The Poison Review

Medical examiner and medical toxicologist agreement on cause of death. Manini AF et al. Forensic Sci Int (2010), doi:10.1016/j.forsciint.2010.06.021

Abstract

This is a somewhat interesting paper on a very important topic.  The authors, all from New York City, identified 256 fatalities over a 7-year period that were evaluated by the medical examiner’s office (MEO) and the local poison control center, and determined to be poison-related by at least one of them.  These cases were retrospectively analyzed by a panel of 3 board-certified toxicologists (MTs), with the goal of determining level of agreement between the MEO and MTs as to whether or not the death was related to poisoning.  The authors found that there was agreement in only 66% of cases.

The paper points out that the official cause of death can have a number of important consequences, including effects on criminal investigations, insurance payments, religious burial considerations, and civil workplace liability suits.  It also points out that there was, in fact, also a relatively level of disagreement among the three members of the medical toxicology panel.  The authors conclude by recommending increased information sharing and consultation between MEOs and medical toxicologists in these cases.