7. Hanging
- by another, deliberate self-harm, or autoerotic
asphyxia
- refers to the situation where a victim’s own body
weight (or part of their body weight) causes a
compressive force to be applied to the neck.
- A ligature device (e.g., rope, cord, belt or other
material fashioned into a slip knot) is wound
around the neck in a snug fit, after which the
person lets his/her own weight apply the
suffocating force
ASPHYXIAL DEATH BY HANGING MAY COME BY
ANY OF THESE FOUR MEANS:
1. Occlusion of the carotids and vertebral arteries
2. The base of the tongue is pressed to the back and
upwards inside the neck occluding the nasopharynx
3. Direct laryngeal or tracheal damage and occlusion;
and
4. Cervical fracture (“drop” hanging) causing brainstem
injury
DROWNING
- refers to a form of death that occurs when atmospheric at
is prevented from entering the lungs due to submersion
of the body in water or other fluids.
- it is specialized form of asphyxia in which environmental
oxygen (air) is displaced by a liquid (usually water).
- frequent cause of death in bodies that are recovered from
water, such as swimming pools, ponds, lakes, oceans,
rivers, fountains and well.
- common among infants, toddlers and young children
who fall into water and cannot extricate themselves.
- Merely finding a human body submerged or floating in
the water does not necessarily indicate drowning.
SEVERAL PHASES INVOLVED IN DROWNING:
1. Upon submersion in water, the body initiates a
prompt involuntary reflex of breath-holding.
2. This is quickly followed by the voluntary act of
holding one’s breath because the victim id fully
conscious and aware of the dangers of inhaling water.
Panic usually sets in and a desperate effort to swim or
to float to the surface knowing fully well that if this is
 CDI 104- SPECIAL IZED CRIME INVESTIGATION WITH LEGAL MEDICINE | Ma’am Odhezza F Fajilagmago, RCrim
not possible, the result will be death. A person in
good physical condition can probably hold his/her
breath for about one minute, possibly even longer,
but there is a limit (usually under 2 minutes).
3. After this, another involuntary reflex occurs and the
victim gasps for air. At this moment, enormous
quantities of water are inhaled and swallowed. A
choking cough reflex may be set up, which leads to
further discomfort, terror, and the inhalation and
swallowing of more water.
4. As the victim loses consciousness, the water filling
the lungs oozes out of these organs into the pleural
cavities (the spaces in the chest that house the lungs).
As the body fills with water, additional water may
begin to leach into the abdominal (peritoneal) cavity
and into the pericardial sac.
5. Severe deficiency of oxygen in tissues or organs,
possibly involving hydrostatic and osmotic effects of
inhaled fluid within the small airways, thereby results
in death.
INDICATORS THAT HELP DETERMINE THE CAUSE
OF DROWNING:
1. Suicidal
- Heavy articles or weight may be found in the pocket
of clothing
- Presence of suicidal note
- Strong reason to commit suicide
- Mentality of the person
- Previous attempts of suicide
2. Homicidal
- Evidence of struggle
- Articles belonging to the assailant
- Presence of ligature on the hands or legs
- Presence of physical injuries which could not be
self-inflicted
- Testimony of witnesses
3. Accidental
- Absence of any mark of violence
- Condition and the situation of the victim before
death
- Exclusion of homicidal or suicidal nature of
drowning
- Testimony of witnesses
4. Natural death while in water
- Presence of pre-existing cardiovascular disease
- Exacerbation of current condition due to physical
exertion of swimming or struggling
5. Injuries sustained while in water
- Can be due to waves or current against any kind of
obstruction
- Contact with rough bottom of a river or stony beach
- Damage from boat or ship’s propeller
Regardless of the cause, there is a need to perform an autopsy
on a body found in the water to rule out natural disease or
injury as the cause of why the decedent was unable to escape
the deadly aqueous environment.
External findings may include the following:
1. Skin maceration as major sign of immersion
(wrinkled, pale, sodden, "washerwoman" changes to
the skin) that may develop within 4-5 hours
depending on temperature;
2. Submersion of mouth and nostrils in water for a time
preventing free entrance of air into the lungs
3. Death usually occurs 2-5 minutes later; and
4. Gross skin shedding, muscle loss with skeletal
exposure, and partial liquefaction
 There are no specific autopsy findings for pathologist that
drowning has occurred.
 The findings are different in cases of wet drowning in fresh
water and sea water.
 In dry drowning, water enters the air passages and
induces laryngeal spasm, which in turn, leads to complete
closure of air entry into lungs; water does not reach the
lungs and characteristic features of drowning are absent.
 Internal examination may indicate the presence of froth
(usually white, sometimes pink) in the nostrils and mouth,
as well as in the upper and lower airways.
