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Forensic Toxicology Analytical Toxicology Fall 2007

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Page 1: Forensic Toxicology Analytical Toxicology Fall 2007 Analytical Toxicology Fall 2007

Forensic ToxicologyForensic Toxicology

Analytical Toxicology

Fall 2007

Analytical Toxicology

Fall 2007

Page 2: Forensic Toxicology Analytical Toxicology Fall 2007 Analytical Toxicology Fall 2007

Forensic ToxicologyForensic Toxicology

Toxicology is defined as the study of the adverse effects of chemicals on living organisms.

Forensic toxicology is defined as the application of toxicology for the purposes of the law.

Page 3: Forensic Toxicology Analytical Toxicology Fall 2007 Analytical Toxicology Fall 2007

Forensic ToxicologyForensic ToxicologyPostmortem forensic

toxicology.

Human performance toxicology.

Forensic drug testing.

Page 4: Forensic Toxicology Analytical Toxicology Fall 2007 Analytical Toxicology Fall 2007

HistoryHistoryAncient Egyptians and Grecians

reported poisonings due to herbs, plants and food.

Opium, arsenic and hydrocyanic acid were used throughout Europe during the middle ages.

Page 5: Forensic Toxicology Analytical Toxicology Fall 2007 Analytical Toxicology Fall 2007

HistoryHistory Philippus Theophrastus Aureolus

Bombastus von Hohenheim (or Paracelsus) observed that any substance could be a poison, depending on its dose

“ What is there that is not poison? All things are poison and nothing without poison. Solely the dose determines that a thing is not a poison”

Page 6: Forensic Toxicology Analytical Toxicology Fall 2007 Analytical Toxicology Fall 2007

HistoryHistory In 1814, M.J.B. Orfila, the

chairman of the legal medicine department at the Sorbonne in France, published a book entitled Traite des poisons ou Toxicologie Generale.

Page 7: Forensic Toxicology Analytical Toxicology Fall 2007 Analytical Toxicology Fall 2007

HistoryHistory In 1851, Stas developed the first

effective method for extracting alkaloids from biological specimens.

This was modified several years later by Otto, which enabled the isolation of purer alkaloid substances.

Page 8: Forensic Toxicology Analytical Toxicology Fall 2007 Analytical Toxicology Fall 2007

HistoryHistory In the U.S., forensic toxicology did

not develop until the early 20th century.

Dr. Alexander Gettler is considered this country’s first forensic toxicologist.

Page 9: Forensic Toxicology Analytical Toxicology Fall 2007 Analytical Toxicology Fall 2007

Postmortem Forensic Toxicology

Postmortem Forensic Toxicology

Suspected drug intoxication cases Homicides Arson fire deaths Motor vehicle fatalities Deaths due to natural causes

Page 10: Forensic Toxicology Analytical Toxicology Fall 2007 Analytical Toxicology Fall 2007

Postmortem Forensic Toxicology

Postmortem Forensic Toxicology

Death Investigations

Coroner

Medical Examiner

Page 11: Forensic Toxicology Analytical Toxicology Fall 2007 Analytical Toxicology Fall 2007

Postmortem Forensic Toxicology

Postmortem Forensic Toxicology

Specimens Blood – from the heart and from the

femoral or jugular veins Vitreous humor Urine Bile Liver Other – lung, spleen, stomach contents or

brain

Page 12: Forensic Toxicology Analytical Toxicology Fall 2007 Analytical Toxicology Fall 2007

Postmortem Forensic Toxicology

Postmortem Forensic Toxicology

Analytical Process Separation

Identification

Confirmation

Quantitation

Page 13: Forensic Toxicology Analytical Toxicology Fall 2007 Analytical Toxicology Fall 2007

Postmortem Forensic Toxicology

Postmortem Forensic Toxicology

Analytes Volatiles (Carbon Monoxide,

Cyanide, and Alcohols)

Drugs

Metals

Page 14: Forensic Toxicology Analytical Toxicology Fall 2007 Analytical Toxicology Fall 2007

AC

ET

AL

DE

HY

DE

(1.

