TOKSIKOLO

GI
FORENSIK
dr. Farah Primadani Kaurow, SpFM
PJJ – FK YARSI
2021
 introduction
• Toxicology is one of a branch of science
that focus on chemicals that can cause
toxic effect for human bodies

• It studies about: the sources, nature,

efficacy, symptoms, treatment and
abnormalities that occur in victims

• Simpson’s Forensic Medicine 13th ed. Jason Payne-James. 2011

 introduction
The term ‘toxic’ can be applied in different ways.

Some use the term synonymously with ‘poisonous’, meaning to imply that ingestion of a
particular substance will cause death.

Others mean only to imply that some sort of illness will result if the substance is ingested.

The definition of ‘lethal dose’ is more precise, but now that the molecular mechanisms of
many poisons are known, the relevance of this concept is not as important as it once was

• Simpson’s Forensic Medicine 13th ed. Jason Payne-James. 2011

 The  clinical toxicologist is most
concerned with diagnosis and
treatment of the living patient

the analytical toxicologist has the

introductio complex task of laboratory
n investigation; and

the pathologist is concerned with

evaluating poisons as a cause or a
contribution to death

• Knight’s Forensic Pathology 4th Ed. Saukko & Knight

 FORENSIC TOXICOLOGY…

• Forensic toxicology itself is related to the application of toxicology in

a variety of cases and criminal problems where drugs and chemicals
that can cause medicolegal consequences and to become evidence in
court

The Forensic Toxicology Council. Briefing: What is Forensic Toxicology?. The American Board of Forensic Toxicology (ABFT). 2010
• Drugs can reliably be detected and quantitated in any tissue of the
body. It is the interpretation of those quantities that is critical.

• Interpeting the significance of any drug found is the major issue

facing forensic practitioners on a daily basis.

• Detection proves that ingestion or at least exposure has taken place,

but the mere presence of a drug, even in seemingly large quantities,
says nothing about toxicity and even less about intention or motivation

• Simpson’s Forensic Medicine 13th ed. Jason Payne-James. 2011

 Sources of Toxicants…??
1. Air pollution
Environment 2. Poor ventilation
3. Volatile compounds
4. Plants
5. Animals

1. Drugs
Food/ Water
2. Heavy metals
 How you get intoxicated…??

INTENTIONAL ACCIDENTAL
Basic exposure routes..

1. Inhalation  Gas
2. Dermal/ skin contact
3. Ingestion
4. Intravenous
Diagnosis…

1. Looking for signs and symptoms

that correspond to the toxin

2. Important: found toxin/ its

metabolite in the body/ body fluid/
other parts of body
 Forensic Examination….
On dead victims

1. Crime Scene Examination

2. External Examination
3. Autopsy

• Simpson’s Forensic Medicine 13th ed. Jason Payne-James. 2011

TKP
External
Examination…
• Smell
• Clothing
• Livor mortis
• Skin changes
• Nails
• Hair
• Injection site
 • The autopsy in these circumstances can be
amongst the most difficult of problems faced by
a forensic pathologist – not in the technical
procedure of the examination, but in the final
evaluation of all the available information.
Autopsy….
• but in most poisonings the major function of the
autopsy is to evaluate any other conditions
present, both from trauma and natural disease –
but also to collect suitable material for
laboratory analysis

• Knight’s Forensic Pathology 4th Ed. Saukko & Knight

 • The investigation of a death from suspected
poisoning may stand or fall upon the
The correctness or otherwise of the sampling of
collection of fluids and tissues from the body
autopsy
• Unsuitable  samples, inadequate amounts,
samples for incorrect sampling sites, poor containers,
toxicological inadequate preservation methods and delayed
or unsatisfactory storage and transport to the
analysis laboratory may frustrate or distort proper
analysis

• Knight’s Forensic Pathology 4th Ed. Saukko & Knight

 Sample Collection
1. Blood  preferred testing matrix for drug detection
2. Urine
3. Vitreous humor  diagnosis of electrolyte disorders, renal
failure, hyperglycaemia and ethyl alcohol ingestion
4. Hair testing  drug exposure and drug compliance
5. Liver  where the drug is highly bound to protein &
undergoes enterohepatic circulation
6. Stomach
7. Kidney
8. LCS
9. Bile
10. Muscle

Simpson’s Forensic Medicine 13th ed. Jason Payne-James. 2011

 Containers for
toxicology sample
1. All containers must be chemically
clean
2. Blood should be collected in screw-
capped universal containers of about
30 ml or, where less will suffice, in
plastic-capped tubes of about 5 ml.
3. Urine is best held in 30 ml universal
containers, as is bile.

• Knight’s Forensic Pathology 4th Ed. Saukko & Knight

 Stomach contents may be retained in glass or plastic jars
with a volume of at least 250 ml, the lid being either a
tight screw-thread with a cardboard or plastic liner, and
a self-sealing plastic top
Containers
for Liver is usually required, preferably a piece weighing 50
g
toxicology
sample Vitreous humour or cerebrospinal fluid (CSF), bijou
bottles of 5 ml capacity or small tubes of similar size,
are needed

• Knight’s Forensic Pathology 4th Ed. Saukko & Knight

 Preservatives?

• It would seem that for general use, a

concentration of 1–2 per cent of sodium
or potassium fluoride is satisfactory

• Knight’s Forensic Pathology 4th Ed. Saukko & Knight

 1. Rapid test NAPZA
Pemeriksaan kualitatif/ 2. Rapid test alcohol
semikuantitatif… 3. Pem Conway 
Pemeriksaan
kuantitatif…
1. GC-MS
2. LC-MS
 Alcohol intoxication
• Ethyl alcohol is the most commonly used
drug in the world and has such numerous
points of contact with medico-legal
pathology that it has to be considered
separately from all other substances
• Death from alcoholic poisoning is not
uncommon and can occur at blood-alcohol
levels in excess of about 300 mg/100 ml.
Most frequently, alcohol poisoning is
attributed to chronic alcoholism as
unaccustomed drinker rarely reaches lethal
BAC

• Knight’s Forensic Pathology 4th Ed. Saukko & Knight

 Carbonmonoxide
Poisoning
• Carbon monoxide has an affinity
for haemoglobin that is between
200 and 300 times greater than
oxygen.
• At autopsy the most striking
appearance of the body is the
colour of the skin, especially in
areas of postmortem hypostasis
• The classical ‘cherrypink’ colour of
carboxyhaemoglobin is usually
evident if the saturation of the
blood exceeds about 30 per cent
• Knight’s Forensic Pathology 4th Ed. Saukko & Knight
Simpson’s Forensic Medicine 13th ed. Jason Payne-James. 2011
Thank You…
dr. Farah Primadani Kaurow, SpFM
+62 813-8110-9581
farahkaurow@gmail.com