Truver Michael T, Chronister Chris W, Davis Gregory G, Gray Teresa R, Hartman Rebecca L, Kahl Joseph H, Karschner Erin L, Kerrigan Sarah, Kronstrand Robert, Krotulski Alex J, Lee Dayong, Logan Barry K, Moore Diane M, Rodda Luke N, Vikingsson Svante, Winecker Ruth E, Goldberger Bruce A
Department of Pathology, Immunology and Laboratory Medicine, University of Florida College of Medicine, 1200 SW 34th Street, Gainesville, FL, 32607, United States.
Division of Forensics, Department of Pathology, University of Alabama at Birmingham, Birmingham, Alabama, United States.
J Anal Toxicol. 2025 Jul 9. doi: 10.1093/jat/bkaf061.
Postmortem forensic toxicology plays a critical role in medicolegal death investigations through the identification and quantitation of drugs and other substances in postmortem fluids and tissues. Due to the complexity of this sub-discipline, consistent application of best practices is critical for ensuring accurate and reliable results, particularly in the context of challenges such as emerging novel psychoactive substances, complex poly-drug interactions, postmortem drug redistribution, and analytical limitations inherent with postmortem specimens. Although there has been significant progress in the development of consensus-based forensic toxicology standards, their scope is intentionally broad to accommodate human performance, postmortem, regulated and non-regulated employment drug testing, court-ordered toxicology, and other applications. Consequently, some aspects specific to postmortem toxicology and medicolegal death investigation are not addressed within the standards. This manuscript seeks to fill these gaps by demonstrating how current standards can be applied in a postmortem toxicology setting and presenting best practices in situations where no established standards exist. These best practices will aid laboratories in prioritizing changes to workflows, allocating resources more efficiently, improving analytical accuracy and reproducibility, ensuring interpretative consistency, and strengthening forensic defensibility in administrative and legal proceedings. Key topics addressed include specimen collection and case submission protocols, method validation approaches tailored for postmortem analysis, optimized analytical workflows based on testing scope and case classification, and quality assurance requirements. Considerations for data review, reporting, and result interpretation are discussed in the context of accurate determination of cause and manner of death. Emphasis is placed on integrating toxicological findings with investigative and autopsy information obtained through ongoing communication with stakeholders. By integrating the application of existing consensus standards with the best community practices for postmortem toxicology, this manuscript aims to support the generation of robust and reliable toxicological data, with the goal of improving forensic investigations, public health surveillance, and drug policy development.
死后法医毒理学在法医学死亡调查中发挥着关键作用，通过鉴定和定量死后体液及组织中的药物和其他物质。由于该子学科的复杂性，持续应用最佳实践对于确保准确可靠的结果至关重要，特别是在面对诸如新型精神活性物质不断涌现、复杂的多药相互作用、死后药物再分布以及死后标本固有的分析局限性等挑战的情况下。尽管基于共识的法医毒理学标准的制定取得了重大进展，但其范围有意设定得较为宽泛，以适应人员表现、死后、受监管和不受监管的就业药物检测、法院命令的毒理学以及其他应用。因此，标准中未涉及死后毒理学和法医学死亡调查的一些特定方面。本手稿旨在填补这些空白，展示如何在死后毒理学环境中应用现行标准，并介绍在没有既定标准的情况下的最佳实践。这些最佳实践将帮助实验室确定工作流程变更的优先级、更有效地分配资源、提高分析准确性和可重复性、确保解释一致性，并在行政和法律程序中加强法医辩护能力。所涉及的关键主题包括标本采集和案件提交协议、为死后分析量身定制的方法验证方法、基于检测范围和案件分类的优化分析工作流程以及质量保证要求。在准确确定死亡原因和方式的背景下，讨论了数据审查、报告和结果解释的注意事项。重点是将毒理学结果与通过与利益相关者持续沟通获得的调查和尸检信息相结合。通过将现有共识标准的应用与死后毒理学的最佳行业实践相结合，本手稿旨在支持生成强大而可靠的毒理学数据，以改善法医调查、公共卫生监测和药物政策制定。