414

min

.)E

HT

AN

OL

(1.

787

min

.)

2-P

RO

PA

NO

L (

2.80

4 m

in.)

ME

K(I

ST

D)

(5.5

84 m

in.)

AC

ET

ON

E (

2.46

2 m

in.)

0 6

Page 15: Forensic Toxicology Analytical Toxicology Fall 2007 Analytical Toxicology Fall 2007

Postmortem Forensic Toxicology

Postmortem Forensic Toxicology

Drugs One Comprehensive Approach:

Page 16: Forensic Toxicology Analytical Toxicology Fall 2007 Analytical Toxicology Fall 2007

Postmortem Forensic Toxicology

Postmortem Forensic Toxicology

Metals Aluminum Arsenic Iron Mercury Lead Thallium

Page 17: Forensic Toxicology Analytical Toxicology Fall 2007 Analytical Toxicology Fall 2007

Postmortem Forensic Toxicology

Postmortem Forensic Toxicology

Metals (continued) Analysis

ColorimetricGraphite Furnace Atomic Absorption

Spectrometry Inductively Coupled Plasma – Mass

SpectrometryNeutron Activation Spectrometry

Page 18: Forensic Toxicology Analytical Toxicology Fall 2007 Analytical Toxicology Fall 2007

Human Performance Toxicology

Human Performance Toxicology

Human performance toxicology is also referred to as behavioral toxicology.

It is the study of human performance under the influence of drugs.

Page 19: Forensic Toxicology Analytical Toxicology Fall 2007 Analytical Toxicology Fall 2007

Human Performance Toxicology

Human Performance Toxicology

Ethanol and driving

History

Behavioral effects

Specimens

Page 20: Forensic Toxicology Analytical Toxicology Fall 2007 Analytical Toxicology Fall 2007

Ethanol ToxicologyEthanol Toxicology

Types of alcohol

Ethanol (ethyl alcohol)

Methanol (methyl alcohol)

Isopropanol

Ethylene glycol

Page 21: Forensic Toxicology Analytical Toxicology Fall 2007 Analytical Toxicology Fall 2007

Ethanol ToxicologyEthanol Toxicology

Ethanol production Fermentation of sugar or starch

Can only achieve 20% ethanol

DistillationDistilled alcoholic beverages are usually

40 to 50% ethanol by volume (80-100 proof)

Page 22: Forensic Toxicology Analytical Toxicology Fall 2007 Analytical Toxicology Fall 2007

Ethanol PharmacokineticsEthanol Pharmacokinetics

Absorption Means of absorption

Dermal Inhalation IVOral

Gastrointestinal tract Presence of food.

Page 23: Forensic Toxicology Analytical Toxicology Fall 2007 Analytical Toxicology Fall 2007

Ethanol PharmacokineticsEthanol Pharmacokinetics Distribution

Gastrointestinal tract Portal vein Liver Heart Lung Heart Body

Page 24: Forensic Toxicology Analytical Toxicology Fall 2007 Analytical Toxicology Fall 2007

Ethanol PharmacokineticsEthanol Pharmacokinetics

Elimination

5-10% in the urine

Saliva, expired air and sweat

Liver (enzymatic oxidation to acetaldehyde, acetic acid and carbon dioxide)

Page 25: Forensic Toxicology Analytical Toxicology Fall 2007 Analytical Toxicology Fall 2007

Ethanol Effects on the BodyEthanol Effects on the Body

Cardiovascular system

Central nervous system

Gastrointestinal tract

Page 26: Forensic Toxicology Analytical Toxicology Fall 2007 Analytical Toxicology Fall 2007

Ethanol Effects on the BodyEthanol Effects on the Body

Kidney

Liver

Page 27: Forensic Toxicology Analytical Toxicology Fall 2007 Analytical Toxicology Fall 2007

Breath Ethanol TestingBreath Ethanol Testing

Theory

Henry’s law

Ethanol in breath Vs ethanol in blood

2100 to 1 ratio

2300 to 1 ratio

Page 28: Forensic Toxicology Analytical Toxicology Fall 2007 Analytical Toxicology Fall 2007