 Lung weights are usually (higher 600-800g) in drowning
cases (non-drowned bodies have 350-550g) although
normal weight is call is possible, as in dry drowning.
 The most valuable positive sign could be an overinflated
filling of the thoracic cavity.
DIFFERENTIATING SUICIDAL FROM HOMICIDAL
ASPHYXIA
Death investigations involving cases of asphyxia require
determining the manner of death.
SUICIDE
 In secured residence
 Suicide note
 History of depression, schizophrenia, or other mental
illness
 On psychiatric medications
 Prior suicide attempt/ideation
 Significant recent life- altering event (example: death
of spouse, being placed in a nursing home, or sent
back to jail)
 Hesitation marks or scars on wrists, neck, or elsewhere
 Ligature furrow above level of thyroid cartilage
 Little internal neck injury (reflecting no or mild
struggle)
 Fracture of thyroid cartilage horns, hyoid bone, and
cricoid cartilage very uncommon
HOMICIDE
• “Dumped” body
• Unlocked residence
• Evidence of burglary or belongings rummaged through
• Jewelry/ belongings missing
• Inconsistent statements from acquaintance/witness/other
• Convincing motive(s) identified
• Recent life insurance policy started/ significant recent
shifts of money
• History of previous physical/ sexual assault
• Ligature binding of extremities
• Body arranged for “display” purposes
• Evidence of possible sexual assault (legs apart, dried
fluid in groin, injuries to genitals)
• Clothing in disarray- it may appear as if the body was
redressed, or panties pulled back up
• Inconsistent pattern of lividity or rigidity- evidence that
the body has been moved
• Defense injuries on hands/arms (broken fingernails,
contusions or abrasions)
• Ligature furrow at/ below level of thyroid cartilage
• Fingernail- type abrasions on the neck
• Large amount of external neck injury
• Often with more than a little internal neck injury
• “Date rape”- type drugs detected in blood, such as
flunitrazepam (rohypnol), ketamine, and GHB
FINALS: Week 3
POISONING
TOXICOLOGY
 defined as the science that deals with knowledge of
source, character and properties of poisons, their
 CDI 104- SPECIAL IZED CRIME INVESTIGATION WITH LEGAL MEDICINE | Ma’am Odhezza F Fajilagmago, RCrim
symptoms in the body, their pharmacological actions,
and their treatment.
 a study of the adverse effects of chemicals, such as
alcohol, drugs, poisonous gases, and industrial
chemicals on living organisms.
 concerned with the detection and measurement of
such chemicals through the analysis of samples such
as blood, urine or hair.
POISON
 a substance or agent capable of producing harm, such
as disease or death, to a living organism.
 it may be introduced through any route in the body,
such as mouth, nostril, anus, vagina, ears, eyes, or by
injection or inhalation.
 legally, a poison is a substance which, if applied or
administered internally, is said to be used with the
intention to kill or to afflict harm.
 A poison can be efficient and deadly instrument of
murder:
o if it is toxic enough even at small quantities,
o if it can be easily disguised (e.g., the taste or
odor can be easily masked when mixed in
water or food),
o if it causes symptoms that are delayed and
nonspecific or appear to be due to natural
illness, and if it is readily obtainable and
easy to work with (Stripp, 2007).
FORENSIC TOXICOLOGY
 involves the use of toxicology for the purposes of the
law, especially when criminal activity is suspected.
 it encompasses the determination of role of drugs and
chemicals in accidental deaths and suicides
EXAMPLES OF TOXICOLOGY-RELATED DEATHS
cases:
• Restless infant- who was drugged in an attempt to
promote sleep
• Drugged student- who became a homicide victim
• Intoxicated driver- who was involved in a fatal car
accident
• Middle-aged chronic victim- who abused opioids and
anxiolytics
• Elderly individual with multiple debilitating medical
conditions- who intentionally or accidentally overdosed on
medications
- all chemicals have the potential to be poisons if present in
sufficient amount.
- “All substances are poisons, there is none which
is not a poison. The right dose differentiates a
poison from a remedy.” - Paracelsus
- people differ widely in their responses to many substances.
FORENSIC TOXICOLOGIST
 responsible for detecting chemical agents in
biological samples, and;
 providing answers to the following questions in order
to assist the medico-legal investigation (Stripp, 2007,
pp. 16-17):
o What drug was taken, when, and how?
o Was the drug or drugs sufficient to kill or to
affect behavior?
o Was a substance taken for therapeutic
purposes, was it abused recreationally, was
it used for suicidal purposes, or was it
administered homicidally?
o Was the person intoxicated at the time of the
incident?
o What are the effects on behavior or
performance?
o How would a person show intoxication with
this substance?
o Is there an alternative explanation for the
findings?
o What additional tests might shed light on
these questions?
