In the case of a person dying for whatever reason, why does it take so long for toxicology analysis to be conducted and reports delivered?
February 13, 2012 6:30 AM Subscribe
Post mortem toxicology tests - why does it take so long for results to be delivered?
Barring the issues with notification of family and other things like that, in a strict medical sense, it always seems that in the case of a person who passed unexpectedly and via an unconfirmed means, it is always reported that toxicology results will take 6 weeks or so to be available. Why is the process so long? There are a number of answers out there on web already, but could someone distill it down a bit? Or is this one of those things that has so many variable there is not simple answer?
Of course this was prompted by the recent Whitney Houston passing, but it is a situation that seems to be with just about any person who has died unexpectedly.
Barring the issues with notification of family and other things like that, in a strict medical sense, it always seems that in the case of a person who passed unexpectedly and via an unconfirmed means, it is always reported that toxicology results will take 6 weeks or so to be available. Why is the process so long? There are a number of answers out there on web already, but could someone distill it down a bit? Or is this one of those things that has so many variable there is not simple answer?
Of course this was prompted by the recent Whitney Houston passing, but it is a situation that seems to be with just about any person who has died unexpectedly.
Best answer: They can do a preliminary test that is fast to find out what type of drug is present in their body, but then...
“You confirm the preliminary test,” said Douglas Rohde, supervisor of chemistry and toxicology at the Lake County Crime Lab in Ohio. “You confirm that drug is actually there. There’s not one test as seen in 'CSI.' There’s no quick test that gives you a positive identification and confirmation. The confirmatory tests can take days or weeks, if they have to be repeated.”
Since this is a high profile case involving a celebrity, there's additional pressure to get the Is dotted and the Ts crossed so there will likely be several tests run to confirm the results.
posted by inturnaround at 7:30 AM on February 13, 2012 [1 favorite]
“You confirm the preliminary test,” said Douglas Rohde, supervisor of chemistry and toxicology at the Lake County Crime Lab in Ohio. “You confirm that drug is actually there. There’s not one test as seen in 'CSI.' There’s no quick test that gives you a positive identification and confirmation. The confirmatory tests can take days or weeks, if they have to be repeated.”
Since this is a high profile case involving a celebrity, there's additional pressure to get the Is dotted and the Ts crossed so there will likely be several tests run to confirm the results.
posted by inturnaround at 7:30 AM on February 13, 2012 [1 favorite]
Best answer: Because its not an episode of "House" where the team does all the tests and has results in an hour.
Its real doctors and lab techs who may or may not do shift work. Most lab tests are run on a schedule according to staff and the type of machine that produces the results. Then the tests have to be either repeated or approved with possibly different doctors consulted. When thats all said and done the recording of the paperwork begins with real transcriptionists, secretaries, and other staff who also may or may not do shift work. All this has to be done in a secure fashion with all kinds of privacy laws and regulations. I'm sure its even worse when there's a celebrity envolved. I believe different states have their own regulations and some paperwork is approved by state medical examiners before things are finalized.
posted by PJMoore at 7:38 AM on February 13, 2012 [1 favorite]
Its real doctors and lab techs who may or may not do shift work. Most lab tests are run on a schedule according to staff and the type of machine that produces the results. Then the tests have to be either repeated or approved with possibly different doctors consulted. When thats all said and done the recording of the paperwork begins with real transcriptionists, secretaries, and other staff who also may or may not do shift work. All this has to be done in a secure fashion with all kinds of privacy laws and regulations. I'm sure its even worse when there's a celebrity envolved. I believe different states have their own regulations and some paperwork is approved by state medical examiners before things are finalized.
posted by PJMoore at 7:38 AM on February 13, 2012 [1 favorite]
Best answer: This happened in my family last year. Basically the death certificate needs to have the cause of death on it. In an unattended high profile death this may be disputed. People want to make sure they actually have the cause of death to the best of their ability because lawsuits may be hinging on it, not just "Oh there were drugs in her system but we don't know if that killed her" and there are a lot of tests to run.
The short form is "Because the lab is backed up doing crime stuff and is understaffed and tox texts are low priority because the dead person is going to stay dead." When my father died we dealt with this exact thing and my sister works for the state crime lab that did his tests and was able to at least try to pull a few strings to jump queue so we got results in a few weeks not a few months but the short form is because there's a state agency that has to deal with this and they are busy and understaffed and the tests are complicated. My guess is they'll have the results sooner but party line is "Six weeks, quit asking us"
posted by jessamyn at 7:42 AM on February 13, 2012 [1 favorite]
The short form is "Because the lab is backed up doing crime stuff and is understaffed and tox texts are low priority because the dead person is going to stay dead." When my father died we dealt with this exact thing and my sister works for the state crime lab that did his tests and was able to at least try to pull a few strings to jump queue so we got results in a few weeks not a few months but the short form is because there's a state agency that has to deal with this and they are busy and understaffed and the tests are complicated. My guess is they'll have the results sooner but party line is "Six weeks, quit asking us"
posted by jessamyn at 7:42 AM on February 13, 2012 [1 favorite]
Best answer: Others have been wondering the same thing, with this explanation at Slate.
