Category Archives: Forensic pathology

Journal articles relating to forensic pathology including coronial autopsies and Disaster victim identification.

New book in the library collection – Miscarriages of justice

Miscarriages of justice: criminal appeals and the rule of law in Australia (2015) / Bibi Sangha & Robert N. Moles

The authors identify a fundamental flaw that lies at the heart of the Australian criminal justice system: an inconsistency between what constitutes a miscarriage of justice under substantive law against what constitutes a miscarriage of justice under procedural law. By examining the problematic nature of the criminal appeal rights in Australia, Sangha and Moles argue that the existing system does not comply with the rule of law provisions or Australia’s international human rights obligations.

South Australia has introduced a new statutory right of appeal and Tasmania is considering doing the same. This represents the first substantive change to the criminal appeal rights in Australia in 100 years.

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Cannabis induced asystole

Journal of Electrocardiology  Available online 13 October 2015;  doi:10.1016/j.jelectrocard.2015.10.003

Cannabis or marijuana is the most used recreational, and until recently illegal, drug in the United States. Although cannabis has medicinal use, its consumption has been linked to motor vehicle accidents in dose dependent fashion. Marijuana and other cannabinoids produce a multitude of effects on the human body that may result in these motor vehicle accidents. Some of the effects that marijuana has been known to cause include altered sensorium, diminished reflexes, and increased vagal tone. We present a case of cannabis induced asystole from hypervagotonia.

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Journal of Forensic Sciences

Table of Contents  |  Volume 60 Issue 5  September 2015

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Mephedrone related fatalities: a review

Eur Rev Med Pharmacol Sci. 2015 Oct;19(19):3777-90


Synthetic cathinones are an emerging class of designer drugs abused of due to their psychostimulant and hallucinogenic effects, similar to those of cocaine, methylenedioxymethamphetamine (MDMA), amphetamines and methamphetamines. Mephedrone is a cathinone analogue (4-methyl aromatic analogue of methcathinone) that was reported to be implicated in several fatalities in the media across Europe, but only a few have actually resulted in mephedrone cited as the cause of death. In this paper, we aim to systematically review analytically confirmed cases of mephedrone-related fatalities.


Relevant scientific articles were identified from Medline, Cochrane Central, Scopus, Web of Science, Science Direct, EMBASE and Google Scholar, through May 2015 using the following keywords: “Mephedrone”, “fatal intoxication,” “fatalities”, “acute intoxication” and “death”.


In total, 10 citations met the criteria for inclusion, representing 18 fatal cases with analytically confirmed mephedrone in biological sample/s of the deceased. The death was attributed to mephedrone intoxication in 9 cases (range of post-mortem blood mephedrone concentration: 1.33-22 mg/L), whereas multiple drug toxicity, involving mephedrone was cited as cause of death in 6 cases (range of post-mortem blood mephedrone concentration: 0.04-1.3 mg/L).


Data suggest that the abuse of mephedrone remains to be a public health issue. Mephedrone appears to have a rather narrow therapeutic window that makes its use dangerous. Dosages which supposedly fall within recreational use limits could also lead to death when combined with other drugs in certain circumstances. Forensic Toxicology laboratories must assess their testing procedures to ensure they can achieve both an appropriate screening regime and targeted quantitative analysis for the detection of mephedrone in various biological matrices.

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Postmortem propofol levels: a case of residual detection long after administration

American Journal of Forensic Medicine & Pathology  28 October 2015;  DOI: 10.1097/PAF.0000000000000209

Propofol has gained notoriety in recent years because of its involvement in high-profile deaths and has increasingly become a drug of misuse and abuse particularly by health care personnel with easy access to it. In addition, propofol has also been used for more nefarious purposes such as murder and suicide. These, coupled with the drug’s routine use for both major and minor medical procedures, provide ample opportunities for it to be implicated as a cause of death or contributing factor. In such instances, forensic investigators may be faced with the task of not only detecting the presence of propofol on postmortem toxicology screening, but also determining if it was indeed responsible for the decedent’s demise. While propofol has a high volume of distribution, it is thought to equilibrate and be eliminated rapidly and not show significant tissue accumulation. However, this article presents a case illustrating that propofol can accumulate in the tissues and may be found up to a week after administration. This capacity to accumulate implies that postmortem detection does not necessarily confirm administration near the time of death, and further investigation needs to be undertaken to determine the timeline of events in order to rule out other factors, such as recent medical interventions, before attributing the cause of death to the presence of the drug.

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Death following intentional ingestion of e-liquid

Clinical Toxicology  Volume 53, Issue 9, 2015;  DOI: 10.3109/15563650.2015.1090579

Context: Electronic cigarette (e-cigarette) use is growing within the United States, resulting in both intentional and unintentional exposures to concentrated liquid nicotine or “e-liquid.” Nicotine has been culpable for severe poisoning and deaths in the past. However, sources of nicotine have traditionally been from cigarettes, cigars, or pesticides. Fatalities due to liquid nicotine are rare, and fatalities following ingestion of e-liquid are even scarcer. Case: We present a case of a 24-year-old woman who intentionally ingested up to 3000 mg of liquid nicotine intended for e-cigarette use. She was found in pulseless electrical activity and had return of spontaneous circulation (ROSC) after undergoing approximately 10 min of cardiopulmonary resuscitation with a blood pressure of 74/53 mmHg and a pulse rate of 106 beats/min. Despite aggressive supportive care, she ultimately died after she was found to have multiple acute infarcts, consistent with severe anoxic brain injury, on magnetic resonance imaging. The patient’s toxicologic testing, obtained shortly after ROSC, was notable for plasma nicotine and cotinine levels each >1000 ng/mL. Discussion: This fatality highlights the potential toxicity associated with suicidal ingestion of liquid nicotine.

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Down on the [body] farm

Popular Science November 2015 Anna Denejkina

Australia will soon open its first taphonomic research centre, where bodies will be left in the open (and other places) so we can study how they decay.

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