TYPES OF POISONS INVOLVED IN CRIMINAL ACTS
ARSENIC
 Arsenic is a metal that is not itself poisonous;
 arsenic compounds used in insecticides, pesticides,
herbicides, alloys, wood preservatives, additives to
animal feed, semiconductors and light-emitting
diodes, homeopathic medicines, paints, and ceramics
are the ones that make potent poisons.
 Arsenic has been widely used for homicidal purpose
as it is cheap, easily available, tasteless and odorless,
and
 therefore, cannot be detected in food or water.
 Low doses can be given slowly over a long period of
time so that death may appear to be natural.
 Intentional poisonings most often involve rodent
poisons or pesticides.
Accidental Occupational Exposure to arsenic compounds
occurs in industrial settings, such as in the manufacture of
pesticides or herbicides, and in smelting industries.
Environmental Arsenic Exposure can also occur from
arsenic-contaminated drinking water
also occurs from burning of coal that contains naturally high
levels of arsenic, perhaps from wood treated arsenical
preservatives.
 lewisite, an arsenic-containing gas, has been used in
chemical warfare.
ARSINE GAS
 is a potent hemolytic agent that can produce acute
symptoms of nausea, vomiting, shortness of breath
and headache.
 exposure to arsine can be fatal and can result in
hemoglobinuria, renal failure, jaundice, and anemia.
 Sub-lethal doses of arsenic cause irritation of the:
o stomach and intestines (stomach pain,
nausea, vomiting, and diarrhea),
o anemia arrhythmia (abnormal heart rhythm),
o sore throat and irritated lungs (if inhaled),
o impaired peripheral nerve function, and
o darkening of the skin, particularly on the
palms and soles.
 With large doses of arsenic, much may be vomited
and can be survived.
 With fatal doses, death can occur within hours from
shock and cardiorespiratory failure, or may be
delayed for many days.
 Arsenic exposure has also been reported to increase
the risk of cancer of the liver, bladder, kidneys,
prostate, and lungs.
 Upon exposure, arsenic can be detected in blood,
urine, gastric contents, and other tissues (including
bone) by atomic absorption spectrophotometry (UV
light).
 Arsenic can be measured in bone and hair for a long
time after death
CYANIDE
 Cyanides are chemical compounds, many of which
are highly toxic.
 Cyanide products are used in several industrial
processes mainly for mining of gold and silver.
 It is also employed in several chemical processes
such as fumigation, case hardening of iron and steel,
electroplating and photographic processing.
 CDI 104- SPECIAL IZED CRIME INVESTIGATION WITH LEGAL MEDICINE | Ma’am Odhezza F Fajilagmago, RCrim
 Cyanide is a rapid-acting and deadly poison that can
kill in a matter of minutes.
 Its use has been relatively common in suicides and
accidents, and has also been used in homicides.
 The most hazardous compound is hydrogen cyanide
(also known as prussic acid or hydrocyanic acid or
HCN), very pale, blue, transparent liquid or colorless
gas that can kill a human within minutes.
 It has been used for capital punishment in gas
chambers and by terrorists as a chemical weapon.
 Other common poisonous cyanide compounds
include potassium cyanide (KCN) and sodium
cyanide (NaCN), which come in the form of white
crystalline salts with a faint almond-like odor.
 Cyanide in salt form is often administered orally, but
can also be an inhalation hazard when dissolved in
acidic liquids.
 The toxicity of cyanide is due to its ability to stop
cellular respiration and ATP synthesis in cells,
thereby causing anoxia.
 Symptoms of poisoning include:
o headache,
o dizziness,
o nausea, vomiting,
o shortness of breath, and
o mental deterioration.
 Ultimately:
o seizures
o apnea
o coma
o cardia arrest cause death
STRYCHNINE
 Strychnine is a highly toxic crystalline alkaloid
usually obtained from the seeds of the Strychnosnux-
vomica tress, which is commonly found in India and
Southeast Asia.
 It is odorless and appears as a white or translucent
crystal or crystalline powder, with an extremely bitter
taste that can easily be detected in foods and
beverages.
 It is primarily used as pesticide against rodents.
 Fatal poisoning can occur following exposure by
inhalation, swallowing or absorption through eyes or
mouth.
 It produces excruciatingly painful and violent spastic
reactions, resulting in a horrific death.
 A lethal dose results in painful muscle cramps,
followed by extremely intense muscle contractions
that are worsened by the slightest external stimulus
such as simple touch.
 The convulsions appear to resemble seizures, but the
victim is completely conscious and aware of the
painful event.
 At this point, the contractions will progress,
ultimately resulting in death due to asphyxiation
caused by muscle spasms.
