tag:blogger.com,1999:blog-20629163.comments2023-05-24T03:14:39.889-05:00"Live from the Coroner's Office"Dr. Richard Kellerhttp://www.blogger.com/profile/11307076697112567697noreply@blogger.comBlogger836125tag:blogger.com,1999:blog-20629163.post-44338524694820219192018-05-16T17:21:59.476-05:002018-05-16T17:21:59.476-05:00The short answer is no.
There would be nothing t...The short answer is no. <br /><br />There would be nothing to test, no way to find the usual poison suspects: No urine, no blood, no vitreous, no liver. Only skeletal remains.Dr. Richard Kellerhttps://www.blogger.com/profile/11307076697112567697noreply@blogger.comtag:blogger.com,1999:blog-20629163.post-2268353308514917722018-05-15T19:57:47.822-05:002018-05-15T19:57:47.822-05:00My mom died 16 years ago. There was no autopsy or ...My mom died 16 years ago. There was no autopsy or toxicology report done but my sister wants to exhume the body to see if she was poisoned. Would they still be able to find it in her after that many years being deceasedAnonymoushttps://www.blogger.com/profile/01502909400348347387noreply@blogger.comtag:blogger.com,1999:blog-20629163.post-7680222686154885882018-05-14T18:26:11.147-05:002018-05-14T18:26:11.147-05:0040 mg OVERDOSED seriously? I'm on 120 mg a day...40 mg OVERDOSED seriously? I'm on 120 mg a day your FAR from being g overdosedAnonymoushttps://www.blogger.com/profile/15583319986465909548noreply@blogger.comtag:blogger.com,1999:blog-20629163.post-27309688176802851682018-05-14T18:14:02.016-05:002018-05-14T18:14:02.016-05:00Mixing methadone and weed does not kill you. He mu...Mixing methadone and weed does not kill you. He must have taken something else with itAnonymoushttps://www.blogger.com/profile/15583319986465909548noreply@blogger.comtag:blogger.com,1999:blog-20629163.post-50202650287918783792018-05-11T20:26:07.199-05:002018-05-11T20:26:07.199-05:00Thank you for your response. You helped clarify so...Thank you for your response. You helped clarify some things for me and I really appreciate it. Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-20629163.post-57460730977204524862018-05-11T13:07:51.231-05:002018-05-11T13:07:51.231-05:00It would appear that your cousin died from a combi...It would appear that your cousin died from a combination of fentanyl and heroin (the latter evidenced by the 6 mono-acetyl-morphine). Fentanyl can kill with what might appear to be low levels, particularly in combination with other drugs with similar lethality effects. Both these drugs cause respiratory and cardiac depression as their pathway to death. When you combine 2 drugs with similar profiles it is not 1+1=2, it's 1+1=all bets are off on lethal vs. "safe", multiplicative not additive.<br /><br />My condolences Dr. Richard Kellerhttps://www.blogger.com/profile/11307076697112567697noreply@blogger.comtag:blogger.com,1999:blog-20629163.post-65052324743549163432018-05-11T12:58:18.318-05:002018-05-11T12:58:18.318-05:00Yes, an individual in drug-induced delirium can pl...Yes, an individual in drug-induced delirium can plan and can die by suicide. The delirium is often not a totally "out of the head" occurrence, but a lack of what many would say was "rational" thought.<br /><br />Drugs/medications can contribute in at least 2 ways to acts of suicide: 1) giving the individual the "energy" to act on long held feelings and 2) they can push the individual with their thinking "it" is not ever going to get better.<br /><br />My condolences Dr. Richard Kellerhttps://www.blogger.com/profile/11307076697112567697noreply@blogger.comtag:blogger.com,1999:blog-20629163.post-84570671867381196842018-05-10T12:19:41.026-05:002018-05-10T12:19:41.026-05:00Please help, I'm really confused. My cousin pa...Please help, I'm really confused. My cousin passed away in november of 2017 and we just got back the medical examiners report and toxicology report. The cause of death is listed as accident. The toxicology report revealed that he had 25.7 mcg/L of fentanyl in his blood. His urine revealed he had 0.064 mg/L of codeine, 1.176 mg/L of morphine, and 0.240 mg/L of 6-mono-acetyl-morphine in his system. He was an active heroin user, so none of this came as a huge surprise, but my question is was this an overdose or did he die because of the fentanyl? From the research that I've done it doesn't seem that 25mcg of fentayl is lethal, but perhaps I'm mistaken. Also, I'm fairly certain he passed away the night before and wasn't taken by the coroner's office until approximately 12 hours later. Could this be a reason the levels are lower? I'm so confused. Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-20629163.post-4245452563018870582018-05-08T02:15:40.381-05:002018-05-08T02:15:40.381-05:00Hello. Do you still take?'s? I really need to ...Hello. Do you still take?'s? I really need to know if & how some prescribed meds led my brother to suicide? What info do you need from tox rept? I just can't believe this happened. I only know of 2x within 6mo of his death he exceeded doseage. He wasn't in any delirium. How/could it cause drug induced delirium & he still able to plan (coming up with idea, prep,etc) and physically able to hang himself?Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-20629163.post-3781251607672307672018-04-23T11:31:32.900-05:002018-04-23T11:31:32.900-05:00Thank you for your response I really appreciate yo...Thank you for your response I really appreciate your feedback . The whole investigation is “messy” unfortunately , with no attention to detail or accuracy, thank you again Anonymoushttps://www.blogger.com/profile/05193891636812641341noreply@blogger.comtag:blogger.com,1999:blog-20629163.post-4620986729748223962018-04-23T10:15:04.560-05:002018-04-23T10:15:04.560-05:00Ms Robinson
Because alcohol is a volatile substan...Ms Robinson<br /><br />Because alcohol is a volatile substance, no matter how the body was stored, a level drawn on post-mortem day 5 or 6 would be of questionable accuracy. It could have increased with decomposition or decreased volatilizing from the body.<br /><br />The fact that the specimen "was of insufficient size" for other testing and the fact that the testing was run 3 weeks after drawn would also call result accuracy into question.<br /><br />The BAC would be quite questionable in this 'messy' situation.Dr. Richard Kellerhttps://www.blogger.com/profile/11307076697112567697noreply@blogger.comtag:blogger.com,1999:blog-20629163.post-39034848238119465882018-04-21T10:35:22.755-05:002018-04-21T10:35:22.755-05:00Hi , I would like to know if elevated BAC levels t...Hi , I would like to know if elevated BAC levels taken 5 days after death, where the body was not stored in lower temperatures until at least several hours after death on a warm May with no other samples tested for BAC could stand up in court as being accurate in that the person was over the drink drive limit ? The report also states after the initial analysis on three different dates the sample was insufficient to carry out further tests Also the blood was not analysed by the toxicologist until 3 weeks after the blood sample was taken . Many thanks Anonymoushttps://www.blogger.com/profile/05193891636812641341noreply@blogger.comtag:blogger.com,1999:blog-20629163.post-57546542570188484612018-04-20T17:30:15.312-05:002018-04-20T17:30:15.312-05:00Could I also ask please if the blood was taken on ...Could I also ask please if the blood was taken on the 6 th day after death but then not analysed until 3 weeks later at the lab could this also have an impact on the BAC , many thanks Anonymoushttps://www.blogger.com/profile/05193891636812641341noreply@blogger.comtag:blogger.com,1999:blog-20629163.post-14352373615486896282018-04-20T17:22:39.363-05:002018-04-20T17:22:39.363-05:00Could there be a possibility that the results of t...Could there be a possibility that the results of the BAC likely to still be falsely elevated if the body was stored correctly , but only after at least seven hours , No other samples were analysed for any validation either , thank you Anonymoushttps://www.blogger.com/profile/05193891636812641341noreply@blogger.comtag:blogger.com,1999:blog-20629163.post-5160681125603961722018-04-20T17:18:09.594-05:002018-04-20T17:18:09.594-05:00Hi the toxicologist is saying in his report that t...Hi the toxicologist is saying in his report that the results represent alcohol consumption not fermentation . Bloods taken on day 6 after death. They are saying as his body was stored correctly, although not until at least seven hours after death that elevated BAC would be due to alcohol consumption. I would appreciate your view , many thanks Anonymoushttps://www.blogger.com/profile/05193891636812641341noreply@blogger.comtag:blogger.com,1999:blog-20629163.post-18574379681553272072018-04-18T14:22:36.545-05:002018-04-18T14:22:36.545-05:00It would seem most likely to me, in view of the si...It would seem most likely to me, in view of the significant autopsy lung findings, that when he was collapsing he was collapsing in death.