National Association of Medical Examiners Position Paper on the Certification of Cocaine-Related Deaths

Boyd G. Stephens, Jeffrey M. Jentzen, Steven Karch, Charles V. Wetli, Deborah C Mash

Research output: Contribution to journalArticle

38 Citations (Scopus)

Abstract

The National Association of Medical Examiners Committee on Cocaine-related Deaths recommends that the following guidelines be applied in the process of documenting, interpreting, and certifying potential cocaine-related fatalities. The committee cautions that the investigation of any drug-related death requires a complete investigation of the circumstances of death, the death scene, and past medical history. It is also necessary to have the results of the forensic toxicological analysis and those of a complete forensic autopsy examination prior to formulating an opinion as to the cause and manner of death. Cocaine should be considered the underlying cause of the death when 1 or more of the following is true: (1) the circumstances surrounding the death can be associated with an acute cocaine exposure and there are no supervening causes of death; (2) the immediate cause of death is directly due to a readily identifiable mechanism or disease such as a gunshot wound or a stroke, yet the acute use of cocaine was the direct underlying cause of the trauma or the disease process; and (3) chronic cocaine use leads to a disease that results in an ultimately fatal pathologic process leading to organ injury and death. The committee further cautions that reported drug levels may not directly relate to the toxic or lethal effects of the drug upon the patient. These guidelines are intended for use by practicing medical examiners and physicians who certify drug deaths, as well as providing education tools for students.

Original languageEnglish
Pages (from-to)11-13
Number of pages3
JournalAmerican Journal of Forensic Medicine and Pathology
Volume25
Issue number1
DOIs
StatePublished - Mar 1 2004

Fingerprint

Coroners and Medical Examiners
medical examiner
Certification
Cocaine
certification
death
Cause of Death
drug
Pharmaceutical Preparations
Disease
cause of death
Guidelines
cause
Gunshot Wounds
Poisons
Wounds and Injuries
Pathologic Processes
Toxicology
Autopsy
stroke

Keywords

  • Certification of death
  • Cocaine
  • Proximate cause

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Pathology and Forensic Medicine
  • Law

Cite this

National Association of Medical Examiners Position Paper on the Certification of Cocaine-Related Deaths. / Stephens, Boyd G.; Jentzen, Jeffrey M.; Karch, Steven; Wetli, Charles V.; Mash, Deborah C.

In: American Journal of Forensic Medicine and Pathology, Vol. 25, No. 1, 01.03.2004, p. 11-13.

Research output: Contribution to journalArticle

Stephens, Boyd G. ; Jentzen, Jeffrey M. ; Karch, Steven ; Wetli, Charles V. ; Mash, Deborah C. / National Association of Medical Examiners Position Paper on the Certification of Cocaine-Related Deaths. In: American Journal of Forensic Medicine and Pathology. 2004 ; Vol. 25, No. 1. pp. 11-13.
@article{212869dcd43d44bcb0f9a5cb0e8c8d57,
title = "National Association of Medical Examiners Position Paper on the Certification of Cocaine-Related Deaths",
abstract = "The National Association of Medical Examiners Committee on Cocaine-related Deaths recommends that the following guidelines be applied in the process of documenting, interpreting, and certifying potential cocaine-related fatalities. The committee cautions that the investigation of any drug-related death requires a complete investigation of the circumstances of death, the death scene, and past medical history. It is also necessary to have the results of the forensic toxicological analysis and those of a complete forensic autopsy examination prior to formulating an opinion as to the cause and manner of death. Cocaine should be considered the underlying cause of the death when 1 or more of the following is true: (1) the circumstances surrounding the death can be associated with an acute cocaine exposure and there are no supervening causes of death; (2) the immediate cause of death is directly due to a readily identifiable mechanism or disease such as a gunshot wound or a stroke, yet the acute use of cocaine was the direct underlying cause of the trauma or the disease process; and (3) chronic cocaine use leads to a disease that results in an ultimately fatal pathologic process leading to organ injury and death. The committee further cautions that reported drug levels may not directly relate to the toxic or lethal effects of the drug upon the patient. These guidelines are intended for use by practicing medical examiners and physicians who certify drug deaths, as well as providing education tools for students.",
keywords = "Certification of death, Cocaine, Proximate cause",
author = "Stephens, {Boyd G.} and Jentzen, {Jeffrey M.} and Steven Karch and Wetli, {Charles V.} and Mash, {Deborah C}",
year = "2004",
month = "3",
day = "1",
doi = "10.1097/01.paf.0000114041.70865.24",
language = "English",
volume = "25",
pages = "11--13",
journal = "American Journal of Forensic Medicine and Pathology",
issn = "0195-7910",
publisher = "Lippincott Williams and Wilkins",
number = "1",