 The deceased person is usually seen with an intense,
blank, and frightening stare.
CARBON MONOXIDE
- It is highly toxic gas produced by the incomplete
combustion of organic materials. It forms when there
is insufficient oxygen to produce carbon dioxide. It is
colorless, odorless, tasteless and initially non-
irritating hence, it is very difficult for people to
detect.
- It produces its toxic effects by binding to hemoglobin
in red blood cells and thus preventing oxygen from
binding, which in turn causes tissue anoxia and
impairment of ATP synthesis.
- The most significant post-mortem change in carbon
monoxide poisoning is a cherry red color of the
blood, which manifests itself a reddish coloration of
the skin
EARLY SYMPTOMS OF POISONING (Carbon
Monoxide)
- Progressively worsening headaches
- Light-headedness
- Nausea
- Fatigue
- Visual disturbances
- Mental confusion
- Coma and death
COMMON CAUSES OF CARBON MONOXIDE
POISONING ACCORDING TO SAUKKO AND KNIGHT
(2004)
- Faulty heating systems that lead to absent or
inadequate ventilation;
- Automobile exhaust fumes confined to a small space,
producing a lethal concentration of carbon monoxide
in the atmosphere;
- Structural fires in houses and buildings where victims
are overcome by the gradually spreading monoxide
while trapped or asleep;
- When a drunken person collapses with a lit cigarette
then the bed cover catches fire; the smoldering bed
cover results in a high level of carboxyhemoglobin;
and
- Many industrial processes that could lead to
monoxide poisoning, especially in iron and steel
works, where producer gas and water gas are
deliberately formed and stored as part of the
manufacturing process.
THALLIUM
- Thallium (TI) is a soft gray metal mostly found
geologically in potassium-based ores at the Earth’s
crust.
- It can also be commercially produced as a byproduct
from the refining of heavy metal sulfate ores, and
used in the manufacture of electronic devices,
switches, the semiconductor industry, manufacturer
of special glass, and for certain medical procedures.
- Thallium sulfate is an odorless, tasteless and highly
toxic dense white powder salt that has been
commonly employed as a rat poison.
o This sulfate salt is soluble in water and can
enter the body by ingestion, inhalation, or
through contact with the skin.
o It has been banned in several countries due
to safety concerns.
- Thallium disrupts many cellular functions and is also
a suspect’s cause of carcinogen.
- Following absorption, it is distributed to the red
blood cells and also appears in the brain, lungs, guts,
muscle tissue, salivary glands, pancreas, testes,
spleen, kidney, liver, and bones.
CHARACTERISTICS SYMPTOMS OF THALLIUM
POISONING INCLUDE:
- loss of hair paresthesia (damage to peripheral nerves
causing pain in the hands and feet described as a
sensation of walking on hot coals),
- endocrine disorders,
- gastrointestinal and pulmonary distress,
- psychosis delirium, and
- convulsions.
- Death may result from cardio-respiratory collapse
ACONITE
- Aconite or aconitine is a toxin produced by the Aconitum
napellus plant, which is also known as monk’s hood,
wolf’s bane, women's bane, devil’s helmet and blue rocket;
 CDI 104- SPECIAL IZED CRIME INVESTIGATION WITH LEGAL MEDICINE | Ma’am Odhezza F Fajilagmago, RCrim
- it is found chiefly in mountainous parts of the northern
hemisphere
- most toxic substance known to man
- historically used to poison the water supply of enemies
- Women were thought to be especially vulnerable as the
poison.
- Aconite is a white powder that is barely soluble in water
but very soluble in alcohol
- The rapidly acting poison takes effect within minutes of
exposures and targets the electrically excitable cells of the
nervous, cardiovascular and skeletal muscular tissues,
causing abnormal and potentially fatal heart rhythms.
EARLY SYMPTOMS OF ACONITE POISONING
INCLUDE:
- a tingling and numbness at the poxel of contact (usually
the mouth and throat),
- sweating
- nausea
RICIN
- Ricin is a highly toxic, naturally occurring protein derived
from the seeds of the castor oil plant “Ricinus communis”
- It is twice as deadly has a high lethality, causing weakness,
fever and pulmonary eternal after inhalation that can lead
to death from hypoxemia in 2 to 3 days
- Following ingestion, the first symptoms of ricin poisoning
usually occurs in less than 6 hours.
- Death takes place within 36 to 72 hours of exposures,
depending on the route of exposure.
3 CHANNELS (Ricin Poisoning)
1. In halation – difficulty breathing fever, cough, nausea,
tightness in the chest heavy sweating, fluid building up
in the lungs that makes breathing even more difficult,
the skin might turn blue; low blood pressure and
respiratory failure may occur, eventually leading to
death.