Breath Ethanol TestingBreath Ethanol Testing

Types of analyzers Chemical

Reaction of ethanol with potassium dichromate/sulfuric acid solution

Colored solution that results is measured spectrophotometrically

IR spectrophotometry Electrochemical oxidation - fuel cell

Page 29: Forensic Toxicology Analytical Toxicology Fall 2007 Analytical Toxicology Fall 2007

Breath Ethanol TestingBreath Ethanol Testing

IR Spectrophotometry Based on absorbance of light by the

ethanol molecule Mainstay in evidential breath testing

devices

Electrochemical Oxidation Oxidation of ethanol to acetic acid Also used in evidential breath testing

Page 30: Forensic Toxicology Analytical Toxicology Fall 2007 Analytical Toxicology Fall 2007

Blood Ethanol TestingBlood Ethanol Testing

Chemical

Screening

Quantitative

Disadvantage - aldehydes and ketones will interfere with the test

Page 31: Forensic Toxicology Analytical Toxicology Fall 2007 Analytical Toxicology Fall 2007

Blood Ethanol TestingBlood Ethanol Testing Enzymatic

Conversion of NAD to NADH by ethanol (serum, urine and whole blood)Measured spectrophotometrically at

340 nm

Same reaction with a blue dye (thiazoyl blue) (serum, urine, fresh blood and postmortem blood)Measured with a fluorometer

Page 32: Forensic Toxicology Analytical Toxicology Fall 2007 Analytical Toxicology Fall 2007

Blood Ethanol TestingBlood Ethanol Testing

Gas Chromatography Can measure ethanol in a wide range

of specimens Can distinguish ethanol from other

alcohols, aldehydes and ketones Two common methods

Head spaceDirect injection

AC

ET

AL

DE

HY

DE

(1.

414

min

.)E

HT

AN

OL

(1.

787

min

.)

2-P

RO

PA

NO

L (

2.80

4 m

in.)

ME

K(I

ST

D)

(5.5

84 m

in.)

AC

ET

ON

E (

2.46

2 m

in.)

0 6

Page 33: Forensic Toxicology Analytical Toxicology Fall 2007 Analytical Toxicology Fall 2007

Assessment of Ethanol Impairment

Assessment of Ethanol Impairment

In a British study: Detectable deterioration of drivers at

between 30 – 50 mg/dL Obvious deterioration observed at between

60 – 100 mg/dL

In another British study: Pilots exhibited impairment at 40 mg/dL

Page 34: Forensic Toxicology Analytical Toxicology Fall 2007 Analytical Toxicology Fall 2007

Assessment of Ethanol Impairment

Assessment of Ethanol Impairment

Blood alcohol concentration: 10-50 mg/dL: Impairment detectable

by special tests 30-120 mg/dL: Beginning of

sensory-motor impairment 90-250 mg/dL: Sensory-motor

incoordination; impaired balance 180-400 mg/dL: Increased muscular

incoordination; apathy; lethargy

Page 35: Forensic Toxicology Analytical Toxicology Fall 2007 Analytical Toxicology Fall 2007

Assessment of Ethanol Impairment

Assessment of Ethanol Impairment

Blood alcohol concentration: 250-400 mg/dL: Impaired

consciousness; sleep; stupor 350-500 mg/dL: Complete

unconsciousness; coma 450 and greater mg/dL: Death from

respiratory arrest

Page 36: Forensic Toxicology Analytical Toxicology Fall 2007 Analytical Toxicology Fall 2007

Stages of Acute Alcohol Intoxication*

*Reprinted by permission of K.M. Dubowski, 1997.

