Postmortem Toxicology

EVIDENCE REVIEW

How to review toxicology after death

Postmortem toxicology requires special attention to specimen source and the biological changes that can occur after death. A review should identify whether blood was peripheral or central, which additional matrices were collected, how specimens were preserved and stored, the interval before collection, the condition of the body, and whether decomposition or medical treatment could affect the findings. Results from heart blood, femoral blood, urine, vitreous fluid, liver, and other tissues are not directly interchangeable.

Interpretation should also address postmortem redistribution, instability, microbial activity, contamination, tolerance, disease, trauma, and the complete autopsy context. A concentration associated with toxicity in one setting may not independently establish cause or contribution in another. The most supportable conclusion usually comes from integrating validated analytical data with scene history, medications, pathology, and other case evidence while stating the remaining uncertainty. The guides below provide a structured starting point for that review.

A complete review should compare findings across every available specimen and reconcile apparent differences rather than selecting a single concentration in isolation. It should also identify analytes that were not tested, limits of detection and reporting, possible degradation products, and whether confirmatory methods addressed compounds suggested by the history or initial screen. Transparent documentation of those boundaries makes the final opinion easier to evaluate and less likely to overstate what the toxicology can establish. The resulting opinion should remain reproducible from the documented record.