2. Ingestion – vomiting, diarrhea that may become bloody,
severe dehydration, low blood pressure, hallucinations,
seizures, blood in the urine; within several days, the
liver, spleen, and kidneys might stop working, and the
person could die.
3. Skin and eye exposure – ricin in the powder or mist
form can cause redness and pain of the skin and the
eyes.
LEAD
- soft and malleable metal used in building construction,
lead-acid batteries, bullets and shots, weights, as a part of
solders, pewters, fusible alloys, and as a radiation shield.
- Lead acetate- most common salt that causes acute
poisoning
- Paralysis of lower limbs may be seen, and death may occur
SYMPTOMS OF LEAD INGESTION:
- Sweet, metallic astringent taste in mouth
- Burning sensation in the throat and stomach
- Salivation and intense thirst
- Vomiting
- Constipation
- Cold clammy skin
- Feeble rapid pulse and shock
- Drowsiness
- Headache
- Muscular cramps
- Convulsions
DRUG ABUSE
• Is a growing global problem often resulting in
accidents, criminal activity and death.
•Drug-related crimes are usually committed either to
fund the purchase of drugs or as a consequence of
drug misuse.
• The World Health Organization (WHO), defines a
Drug as “any substance, other than those required for
the maintenance of normal health, that, when taken
into the living organism may modify one or more of
its functions”
• Deaths related to drugs may be from recreational
usage of illegal drugs or from deliberate or
inadvertent misuse of over-the-counter preparations
or prescription medications.
• In many cases, a drug related death scene will include
drug paraphernalia, such as syringes, needles, spoon
“cookers” with small foil-cooking sheets, lighters,
bongs, and so on.
• It is not unusual to find a cooking utensil for heroin
or components of a crack pipe (the crack pipe is often
recognizable as a hollow metal glass, or plastic tube
often burned at one or both ends).
• Toxicology reports involving drug-related deaths
should be considered in the context of the entire case
investigation, including the person’s medical history,
drug abuse/abuse history, scene investigation,
circumstances of the death, and complete autopsy
findings. The drugs may have played a primary role
in a death and may, therefore, be listed as the cause of
death.
DRUG MISUSE
• Is defined as “any taking of a drug which harms or
threatens to harm the physical and mental health or
social well-being of an individual, of other
individuals, or of society at large, or which is illegal.”
DRUG DEPENDENCY
• Is defined as “a state, psychic and sometimes also
physical, resulting from the interaction between a
living organism and a drug,
• characterized by behavioral and other responses that
always include a compulsion to take the drug on a
continuous or periodic basis in order to experience its
psychic effects and sometimes to avoid discomfort of
its absence”
AN AUTOPSY CAN REVEAL THE FOLLOWING CLUES
THAT A PERSON MAY HAVE DIED OF A DRUG
OVERDOSE:
- “Foam Cone” over nose and/or mouth;
- Colorful discoloration of lips, tongue, oral mucosa or
stomach;
- Granular, grainy, or pasty pill material in mouth and/or
stomach
- Pills in stomach
- Pulmonary congestion and/or edema;
- Frothy fluid in bronchi and trachea;
- Mucus in bronchi; and
- Increased amount of urine in urinary bladder
KINDS OF STIMULANTS & DEPRESSANTS
STIMULANTS
• Also called “Uppers” are psychoactive drugs that
stimulate the nervous system, resulting in euphoria,
increased energy and alertness with loss of appetite.
EFFECTS MAY ALSO INCLUDE:
- increased heart rate
- blood pressure and respiratory rate;
- aggressive behavior and confused thinking leading to
exhaustion and sleep;
- dry mouth
- sweating
- dilated pupils and hyperactive reflexes;
- hallucinations
- delusions and paranoia;
 CDI 104- SPECIAL IZED CRIME INVESTIGATION WITH LEGAL MEDICINE | Ma’am Odhezza F Fajilagmago, RCrim
- and even fits, coma and death.
• Stimulants are widely used as prescription medicines
for treatment of narcolepsy obesity attentional
disorders and clinical depression.
• Amphetamine is the most popular stimulant. it may
be taken intravenously, orally or sniffed/snorted, with
effects coming on quickly and lasting for several
hours.
• Other notable stimulants include:
• Caffein (found in coffee, tea, cocoa,
chocolate, soft drinks and energy drinks),
• Nicotine (the active chemical constituent in
tobacco),
• Ephedrine (commonly used as a stimulant,
appetite suppressant, concentration aid and
decongestant), and
• Anabolic steroids (used for cosmetic
purposes to develop and maintain masculine
characteristics).