Death from respiratory arrestDeath0.45+

Possible deathImpairment of circulation and respirationSubnormal temperatureDepressed or abolished reflexesComplete unconsciousness; coma; anesthesiaComa0.35-0.50

Impaired consciousness; sleep or stuporVomiting; incontinence of urine and fecesMarked muscular incoordination; inability to stand or walkMarkedly decreased response to stimuliGeneral inertia; approaching loss of motor functionsStupor0.25-0.40

Apathy, lethargy

Increased muscular incoordination; staggering gait; slurredspeech

Increased pain threshold

Disturbances of vision (diplopia, etc.) and of perception ofcolor, form, motion, dimensions

Exaggerated emotional states (fear, rage, grief, etc.)Disorientation, mental confusion; dizzinessConfusion0.18-0.30

DrowsinessSensory-motor incoordination; impaired balance

Reduced visual acuity, peripheral vision, and glarerecovery

Decreased sensory response; increased reaction timeImpairment of perception, memory, and comprehensionEmotional instability; loss of critical judgmentExcitement0.09-0.25

Loss of efficiency in critical performance testsSlowed information processingBeginning of sensory-motor impairmentDiminution of attention, judgment, and controlIncreased self-confidence; decreased inhibitionsMild euphoria, sociability, talkativenessEuphoria0.03-0.12

Impairment detectable by special testsBehavior nearly normal by ordinary observationInfluence/effects not apparent or obviousSub clinical0.01-0.05

Clinical Signs/Symptoms

Stage ofAlcoholicInfluence

Blood-AlcoholConcentrationg/100mL

Page 37: Forensic Toxicology Analytical Toxicology Fall 2007 Analytical Toxicology Fall 2007
Page 38: Forensic Toxicology Analytical Toxicology Fall 2007 Analytical Toxicology Fall 2007

Human Performance Toxicology

Human Performance Toxicology

Drugs and driving

DEC program

Drug recognition expert

Toxicologist

Prosecution

Page 39: Forensic Toxicology Analytical Toxicology Fall 2007 Analytical Toxicology Fall 2007

Human Performance Toxicology

Human Performance Toxicology

Drug Recognition Evaluation - 12 Step Process Breath alcohol test Interview of the arresting officer. Preliminary examination of the suspect. Examination of the eyes. Divided attention psychophysical tests. Vital signs examination.

Page 40: Forensic Toxicology Analytical Toxicology Fall 2007 Analytical Toxicology Fall 2007

Human Performance Toxicology

Human Performance Toxicology

Drug Recognition Evaluation (continued) Dark room examination. Examination of muscle tone. Examination for injection sites. Suspect’s statements and other

observations. Opinion of the evaluator. Toxicological examination.

Page 41: Forensic Toxicology Analytical Toxicology Fall 2007 Analytical Toxicology Fall 2007

Human Performance Toxicology

Human Performance Toxicology

Drug Recognition Evaluation

Page 42: Forensic Toxicology Analytical Toxicology Fall 2007 Analytical Toxicology Fall 2007

Human Performance Toxicology

Human Performance Toxicology

Drug Recognition Evaluation

Page 43: Forensic Toxicology Analytical Toxicology Fall 2007 Analytical Toxicology Fall 2007

Human Performance Toxicology

Human Performance Toxicology

Drug Recognition Evaluation (continued)

Toxicology

Type of Testing

Specimens

Page 44: Forensic Toxicology Analytical Toxicology Fall 2007 Analytical Toxicology Fall 2007

Human Performance Toxicology

Human Performance Toxicology

Drug Recognition Evaluation (continued) Drug Class Effects

Central Nervous System DepressantsCentral Nervous System StimulantsHallucinogensPhencyclidineNarcotic Analgesics InhalantsCannabis

Page 45: Forensic Toxicology Analytical Toxicology Fall 2007 Analytical Toxicology Fall 2007

Forensic Drug TestingForensic Drug Testing

Introduction History

Military Criminal justice system Public sector Private sector

Rationale

Page 46: Forensic Toxicology Analytical Toxicology Fall 2007 Analytical Toxicology Fall 2007

Forensic Drug TestingForensic Drug Testing

Uses in the workplace: Pre-employment screening Post-accident testing Return to Work testing “For Cause” testing Random testing

Page 47: Forensic Toxicology Analytical Toxicology Fall 2007 Analytical Toxicology Fall 2007

Forensic Drug Testing Forensic Drug Testing

Military ExperienceMilitary Experience

Page 48: Forensic Toxicology Analytical Toxicology Fall 2007 Analytical Toxicology Fall 2007

Forensic Drug Testing Forensic Drug Testing

President Ronald Reagan

1986

Executive Order No. 12564

Objective: To develop a

“drug-free” workplace.

