ABSTRACT
In post-mortem toxicology, the sample most commonly submitted for analysis is blood and the most frequently encountered substance is alcohol. The technical details and procedures for measuring ethanol in blood and other body fluids obtained from a corpse are essentially the same as those used when analyzing specimens from the living. However, the interpretation of the analytical results obtained from autopsy samples is confounded by problems such as the lack of homogeneity of blood samples, microbial alcohol production post-mortem, alcohol diffusion from gastric residue and contaminated airways, and the lack of or unreliability of information on the clinical condition of the person immediately prior to death. On the other hand, autopsy offers opportunities for sampling body fluids and tissues not accessible or not readily available in the living. Sampling of blood from multiple vascular sites, the vitreous humor of the eye, gastric contents, sequestered
hematomas, as well as bile, brain, skeletal muscle, cerebrospinal fluid, and liver are all possible. Nevertheless, multiple sampling at autopsy can only partly compensate for the increased interpretative difficulties created by the various post-mortem confounding factors. As a result it is necessary to apply a greater degree of caution in the interpretation of post-mortem ethanol analyses and to take into account the totality of the available information, which should always include not only the results of the autopsy examination but also the scene of death examination and anamnestic data. A single autopsy blood ethanol concentration is commonly uninterpretable without concurrent vitreous humor and urine ethanol concentrations, as well as information gleaned from the scene of death and case history.