• Abuse of CNS stimulants can lead to insomnia and
severe depression, as well as medical, psychiatric,
and psychosocial deterioration.
COCAINE
• Is a strongly addictive controlled substance derived
from the leaf of the Erythroxylon coca bush. it has
become an extremely popular drug with some
medicinal value, although it also has a high potential
for abuse.
• Cocaine in the form of white crystalline powder can
be snorted intranasally or injected intravenously,
while crack cocaine is the less expensive form that
can be smoked.
INJECTING COCAINE PRODUCES THE MOST
RAPID, ALMOST IMMEDIATE EFFECTS:
- snorting results in a peak effect within 30-120
minutes;
- while smoking effects peak within 5 minutes
- episode of bizarre behavior called “cocaine
psychosis” or “excited delirium,”
- which manifests in hyperthermia (elevated body
temperature)
- delirium
- paranoia
- abnormally great strength
- highly agitated state
- cardiorespiratory arrest
- sudden death
ECSTASY
• Is the street name for Methylene
dioxymethamphetamine (MDMA).
• It is a “party drug” that is classified as both a
stimulant and a hallucinogen.
• It is administered orally as a tablet or capsule, and the
effects last approximately three to six hours.
• Its popularity in nightclubs and raves is due to its
empathy-enhancing properties, which increases a
sense of intimacy and diminished anxiety with others,
which can induce euphoria and mild psychedelia.
High doses of MDMA can damage NEURONS resulting in:
- Depression
- Anxiety
- memory loss
- learning difficulties
- sleep disorder
- sexual dysfunction.
- It can also lead to increase in:
o heart rate and blood pressure
o Fainting
o panic attacks
o (in severe cases) loss of consciousness and
seizures.
• Although not commonly fatal, a potentially
dangerous side effect is hyperthermia (an increase in
body temperature), which can lead to the death
• MDMA-related deaths have in fact increased
markedly, possibly due its wide availability to young
people, especially in parties and clubs.
METHAMPHETAMINE HYDROCHLORIDE
• A.K.A “Shabu”
• is a synthetic drug that comes as a white odorless
powder, tablet or as crystals that look shards of glass
with a bitter numbing taste.
• It can be swallowed, sniffed/snorted, smoked, or
injected;
• Resulting in a feeling of physical and mental well-
being, as well as a surge of euphoria and exhilaration.
• If not treated immediately, methamphetamine
overdose can lead to hyperthermia, which can result
in death.
• EFFECTS:
• When smoked or injected, it produces an
instantaneous “rush” and euphoria that can
last from 4 to 12 hours.
• Effects from oral injection (swallowing)
occur in around 30 minutes
• 3 to 5 minutes from snorting/sniffing
• Effects may continue for up to 24 hours; the
half-life of the drug is 12 hours.
• According Stark and Norfolk (2009), oral
ingestion or snorting does not produce the
“rush”.
BAD EFFECTS OF ADDICTION:
MENTAL HEALTH
o aggressiveness
o violent behavior
o auditory hallucinations
o mood disturbances
o delusions
o psychotic and paranoid episodes that can result in
homicidal and suicidal thoughts
PHYSICAL HEALTH
o cardiac problems
o neurological problems
o hypertension
o stroke
HALLUCINOGENS
• Also known as “psychedelics”
• Are drugs that alter the perception of reality.
• They rarely cause toxicity sufficient enough to result
in death, but may cause convulsions, respiratory
depression, coma, hyperthermia and seizures that
may prove fatal.
• In addition, the effect of altered perceptions,
psychosis, and bizarre behavior may lead to or
contribute in some way to traumatic death.
Examples of hallucinogens:
• Lysergic acid diethylamide (LSD)
• Cannabis
• Phencyclidine (PCP) also called “angel dust”
• Mescaline (from the peyote cactus)
• Psilocybin (from mushrooms)
LYSERGIC ACID DIETHYLAMIDE (LSD)
• A powerful hallucinogenic that is not fatal in itself.
• It is usually taken orally.
LSD EFFECTS:
• It has a sympathomimetic effect within 5 to 10
minutes and psychological effects within 30 to 60
minutes, depending on the dose taken.
• The effects can last for 8 to 12 hours, with a recovery
period of 10 to 12 hours.
 CDI 104- SPECIAL IZED CRIME INVESTIGATION WITH LEGAL MEDICINE | Ma’am Odhezza F Fajilagmago, RCrim
• Visual effects such as intensified colors and distorted
shapes occur, as well as distortions of hearing.
CANNABIS (Cannabis sativa)
• A.K.A “Marijuana”
• Is a tobacco-like greenish or brownish material made
of the dried flowering tops and leaves of the cannabis
(hemp) plant
• It is usually smoked or taken orally as “brownies”,
and can make users feel pleasurably relaxed or
euphoric.