President Ronald Reagan

1986

Executive Order No. 12564

Objective: To develop a

“drug-free” workplace.

Page 49: Forensic Toxicology Analytical Toxicology Fall 2007 Analytical Toxicology Fall 2007

Forensic Drug Testing Forensic Drug Testing

Mandatory Guidelines

for Federal

Workplace

Drug Testing

Programs

Mandatory Guidelines

for Federal

Workplace

Drug Testing

Programs

Page 50: Forensic Toxicology Analytical Toxicology Fall 2007 Analytical Toxicology Fall 2007

Forensic Drug Testing Forensic Drug Testing

Mandatory Guidelines

Laboratory AccreditationSpecified Menu & Cutoffs

Proficiency TestingInspections

External Blind ControlsCorrective Actions

Mandatory Guidelines

Laboratory AccreditationSpecified Menu & Cutoffs

Proficiency TestingInspections

External Blind ControlsCorrective Actions

Page 51: Forensic Toxicology Analytical Toxicology Fall 2007 Analytical Toxicology Fall 2007

Forensic Drug Testing Forensic Drug Testing

Programs:Federal Dept. of Health & Human

Services (DHHS)

National Institute on Drug Abuse (NIDA)

Substance Abuse & Mental Health Services Administration (SAMHSA)

Programs:Federal Dept. of Health & Human

Services (DHHS)

National Institute on Drug Abuse (NIDA)

Substance Abuse & Mental Health Services Administration (SAMHSA)

Page 52: Forensic Toxicology Analytical Toxicology Fall 2007 Analytical Toxicology Fall 2007

Forensic Drug Testing Forensic Drug Testing

Programs:Department of Transportation

(DOT)Nuclear Regulatory Commission

(NRC)College of American Pathologists

(CAP)Forensic Urine Drug Testing (FUDT)

Programs:Department of Transportation

(DOT)Nuclear Regulatory Commission

(NRC)College of American Pathologists

(CAP)Forensic Urine Drug Testing (FUDT)

Page 53: Forensic Toxicology Analytical Toxicology Fall 2007 Analytical Toxicology Fall 2007

Forensic Drug Testing Forensic Drug Testing Specimen Collection

External Custody & Control Form

Unobserved/Observed Collection

Toilet Water (Off or Blue)

Sink Water (Off or Cold)

No purses or bags

No large coats

Minimum Volume

Check Temperature

Split specimen

Specimen Bottle Seal

Specimen Collection

External Custody & Control Form

Unobserved/Observed Collection

Toilet Water (Off or Blue)

Sink Water (Off or Cold)

No purses or bags

No large coats

Minimum Volume

Check Temperature

Split specimen

Specimen Bottle Seal

Page 54: Forensic Toxicology Analytical Toxicology Fall 2007 Analytical Toxicology Fall 2007

Forensic Drug Testing Forensic Drug Testing Standard

Operating

Procedures

SOP

Standard

Operating

Procedures

SOP

Page 55: Forensic Toxicology Analytical Toxicology Fall 2007 Analytical Toxicology Fall 2007

Forensic Drug Testing Forensic Drug Testing Test Menus – SAMHSA

Screen for Drugs:

Amphetamines

Cannabinoids

Cocaine Metabolite

Opiates

Phencyclidine

(Alcohol)

Test Menus – SAMHSA

Screen for Drugs:

Amphetamines

Cannabinoids

Cocaine Metabolite

Opiates

Phencyclidine

(Alcohol)

Page 56: Forensic Toxicology Analytical Toxicology Fall 2007 Analytical Toxicology Fall 2007

Forensic Drug Testing Forensic Drug Testing

Test Menus – SAMHSADrugs Confirmed:

Amphetamine, MethamphetamineDelta-9-Tetrahydrocannabinol Carboxylic

Acid (THCA)Benzoylecgonine

Codeine, Morphine, 6-AcetylmorphinePhencyclidine

(Alcohol)

Test Menus – SAMHSADrugs Confirmed:

Amphetamine, MethamphetamineDelta-9-Tetrahydrocannabinol Carboxylic

Acid (THCA)Benzoylecgonine

Codeine, Morphine, 6-AcetylmorphinePhencyclidine

(Alcohol)

Page 57: Forensic Toxicology Analytical Toxicology Fall 2007 Analytical Toxicology Fall 2007

Forensic Drug Testing Forensic Drug Testing Test Menus – SAMHSA

Specimen Validity:

Temperature

pH

Creatinine

Specific Gravity

Nitrite

Pyridine, Glutaraldehyde, Bleach, Soap, Chromium

Test Menus – SAMHSA

Specimen Validity:

Temperature

pH

Creatinine

Specific Gravity

Nitrite

Pyridine, Glutaraldehyde, Bleach, Soap, Chromium

Page 58: Forensic Toxicology Analytical Toxicology Fall 2007 Analytical Toxicology Fall 2007

Forensic Drug Testing Forensic Drug Testing

Test Menus – CAP & non-DOTDrugs:

“NIDA-5”plus

Barbiturates, benzodiazepines,methadone, propoxyphene

MDA, MDMAOthers?

Test Menus – CAP & non-DOTDrugs:

“NIDA-5”plus

Barbiturates, benzodiazepines,methadone, propoxyphene

MDA, MDMAOthers?

Page 59: Forensic Toxicology Analytical Toxicology Fall 2007 Analytical Toxicology Fall 2007

Forensic Drug Testing Forensic Drug Testing

Test Menus – CAP

Validity:

Same as SAMHSA

Test Menus – CAP

Validity:

Same as SAMHSA

Page 60: Forensic Toxicology Analytical Toxicology Fall 2007 Analytical Toxicology Fall 2007

Forensic Drug Testing Forensic Drug Testing

Test ProceduresSAMHSA / DOT

Screening: Immunoassay (Emit, RIA, FPIA, CEDIA)

Confirmation: GC/MSAlcohol: Alcohol Screening Device

Evidential Breath TesterGC

Test ProceduresSAMHSA / DOT

Screening: Immunoassay (Emit, RIA, FPIA, CEDIA)

Confirmation: GC/MSAlcohol: Alcohol Screening Device

Evidential Breath TesterGC

Page 61: Forensic Toxicology Analytical Toxicology Fall 2007 Analytical Toxicology Fall 2007

Forensic Drug Testing Forensic Drug Testing

Test ProceduresCAP & Non-DOT

Screening: Immunoassay (Emit, RIA, FPIA, CEDIA)

Automated Clinical Analyzer (EtOH)Alcohol: Alcohol Screening Device

Confirmation: GC, GC/MSAlcohol: Evidential Breath Tester

GC

Test ProceduresCAP & Non-DOT

Screening: Immunoassay (Emit, RIA, FPIA, CEDIA)

Automated Clinical Analyzer (EtOH)Alcohol: Alcohol Screening Device

Confirmation: GC, GC/MSAlcohol: Evidential Breath Tester

GC

Page 62: Forensic Toxicology Analytical Toxicology Fall 2007 Analytical Toxicology Fall 2007

Forensic Drug Testing Forensic Drug Testing

Cutoff Concentration

That concentration below which the analytical result must be reported as

“Negative”

A cutoff concentration is specified for screening analysis and for

confirmation analysis for each analyte.

Cutoff Concentration

That concentration below which the analytical result must be reported as

“Negative”

A cutoff concentration is specified for screening analysis and for

confirmation analysis for each analyte.

