Postmortem toxicology

In collaboration with the Department of Forensic Toxicology, National Board of Forensic Medicine, postmortem femoral blood concentrations of pharmaceutical drugs and illicit drugs in certified fatal intoxication cases and postmortem controls are evaluated according to a standardized protocol. Using this strategy, fatal cases are classified as 1) intoxications with one drug only, 2) multiple drug intoxications; and 3) postmortem controls consisting of strictly selected cases where the subject with certainty died from another cause of death and was not incapacitated by drugs at the time of death. All collection, handling, and analysis of the samples follow standardized procedures established at all forensic medicine units in Sweden since 1991. This strategy has resulted in several publications presenting reference concentrations of pharmaceutical drugs in postmortem blood. This reference information is critical in order to correctly interpret such results in obscure postmortem cases. A website, where the database will be available for other researchers and for professionals conducting forensic medicine and toxicology casework, is under construction. Since 2013 a collaboration has been established with Victorian Institute of Forensic Medicine in order to expand the reference database. The ambition is to later include additional laboratories to increase the list of substances so that the database becomes more globally useful. The plan is also to include clinical data, particularly regarding toxicological results found in driving-under-the-influence cases and in non-lethal intoxications.