<br /><br />Realize that time of death is always an approximation, I doubt the medical examiner could be much more specific.<br /><br />I'm glad my answers have been of some help to you.Dr. Richard Kellerhttps://www.blogger.com/profile/11307076697112567697noreply@blogger.comtag:blogger.com,1999:blog-20629163.post-78560334086351246252018-04-17T23:19:09.482-05:002018-04-17T23:19:09.482-05:00I sincerely appreciate you taking the time to answ...I sincerely appreciate you taking the time to answer my questions. It’s really tough not having all of the information to piece together exactly what happened to him. When he collapsed from the failing blood pressure and ventilation would that have likely been when he actually died or would he have just been unconscious but still alive? I don’t know much about this type of death so I’m struggling with trying to figure out exactly what he went through. Is there any way that the medical examiner would be able to give an actual time of death? I cannot thank you enough for your input. I really can’t. Your explanations were so helpful. Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-20629163.post-47991970505614780532018-04-17T15:33:43.805-05:002018-04-17T15:33:43.805-05:00My condolences
Based on this information, it ver...My condolences <br /><br />Based on this information, it very likely that your brother did die as a result of the synergistic effect of the combination of the alcohol and hydrocodone in his system.<br /><br />The BAC in his heart blood blood would be most "accurate", although the vitreous level tells us how much was in and around his brain.<br /><br />The pulmonary changes on autopsy are classic for findings after death due to respiratory and cardiac depressants, like alcohol and hydrocodone. With his heart and lungs no longer working effectively, fluid and blood "backs up" into the lungs. This makes it very likely that he passed out because of failing blood pressure and ventilation, causing him to fall off the platform. He would not have been aware of the fall or any pain that might have resulted from the fall.<br /><br />Clearance of acetaminophen and cyclobezaprine from the blood is too inconsistent to be used to predict time from ingestion to death.<br /><br />The hydrocodone level is not itself a lethal level, although likely was higher at some point. It was the combination that caused his death.<br /><br />The time frame you describe would still give you fairly accurate results of all his lab testing.Dr. Richard Kellerhttps://www.blogger.com/profile/11307076697112567697noreply@blogger.comtag:blogger.com,1999:blog-20629163.post-19403000877638967022018-04-16T21:20:11.968-05:002018-04-16T21:20:11.968-05:00My brother passed away and was found about 5 hours...My brother passed away and was found about 5 hours after he had “collapsed” and fell 6 feet off of a train platform head/face first. The premilinary cause of death was trauma. After the full autopsy, the COD was ruled alcohol and hydrocodone intoxication. The only trauma/injury was compound fractures of his mandible. His toxicology report read<br />Blood Heart- Ethanol .23%<br />Blood Femoral- Ethanol .26%<br />Urine-Ethanol .33%<br />Vitreous- Ethanol .30%<br /><br />Urine was positive for Cyclobenzaprine, Hydrocodone and Acetaminophen<br /><br />Blood Heart was negative for Cyclobenzaprine and Acetaminophen but was positive for Hyrdocodone (<0.05 mg/L)<br /><br />My questions are <br />-Was the amount of alcohol and hydrocodone in his system enough to be fatal? <br />-Which BAC would be the most accurate? <br />-The autopsy report also stated the pulmonary parenchyma was purple and edematous, exuding moderate amounts of blood and frothy fluid. Would this be indicative