Pitfalls in forensic toxicology.

The word `forensic' simply means `to do with courts of law' and, as far as toxicology and biochemistry laboratories are concerned, embraces everything which has or might have legal implications. Some of the work in which the biochemistry department becomes involved is obviously `forensic' but this may not be apparent at the time of receipt of the request; this is the ®rst pitfall. Toseland highlighted the dangers of `. . . an increasing tendency to carry out clinical analytical toxicology with the use of kits, usually in the form of rapid immunoassay ± a system that makes the user believe that such testing is really very simple and that he (or she) cannot understand what all the fuss is about'. Toseland also highlighted the problem of `. . . the increasing referral of what are considered to be simple Coroner's cases to the nearest hospital or Local Authority, in the hope that a quick and simple answer will be forthcoming. The dangers of applying screening immunoassay tests to postmortem or even overdose cases that are admitted to hospital can lead to some quite horrendous errors'. Coroners and others will naturally want their toxicology analyses to be performed by a competent laboratory, and accreditation may be a useful indicator of competence. The demands of such a service and the dangers of its complex nature to the unwary are discussed by de Zeeuw. There are many pitfalls in forensic toxicology that need to be assessed and managed, and this review, by examining some of the problems raised by the requests received, the specimens submitted, performance of the analyses, interpretation of the results and the writing of the report, attempts to highlight the more important ones.