posted by ldthomps at 8:12 AM on February 13, 2012
posted by ldthomps at 8:12 AM on February 13, 2012
Best answer: My uncle's tests took around 6-7 weeks though they'd originally expected a few weeks longer. Same as with jessamyn...the labs were VERY backed up (seems that everyone in the state decided to commit crimes and/or die in that time frame) and they couldn't do much to get the results back any sooner. It was a trying time for the family, but understandable.
posted by PeppahCat at 8:25 AM on February 13, 2012
posted by PeppahCat at 8:25 AM on February 13, 2012
Response by poster: Thanks everyone.
Just to clarify, it was not just the WH incident that prompted this question. (I should have left that part out entirely…sorry). It has been on my mind for a very long time. I do understand the tip-toeing that goes around with a high profile person, their untimely demise and the events that follow that as well as the whole issue with less than accurate TV show doctoring scripts clouding the issue. I have just always wondered why in nearly every situation, there always seems to be that 6-8 week number used, no matter who the person was or their place in life.
It always struck me as odd that, in death, we take so long to determine toxicology, but in life similar tests are performed in minutes (or hours) and can affect a person’s life for the rest of their living days. I guess there are reasons for everything and one of them being a live person metabolizes things in the blood stream whereas a deceased person’s body has stopped that process. Hence the rush to get it done is not as necessary. However, the basic administrative problems, scheduling of staff and the “parts-per-million” issues were not something I considered. So this is all it making clearer.
Thanks again. I appreciate the candor in answering a question about a sensitive subject.
posted by lampshade at 8:54 AM on February 13, 2012
Just to clarify, it was not just the WH incident that prompted this question. (I should have left that part out entirely…sorry). It has been on my mind for a very long time. I do understand the tip-toeing that goes around with a high profile person, their untimely demise and the events that follow that as well as the whole issue with less than accurate TV show doctoring scripts clouding the issue. I have just always wondered why in nearly every situation, there always seems to be that 6-8 week number used, no matter who the person was or their place in life.
It always struck me as odd that, in death, we take so long to determine toxicology, but in life similar tests are performed in minutes (or hours) and can affect a person’s life for the rest of their living days. I guess there are reasons for everything and one of them being a live person metabolizes things in the blood stream whereas a deceased person’s body has stopped that process. Hence the rush to get it done is not as necessary. However, the basic administrative problems, scheduling of staff and the “parts-per-million” issues were not something I considered. So this is all it making clearer.
Thanks again. I appreciate the candor in answering a question about a sensitive subject.
posted by lampshade at 8:54 AM on February 13, 2012
I think the other difference between doing tests on a live person and a dead one is that with a live person you have cues about what's going on. You ask the person (or their family/carers) how they feel and what they've been doing and eating and taking, and you also have other live indicators like blood pressure, heart rate, respiration, etc, to give you a baseline from which to proceed. With a dead person those indicators have all been removed, plus you could be looking for obscure drugs or substances, and probably performing a lot of tests for a lot of different things.
posted by andraste at 1:48 PM on February 13, 2012
posted by andraste at 1:48 PM on February 13, 2012
In addition to what andraste said, the standards of testing are different. In live people, the focus is generally on getting a "good enough" method in a timescale where it can actually have an impact on patient care. Usually this is just testing by one method and often a method that is quick and easy to do rather than the most accurate available.
Once the person is dead, not only is the time pressure removed, but results have to be solid enough legally speaking for the death certificate and any legal process i.e. not subject to any doubt at all. Forensic labs usually use more effort intensive methods and almost always confirm everything with at least two testing methods. Because of the nature of the methods, samples will be batched up, tests normally only run in the daytime and senior staff need to sign off on results. All this takes longer than the routine testing on live people.
posted by *becca* at 3:07 PM on February 13, 2012
Once the person is dead, not only is the time pressure removed, but results have to be solid enough legally speaking for the death certificate and any legal process i.e. not subject to any doubt at all. Forensic labs usually use more effort intensive methods and almost always confirm everything with at least two testing methods. Because of the nature of the methods, samples will be batched up, tests normally only run in the daytime and senior staff need to sign off on results. All this takes longer than the routine testing on live people.
posted by *becca* at 3:07 PM on February 13, 2012
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posted by Lesser Shrew at 7:25 AM on February 13, 2012