Forensic medical examination poisoning

In cases of poisoning to determine the cause of death or the relationship of health disorders with the action of toxic substances is carried out forensic medical examination. Categorical conclusions of the expert largely depends on collected by the investigator of the data about the circumstances of the incident and the nature of the proposed toxic substances, the time passed from the moment of reception of poison and death, nature rendered medical care, proper removal and storage of objects from the corpse allocated to the judicial-chemical study, and others, In some cases, the expert comes to the categorical conclusion about the poisoning of a certain poison, in others only does not exclude the possibility of poisoning certain poison or a certain group of toxic substances that are similar in their effect on the human body (clinical and morphological manifestations).
The suspicion that the death was due to poisoning may occur in cases of unexpected its occurrence, as if among full health. Diagnosis of death from poisoning is often great difficulties related to a number of objective and subjective reasons - misjudgment of laboratory data, considerable time elapsed between taking poison and death, the similarity of the clinical manifestations in poisoning and certain diseases and other
To prove occurred poisoning are collected by the investigation materials containing information about the circumstances of the accident; forensic medical examination of the victim (for non-fatal poisonings) and data - mortem; data judicial-chemical and other laboratory tests of the objects found at the scene, received from the doctors, seized during the autopsy.
The investigation materials. Collected by the investigation materials about the circumstances of the accident (for example, simultaneous sudden illness or death of several people after joint drinking of alcohol drink", with the development of the victims of the same symptoms) can easily specify the possible poisoning. In discovered at the scene remains of food and drink, in container, in a variety of packaging materials from drugs on the body (hands, at the openings of the mouth and other parts of the body), on clothes and her pockets can be found the remains of poison adopted victims. The presence of vomitus may also indirectly serve to indicate the possible poisoning (development vomiting as a protective reaction of the organism to intoxication), vomiting may contain traces of poison.
The examination of the scene and the corpse is expedient to carry out with the participation of the expert in forensic medicine. Found this evidence, require laboratory studies, go to the Bureau of forensic medical examination.
Medical documents (medical, medical history and other), containing a description of the flow of poisoning and information about the nature of medical care, should be submitted to the expert in the original.
Forensic medical study of the corpse of suspected poisoning has its own characteristics. Dissecting room before opening must be ventilated to better understand and define the nature of smell, feel at opening cavities and internal organs of the body. Measures that exclude accidental poison corpse at his autopsy. Crockery extracted to bodies should be washed clean.
Carefully inspect the morgue clothes, underwear and other items, taken together with the corpse. When viewed items of clothing can be found the remains of poison, recipes for obtaining poisonous medicinal substances and other
At the external examination of the corpse can be installed unusual coloring cadaveric spots (bright pink-red color when carbon monoxide poisoning, brown or brownish when poisoning, forming in the blood metgemoglobin, and others), icteric skin color when poisoning arsenic hydrogen and mushroom poisoning; pronounced and fast onset muscle stiffness (with strychnine poisoning, cicutoxin aconitine and others) burns in the form of streaks or spots on the skin around the mouth, chin, cheeks (in case of poisoning cauterizing substances), traces of injections in the field of poison, sharp narrowing of the pupils (at the poisoning of opium, morphine) or their sudden expansion (in the administration of atropine, belladonna, astmatol), phenomena of irritation and ulceration of mucous membrane of the lips and gums under the action of corrosive poison, grayish border of the gums in case of poisoning by lead or mercury.
At the opening cavities and organs may be specific to certain toxic substances smell.
In case of poisoning by many poisons suffer the way of their excretion - kidney that can be identified specific changes. Many ingested substances quickly moving in urine are excreted in sweat and can be found in the clothing of the deceased, and in the urine.
Obtained a forensic medical study of the corpse of the data should be compared with the data of the investigation and with the data obtained in a laboratory study of tissues and organs of the body.
Forensic medical examination carried out at the poisoning, which did not lead to death. Such examination of the victim is made both in-patient and out-patient. The poisoning in such cases it is proved by the investigation materials, medical documents about the care and treatment, as well as the data of examination of the patient by the expert. Having established the fact of poisoning and the nature of its effects, determine the severity of these effects, guided Union "Rules of forensic determine the severity of bodily injuries".
Great value for the preparation of the diagnosis of poisoning by certain poison is given timely laboratory vomit, wash water, urine, feces.
On forensic and other laboratory studies are directed not only seized during the autopsy part of the internal organs, but also found at the scene remains of drinks, food, vomit, and other objects that may contain a poisonous substance. The choice of the type of laboratory investigation of evidence is determined by the nature of the proposed toxic substances. In accordance with this use of chemical, physical (often spectral), histological and biological (animals), Botanical and other research methods.
The results of the forensic chemical analyses should be carefully reviewed by a medical forensic expert.
A positive result of judicial-chemical studies, taken in isolation, is not yet proof of the fact of poisoning, and negative - it does not exclude. In the internal organs of the corpse can be detected by chemical substances, including toxic, which were not a source of poisoning, and have entered the human body as a drug, with food products.
The results of the forensic chemical examination in death from poisoning can be negative for various reasons: because of the rapid selection of the poison from the body, transition poison in other, not found in forensic chemical examination connection, improper removal and preservation of organs and tissues to their research, the use is not appropriate for this poisoning research method, etc. the Time elapsed from the moment of reception of the poison before death and autopsy of the corpse, largely determines the preservation of the poison in the body, and consequently, the possibility of its discovery in forensic chemical examination. However, a number of poisons can be found in the corpses through the big time after the death and burial, for example, salts of heavy metals.
If you suspect that the death was due to poisoning, is the exhumation; judicial-chemical studies can be the boards of the coffin, the surrounding land, where we can get the poisons from the body.

Checklist
1. What is the value of the materials of the investigation for the diagnosis of poisoning?
2. What are the characteristics of the study of the corpse of the suspicious death from poisoning?
3. What data external and internal examination of the body can be used to prove the death from poisoning?
4. What organs and tissues removed from corpses suspected death from poisoning and what is the procedure for withdrawal?
5. How should the medical examiner to evaluate the results of the forensic chemical research (both positive and negative)?
6. What are the most common laboratory tests used in the diagnosis of poisoning.