Page 63: Forensic Toxicology Analytical Toxicology Fall 2007 Analytical Toxicology Fall 2007

Forensic Drug Testing Forensic Drug Testing

Cutoff Concentrations (ng/mL)

Phencyclidine

Screening 25

Confirmation 25

Cutoff Concentrations (ng/mL)

Phencyclidine

Screening 25

Confirmation 25

Page 64: Forensic Toxicology Analytical Toxicology Fall 2007 Analytical Toxicology Fall 2007

Forensic Drug TestingForensic Drug Testing

Cutoff Concentrations (ng/mL)

Screening

Cocaine metabolites 300

Confirmation

Benzoylecgonine 150

Cutoff Concentrations (ng/mL)

Screening

Cocaine metabolites 300

Confirmation

Benzoylecgonine 150

Page 65: Forensic Toxicology Analytical Toxicology Fall 2007 Analytical Toxicology Fall 2007

Forensic Drug TestingForensic Drug Testing

Cutoff Concentrations (ng/mL)

Screening

Marijuana metabolites 50

Confirmation

Delta-9-THCA 15

Cutoff Concentrations (ng/mL)

Screening

Marijuana metabolites 50

Confirmation

Delta-9-THCA 15

Page 66: Forensic Toxicology Analytical Toxicology Fall 2007 Analytical Toxicology Fall 2007

Forensic Drug Testing Forensic Drug Testing

Cutoff Concentrations (ng/mL)

Screening

Amphetamines 1000

Confirmation

Amphetamine 500

Methamphetamine 500

(and Amphetamine 200)

Cutoff Concentrations (ng/mL)

Screening

Amphetamines 1000

Confirmation

Amphetamine 500

Methamphetamine 500

(and Amphetamine 200)

Page 67: Forensic Toxicology Analytical Toxicology Fall 2007 Analytical Toxicology Fall 2007

Forensic Drug Testing Forensic Drug Testing

Cutoff Concentrations (ng/mL)

Screening

Opiates 2000

Confirmation

Codeine 2000

Morphine 2000

(Test for 6-AM 10)

Cutoff Concentrations (ng/mL)

Screening

Opiates 2000

Confirmation

Codeine 2000

Morphine 2000

(Test for 6-AM 10)

Page 68: Forensic Toxicology Analytical Toxicology Fall 2007 Analytical Toxicology Fall 2007

Forensic Drug Testing Forensic Drug Testing

Security of

Laboratory

Facility

Security of

Laboratory

Facility

Page 69: Forensic Toxicology Analytical Toxicology Fall 2007 Analytical Toxicology Fall 2007

Forensic Drug Testing Forensic Drug Testing

Chain of Custody

External Custody and

Control Form

Internal Chain of

Custody Forms

(Specimen and aliquots)

Chain of Custody

External Custody and

Control Form

Internal Chain of

Custody Forms

(Specimen and aliquots)

Page 70: Forensic Toxicology Analytical Toxicology Fall 2007 Analytical Toxicology Fall 2007

Forensic Drug Testing Forensic Drug Testing

Specimen Storage

Refrigerated while analyses in process;

Discarded if negative;

Frozen ( -20 o C) > 1 year if

positive.

Specimen Storage

Refrigerated while analyses in process;

Discarded if negative;

Frozen ( -20 o C) > 1 year if

positive.

Page 71: Forensic Toxicology Analytical Toxicology Fall 2007 Analytical Toxicology Fall 2007

Forensic Drug TestingForensic Drug Testing

Validation of:

Methods

Instruments

Reagents

Validation of:

Methods

Instruments

Reagents

Page 72: Forensic Toxicology Analytical Toxicology Fall 2007 Analytical Toxicology Fall 2007

Forensic Drug Testing Forensic Drug Testing

Reporting Results

“Negative” if either screening or confirmation gives negative result.

“Positive” only if positive result for both screening and confirmation.

“Test Not Performed”

Reporting Results

“Negative” if either screening or confirmation gives negative result.

“Positive” only if positive result for both screening and confirmation.