}

TY - JOUR

T1 - National Association of Medical Examiners Position Paper on the Certification of Cocaine-Related Deaths

AU - Stephens, Boyd G.

AU - Jentzen, Jeffrey M.

AU - Karch, Steven

AU - Wetli, Charles V.

AU - Mash, Deborah C

PY - 2004/3/1

Y1 - 2004/3/1

N2 - The National Association of Medical Examiners Committee on Cocaine-related Deaths recommends that the following guidelines be applied in the process of documenting, interpreting, and certifying potential cocaine-related fatalities. The committee cautions that the investigation of any drug-related death requires a complete investigation of the circumstances of death, the death scene, and past medical history. It is also necessary to have the results of the forensic toxicological analysis and those of a complete forensic autopsy examination prior to formulating an opinion as to the cause and manner of death. Cocaine should be considered the underlying cause of the death when 1 or more of the following is true: (1) the circumstances surrounding the death can be associated with an acute cocaine exposure and there are no supervening causes of death; (2) the immediate cause of death is directly due to a readily identifiable mechanism or disease such as a gunshot wound or a stroke, yet the acute use of cocaine was the direct underlying cause of the trauma or the disease process; and (3) chronic cocaine use leads to a disease that results in an ultimately fatal pathologic process leading to organ injury and death. The committee further cautions that reported drug levels may not directly relate to the toxic or lethal effects of the drug upon the patient. These guidelines are intended for use by practicing medical examiners and physicians who certify drug deaths, as well as providing education tools for students.

AB - The National Association of Medical Examiners Committee on Cocaine-related Deaths recommends that the following guidelines be applied in the process of documenting, interpreting, and certifying potential cocaine-related fatalities. The committee cautions that the investigation of any drug-related death requires a complete investigation of the circumstances of death, the death scene, and past medical history. It is also necessary to have the results of the forensic toxicological analysis and those of a complete forensic autopsy examination prior to formulating an opinion as to the cause and manner of death. Cocaine should be considered the underlying cause of the death when 1 or more of the following is true: (1) the circumstances surrounding the death can be associated with an acute cocaine exposure and there are no supervening causes of death; (2) the immediate cause of death is directly due to a readily identifiable mechanism or disease such as a gunshot wound or a stroke, yet the acute use of cocaine was the direct underlying cause of the trauma or the disease process; and (3) chronic cocaine use leads to a disease that results in an ultimately fatal pathologic process leading to organ injury and death. The committee further cautions that reported drug levels may not directly relate to the toxic or lethal effects of the drug upon the patient. These guidelines are intended for use by practicing medical examiners and physicians who certify drug deaths, as well as providing education tools for students.

KW - Certification of death

KW - Cocaine

KW - Proximate cause

UR - http://www.scopus.com/inward/record.url?scp=1342310496&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=1342310496&partnerID=8YFLogxK

U2 - 10.1097/01.paf.0000114041.70865.24

DO - 10.1097/01.paf.0000114041.70865.24

M3 - Article

VL - 25

SP - 11

EP - 13

JO - American Journal of Forensic Medicine and Pathology

JF - American Journal of Forensic Medicine and Pathology

SN - 0195-7910

IS - 1

ER -