• It has mood-altering property and is addictive.
• When smoked, effects occur within a few minutes
and last up to one hour with low doses, or 2 to 3
hours with higher doses.
• If it is ingested, it may take an hour or more to have
an effect which can last 12 hours or more.
ACTIVE COMPONENT IN MARIJUANA:
 TETRAHYDROCANNABINOL (THC)
-activates the brain’s reward system in the same way
that other drugs of abuse do and causes increased
heart rate, dilation of the blood vessels in the whites
of the eyes, relaxation and dilation of the bronchial
passages, and euphoria.
EFFECTS (THC)
• Dry mouth
• Excessive hunger and thirst
• Sleepiness
• Occasionally dysphoria (anxiety, fear, panic, and
paranoia)
• Impairs memory and attention (in heavy use)
• Impairs the areas of the brain that regulate
balance, posture, coordination of movement, and
reaction time.
- Proof of intake can be obtained from analysis of urine,
blood, and swabs from lips and fingers.
- Marijuana is the most widely used illicit drug in the world.
- It is not known to cause death via direct drug toxicity, but
THC has been detected in a fairly significant numbers of
death, particularly those due to overdose of other drugs and
violent or accidental deaths.
DEPRESSANTS
- CNS depressants (also called "downers") are drugs that
slow brain function in a progressive manner and are most
often used in the treatment of anxiety and sleep disorders.
- These include sedatives, hypnotics (sleep inducing), and
antianxiety drugs (tranquilizers).
- Depression of the nervous system leads to sedation and
relief of anxiety but, because of disinhibition, may initially
result in euphoria, excitation, and risk-taking.
PHYSICAL EFFECTS:
- Disorientation
- Drowsiness
- Slurred speech
- Nystagmus
- Loss of co-ordination
- Ataxia
- Coma
- Death
MOST COMMON CNS DEPRESSANTS:
1. BARBITURATES – used to treat seizures, anxiety,
tension and sleep disorders; particularly dangerous
drugs when taken in overdose and cause a physical
and psychological dependence;
2. BENZODIAZEPINES - prescribed to treat anxiety,
sleep disorders and panic attacks (withdrawal
syndrome includes the major complications of fits
and psychosis);
3. KETAMINE - used as an anesthetic agent that can
be taken intranasally, orally or by injection (users can
experience a cocaine-like "rush" with psychological
dissociation).
ALCOHOL [ETHANOL]
- Ethanol is a colorless, flammable, volatile liquid that is
soluble in water and has a characteristic taste and odor.
- It is commonly referred to simply as alcohol or spirits, and
is the principal type of alcohol found in alcoholic
beverages.
- It is a product of fermentation by the action of yeast cells
on sugars found in fruits and grains.
- Alcohol intoxicated persons are also often involved in fatal
trauma, triggered by their aggressive behavior.
- Road accidents often involve alcoholic vulnerability either
caused by drunk drivers or drunk pedestrians.
Other fatal incidents may occur:
- Falling down the stairs resulting in head injuries
- Falling from high places due to drunken carelessness
or unsteady gait
- Burns and carbon monoxide poisoning (a common
scenario is for a drunk to go to bed and fall asleep
whilst smoking, the cigarette igniting the bedclothes.
Sometimes, a gas electric or kerosene heater may be
knocked over during drunken staggering, which can
also start a fatal fire)
- Drowning especially in river or docking areas (e.g.,
falling from a bridge or passageway into the water)
GAMMAHYDROXYBUTYRATE [GHB]
- an anesthetic with primarily sedative properties.
- It has been used as a bodybuilding drug and as
treatment to conditions such as insomnia, clinical
depression, narcolepsy and alcoholism.
- It is also used as an intoxicant or as a date rape drug
slipped into a drink by sexual predators, causing the
victim to become incapacitated and develop amnesia.
- GHB typically generates feelings of:
o Relaxation
o Euphoria
o Intoxication
- Lower doses cause:
o Drowsiness
o Dizziness
o Nausea
o Visual disturbances
- Higher dosages cause:
o Unconsciousness
o Seizures
o Severe respiratory depression
o Coma
o Death
OPIOIDS
- Opioids are addictive and potentially deadly drugs, in
which analgesic (painkiller) effects decrease the
perception of pain and reaction to pain as well as
increase pain tolerance.
- They are also considered as strong cough
suppressants.
- Side effects include:
o mental clouding
o Drowsiness
o visual disturbances
o sedation
o constipation
o a strong sense of euphoria.
- Severe intoxication can result in respiratory
depression and death.
EXAMPLES OF OPIODS
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- morphine (is the major representative of the general
group of opioids, which comprise natural opium and
a whole series of chemically related derivatives)
- heroine (is the most abused and the most fatal, it has
no medical use and a high potential for abuse.)