of an overdose or was this from the trauma to his mouth and breathing in blood after the injury occurred? We were never told whether he was alive after the fall or if he died before he hit the ground. Is there any way to know this? Would he have likely been too intoxicated to feel the pain from the fall? How long after a collapse would it take for a person to die with these levels? <br />-If the Cyclobenzaprine and Acetaminophen was found in the urine but not in the blood, do you have any idea how long before death it was possibly taken? <br />-Was the amount of Hydrocodone found in the Blood a normal/average dose? <br />-The autopsy was performed the day after he was found, would the toxicology amounts be fairly accurate with what they would’ve been at the time of death? <br /><br />Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-20629163.post-5306898902625751492018-04-04T14:56:18.538-05:002018-04-04T14:56:18.538-05:00Warm May and 5 days, there was decomposition. Deco...Warm May and 5 days, there was decomposition. Decomposition can elevate blood alcohol level as the decomposition results in the production of alcohol.<br /><br />Studies have show increase of blood alcohol levels as much as 0.15% with decomposition (keep in mind, in many places a level of 0.08% is legally drunk). Difficult to predict in a given case, but this may give you an idea of what could have happened, although likely less than the 0.15 in your case.Dr. Richard Kellerhttps://www.blogger.com/profile/11307076697112567697noreply@blogger.comtag:blogger.com,1999:blog-20629163.post-32827641619314889432018-04-04T14:25:56.622-05:002018-04-04T14:25:56.622-05:00in our case toxicology bloods weren't taken un...in our case toxicology bloods weren't taken until 5 days after death in a warm May. Vitreous fluids were not taken for whatever reason is not clear. The description of the body state is not disclosed either in the post mortem report. Is it likely then that the BAC levels reported could be falsely elevated? Thank you. We have been told there a marginal error but we'd like to be clear on how much this could be? Thank youAnonymoushttps://www.blogger.com/profile/01481251150968543317noreply@blogger.comtag:blogger.com,1999:blog-20629163.post-17645159839463517982018-04-03T14:19:27.300-05:002018-04-03T14:19:27.300-05:00While it could go either way, alcohol levels will ...While it could go either way, alcohol levels will tend to rise first in decomposition as the process makes its own alcohol.Dr. Richard Kellerhttps://www.blogger.com/profile/11307076697112567697noreply@blogger.comtag:blogger.com,1999:blog-20629163.post-15706272681623214532018-04-03T11:34:18.544-05:002018-04-03T11:34:18.544-05:00Thank you. Would the BAC levels rise or fall as th...Thank you. Would the BAC levels rise or fall as the decomposition process starts? So for example, if bloods weren't taken until 5 days after death, would the BAC reading be higher than if it had been taken immediately after death? Thank youAnonymoushttps://www.blogger.com/profile/01481251150968543317noreply@blogger.comtag:blogger.com,1999:blog-20629163.post-28290281834668872392018-04-02T16:01:32.742-05:002018-04-02T16:01:32.742-05:00Blood for toxicology testing should be drawn as so...Blood for toxicology testing should be drawn as soon as possible after death. <br /><br />There is an impact from the ambient temperature surrounding the body (hotter area, faster decomposition) and a few other factors (fever before death, for example), but certainly by 24 hours after death decomposition will interfere with blood alcohol levels. That interference can occur sooner, each case is individual. Whether decomposition is going to affect blood alcohol levels is based on examination of the individual who has died.Dr. Richard Kellerhttps://www.blogger.com/profile/11307076697112567697noreply@blogger.comtag:blogger.com,1999:blog-20629163.post-10538403426018717162018-03-28T15:15:53.640-05:002018-03-28T15:15:53.640-05:00How soon after death should blood samples be taken...How soon after death should blood samples be taken for post mortem toxicology before blood alcohol levels become affected due to decomposition? Anonymoushttps://www.blogger.com/profile/01481251150968543317noreply@blogger.com