“Test Not Performed”

Page 73: Forensic Toxicology Analytical Toxicology Fall 2007 Analytical Toxicology Fall 2007

Forensic Drug Testing Forensic Drug Testing Reporting Results

Rejected for Testing

(Give Remark)Fatal Flaw

Uncorrected FlawSpecimen UnsuitableSpecimen AdulteratedSpecimen Substituted

Reporting Results

Rejected for Testing

(Give Remark)Fatal Flaw

Uncorrected FlawSpecimen UnsuitableSpecimen AdulteratedSpecimen Substituted

Page 74: Forensic Toxicology Analytical Toxicology Fall 2007 Analytical Toxicology Fall 2007

Forensic Drug Testing Forensic Drug Testing Reporting Results

If specimen donor requests, “split” specimen may be sent to another

certified laboratory to retest for that substance reported positive.

Reporting Results

If specimen donor requests, “split” specimen may be sent to another

certified laboratory to retest for that substance reported positive.

Page 75: Forensic Toxicology Analytical Toxicology Fall 2007 Analytical Toxicology Fall 2007

Forensic Drug Testing Forensic Drug Testing

Quality Control /

Quality Assurance

Screening Quality Control

Confirmation Quality Control

Proficiency Testing

Quality Control /

Quality Assurance

Screening Quality Control

Confirmation Quality Control

Proficiency Testing

Page 76: Forensic Toxicology Analytical Toxicology Fall 2007 Analytical Toxicology Fall 2007

Forensic Drug Testing Forensic Drug Testing

Screening Quality Control

Calibrator / Cutoff

Controls:

Open - Blank, Negative, Positive,

Blinds (external and internal)

Screening Quality Control

Calibrator / Cutoff

Controls:

Open - Blank, Negative, Positive,

Blinds (external and internal)

Page 77: Forensic Toxicology Analytical Toxicology Fall 2007 Analytical Toxicology Fall 2007

Forensic Drug Testing Forensic Drug Testing

Confirmation Quality Control

Calibrators:

Single vs. Multiple point

Controls:

Open - Blank, Negative, Positive,

Blinds (external and internal)

Carryover

Confirmation Quality Control

Calibrators:

Single vs. Multiple point

Controls:

Open - Blank, Negative, Positive,

Blinds (external and internal)

Carryover

Page 78: Forensic Toxicology Analytical Toxicology Fall 2007 Analytical Toxicology Fall 2007

Forensic Drug Testing Forensic Drug Testing

Proficiency Tests

Samples submitted by an outside agency.

May be negative;

May be positive.

Proficiency Tests

Samples submitted by an outside agency.

May be negative;

May be positive.

Page 79: Forensic Toxicology Analytical Toxicology Fall 2007 Analytical Toxicology Fall 2007

Forensic Drug Testing Forensic Drug Testing

Proficiency Tests

No false positives

Identify 90% of drug challenges

Quaititate 80% within +/- 20% or +/- 2 SD of target value.

Proficiency Tests

No false positives

Identify 90% of drug challenges

Quaititate 80% within +/- 20% or +/- 2 SD of target value.

Page 80: Forensic Toxicology Analytical Toxicology Fall 2007 Analytical Toxicology Fall 2007

Forensic Drug Testing Forensic Drug Testing Inspections

Semi-AnnualNumber of Inspectors &

Number of DaysDepends on size of laboratory

Review SOP, talk to staff, watch sample processing, look at lots of case records,

personnel records, proficiency test records, security records, instrument logs, etc., etc., etc.

InspectionsSemi-Annual

Number of Inspectors &Number of Days

Depends on size of laboratoryReview SOP, talk to staff, watch sample processing, look at lots of case records,

personnel records, proficiency test records, security records, instrument logs, etc., etc., etc.

Page 81: Forensic Toxicology Analytical Toxicology Fall 2007 Analytical Toxicology Fall 2007

Forensic Drug Testing Forensic Drug Testing Personnel

New Titles:

Responsible Person (RP)

Certifying Scientist

Medical Review Officer (MRO)

Collector

Accessioner

Records Custodian

Personnel

New Titles:

Responsible Person (RP)

Certifying Scientist

Medical Review Officer (MRO)

Collector

Accessioner

Records Custodian