- codeine
- methadone
- other opiates
The most common route of exposure:
- intravenous injection
- but it can also be snorted or smoked
Side effects include:
- severe itching
- flushing
- dry mouth
- nausea
- vomiting
In cases of fatal heroin abuse, a person may die suddenly,
sometimes with the needle or the torniquet still around the
arm.
Intravenous abusers may have single scar from a favored
injection site or have multiple needle tracks, usually in the
veins of the arm and hands.
Other injection sites are the veins in the leg, groin and even in
the neck.
POST-MORTEM FORENSIC TOXICOLOGY
- In suspecting drugs and poisoning deaths, the pathologist
collects and preserves the specimen for toxicological
analysis subsequent to the autopsy.
- These cases usually involve toxicological scenarios, such
as:
o drug overdose
o homicide by poison
o alcohol impairment in an accident or
crime
o use of drugs to commit suicide.
TOXICOLOGICAL ANALYSIS
- is also required in determining if assertions of self-
defense against drug-induced psychotic behavior is
plausible,
- if drugs were used to incapacitate a victim of crime, or
- if a patient was in compliance with their prescribed
medicines.
- Sometimes, the cause of death is unknown, and the
toxicologist has to review the case history and
investigation to narrow the search for a specific poison.
SPECIMEN COLLECTION
- The challenge with post-mortem samples is that the
quality and availability of the samples themselves can
vary greatly.
- Unlike testing clinical samples from living individuals,
post-mortem toxicology has the unique problem of
testing samples collected at autopsy that may have
undergone varying levels of decomposition.
BLOOD - most common and preferable sample to use, when
possible
URINE - can be used as a second sample for confirmation of
a drug’s presence
VITREOUS - an excellent specimen to use in absence of
blood; less subject to contamination; water-soluble substances
BILE - usually not a first-line specimen but can be useful in
qualitative screening
TISSUE SPECIMENS - Commonly collected at autopsy and
are readily available in large quantities
MUSCLE - preferred tissue sample.
LIVER - can be used as a secondary sample when blood is
not available
KIDNEY SPECIMEN - used mainly in heavy-metal testing
LUNG SPECIMEN - For inhaled toxins, such as volatile
testing substances
SPLEEN - For cases of carbon monoxide poisoning
ADIPOSE TISSUE - For pesticide poisoning and volatile
analysis
STOMACH CONTENTS - Often collected in cases where an
oral drug overdose is suspected
HAIR - an excellent screening source for arsenic poisoning
and is becoming more commonly used in screening for the
chronic use of illicit drugs, including morphine, cocaine, and
amphetamines
other sample include:
- fly larvae (maggots)
- blood stains
- soil samples
- cremation ash
- Tablet, capsules, vials, and
- various household products may also be collected at the
death scene.
LABORATORY ANALYSIS
- Once the samples have been collected and properly
preserved, the next step is called
- the EXTRACTION PROCEDURE, which involves the
separation of the analytes (the substances you want to
measure) from the biological matter.
- Most specimens require a certain degree of pretreatment
to isolate the drug or poison by using separation
techniques such as distillation, protein precipitation,
liquid-liquid extraction and solid-phase extraction.
- This is followed by forensic toxicological analysis using
two types of tests: screening tests and confirmatory tests.
PRELIMINARY SCREENING TESTS
- Screening tests allow the toxicologist to rapidly test for a
variety drugs and toxins
- ST give preliminary results, and then a positive result must
be verified with a confirmatory test.
- Immunoassays
o are popular techniques that can be used to
screen a large number of drugs.
o Use antibodies that bind with a target class
of compounds.
- Spectrophotometry
o is easy to use but it is not commonly used in
forensic toxicology because of its lack of
sensitivity and specificity.
o Spectrophotometer- measure the changes in
the wavelength of light
- Chromatography
o can be used as a screening test for a large
number of drugs when combined with a
detector.
Gas Chromatography (GC) & Liquid Chromatography
(LC)
- very popular method in forensic toxicology,
because they are easy to perform, sensitive
and can provide good initial separations.
- Example: drugs are dissolved into a mobile
phase allowing for the separation and
isolation of the constituents of the sample.
CONFIRMATORY TEST
- The process of confirmation involves the use
of various methods that give structurally
specific information about a compound in
order to eliminate the potential for false
positive results.
- The confirmatory test should also be more
specific than the screening test.
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MASS SPECTROMETRY
- accomplished by fragmenting a molecule
using a barrage of electrons and then
analyzing the relative abundance of the
fragments or by ionizing molecules and
analyzing the charge transference (Molina,
2010).