Proving Pediatric Poisoning in the Courtroom
Pediatric poisoning is rare. When it does occur, it is usually accidental, the result of a child innocently having ingested a single agent. Very successful public health measures have gradually reduced the frequency of these unfortunate events, although accidental alcohol poisoning remains a problem in teenagers, and occasional cases of accidental methadone and opioid poisoning do occur.1,2,3 Homicidal poisoning, as opposed to accidental poisoning, is so rare in the pediatric age group that a Medline search, done in preparation for writing this chapter, produced only two “hits.” The first was a case review of 709 pediatric deaths, written in 2001.4 Drugs were found to be the cause of death in 11 cases, only two of which were certified as homicides. One was due to alcohol and one to cocaine. Within the series, cases of accidental poisoning followed a bimodal distribution: Six of the decedents were aged 15 to 17 years, and five were under 4 years in age. No details regarding either of the homicidal deaths were provided. Clinical experience suggests that the bimodal nature of the cases fits a common pattern.