Proficiency testing (external quality assessment) of drug detection in oral fluid

Eighteen external quality assessment (proficiency testing) samples were prepared from client specimens collected with the Intercept oral fluid collection device and by spiking drug-free oral fluid. Samples were circulated in pairs at quarterly intervals to 13 UK and USA based laboratories for analysis by a panel of OraSure micro-plate Intercept enzyme immunoassay kits and hyphenated mass spectrophotometric techniques. During the survey, there was a single case of non-specificity in a false report for methadone. The major errors were of lack of sensitivity relative to the concentration thresholds specified for the immunoassays. The sensitivity for overall "present"/"not found" reports calculated as true positives/(true positives+false negatives) were for the amphetamine specific assay 50%, methyl-amphetamines 93%, barbiturates 64%, cannabinoids 73%, cocaine and metabolites 100%, benzodiazepines 69%, methadone 95%, opiates 79% (opiates excluding oxycodone 93%), phencyclidine 93% and human gamma-globulin 97%. A small number of the sensitivity errors were attributable to errors in chromatographic confirmation techniques.     

Oxycodone intoxication in an infant: accidental or intentional exposure?

A case is presented of a 10 month old male who went into cardiac arrest at a local store. The infant subsequently expired and was autopsied at the Office of the Chief Medical Examiner, State of Maryland. The only remarkable finding was the detection of oxycodone in the postmortem specimens; the blood and liver oxycodone concentrations were 0.6 mg/L and 1.6 mg/kg, respectively. Oxycodone was identified and quantitated by gas chromatography-nitrogen-phosphorus detection and confirmed by full scan electron ionization gas chromatography-mass spectrometry. The medical examiner ruled that the cause of death was oxycodone intoxication, and the manner of death was homicide. The key toxicologic question in this case was whether or not it was reasonable for the infant to be exposed to oxycodone exclusively through breast milk or through an alternate source. It was concluded that, at best, there were serious concerns about the likelihood of drug exposure through consumption of breast milk.     

Cardiac concussion: definition, differential diagnosis, and cases presentation and the legal ramification of a misdiagnosis

A cardiac concussion is caused by a sudden, nonpenetrating, localized impact to the chest that is theorized to result in almost simultaneous sudden death from a disruption to the conductive system. The detailed external/internal forensic examination of the body reveals no evidence of structural, pathologic, or histologic signs of trauma to the heart. A cardiac concussion is a rare and often overlooked cause of sudden death. This type of sudden death is typically seen among younger individuals participating in sports involving projectiles and, to a lesser degree, where collisions occur. Cardiac concussions are clinically, pathologically, and chemically different from a cardiac contusion. The objective of this paper will be to define cardiac concussion, differentiate between cardiac concussion and cardiac contusion, and describe the clinical and pathologic features of a 32-year-old white male who died of a cardiac concussion following a collision with a catcher during a softball game. The civil ramification of incorrectly diagnosing the manner of death in cases of death involving a cardiac concussion will also be addressed.     

Fatal diphenhydramine intoxication in infants

Diphenhydramine is an antihistamine available in numerous over-the-counter preparations. Often used for its sedative effects in adults, it can cause paradoxical central nervous system stimulation in children, with effects ranging from excitation to seizures and death. Reports of fatal intoxications in young children are rare. We present five cases of fatal intoxication in infants 6, 8, 9, 12, and 12 weeks old. Postmortem blood diphenhydramine levels in the cases were 1.6, 1.5, 1.6, 1.1 and 1.1 mg/L, respectively. Anatomic findings in each case were normal. In one case the child's father admitted giving the infant diphenhydramine in an attempt to induce the infant to sleep; in another case, a daycare provider admitted putting diphenhydramine in a baby bottle. Two cases remain unsolved; one case remains under investigation. The postmortem drug levels in these cases are lower than seen in adult fatalities. We review the literature on diphenhydramine toxicity, particularly as it pertains to small children, and discuss the rationale for treating these cases as fatal intoxications.     

Deposition of 7-aminoflunitrazepam and flunitrazepam in hair after a single dose of Rohypnol

In recent years, there has been a notable increase in the number of reports on drug-facilitated sexual assault. Benzodiazepines are the most common so-called "date-rape" drugs, with flunitrazepam (Rohypnol) being one of the most frequently mentioned. The aim of this study was to determine whether flunitrazepam and its major metabolite 7-aminoflunitrazepam could be detected in hair collected from ten healthy volunteers after receiving a single 2 mg dose of Rohypnol using solid phase extraction and NCI-GC-MS. Such data would be of great importance to law enforcement agencies trying to determine the best time interval for hair collection from a victim of drug-facilitated sexual assault in order to reveal drug use. Ten healthy volunteers (eight women and two men, 21 to 49 years old) participated in the study. The following hair samples were collected from each volunteer: one before flunitrazepam administration, and 1, 3, 5, 14, 21, and 28 days after. In five volunteers, 7-aminoflunitrazepam was detected 24 h after flunitrazepam administration and remained in hair throughout the entire 28-day study period (0.6-8.0 pg/mg). In two cases, 7-aminoflunitrazepam appeared in hair 21 days after drug intake (0.5-2.7 pg/mg), and in two subjects 14 days later (0.5-5.4 pg/mg). In one volunteer, 7-aminoflunitrazepam was detected on day 14 and 21 but concentrations were below the quantitation limit. Flunitrazepam was detected in some samples but all concentrations were below the quantitation limit (0.5-2.3 pg/mg).     

Parent-adolescent separation: The role of parental divorce

Previous research has identified Emotional Separation and Personal Control as two sets of home leaving indicators that are associated, respectively with relatively troubled and relatively untroubled parent-adolescent separation. As expected, among late adolescent males, parental divorce was highly related to endorsement of Emotional Separation as an important composite indicator of having left home. For females, being a firstborn was associated with endorsing Personal Control as an important composite indicator of home-leaving. Findings were interpreted as supporting previous research which has indicated that males experience more adjustment problems after parental divorce than females.Received Ph.D. from Michigan State University. Current research interests are parent-adolescent separation and perceptions of loneliness.Received Ph.D. from Michigan State University. Current research interests are adolescent-parent separation and evaluation research.     

Feminists and femininity: A case-study of WSPU propaganda and local response at a Scottish by-election

This article examines the attitudes towards femininity expressed by the WSPU speakers at the 1907 Aberdeen by-election and the response these attitudes elicited from Aberdonians. Although the evidence suggests that a majority of the local population accepted the WSPU's demand for votes (for tax-paying women only) on the grounds of equality, the WSPU felt a need to emphasize the expediency of its proposal. In order to argue that such an extension of the franchise would benefit all women WSPU speakers emphasized the priority of sex over all other social divisions but deliberately accepted the specific differences assumed in popular concepts of ‘femininity’ rather than drawing attention to the male ideology and social institutions in which such definitions originated. Some of the imputed feminine attributes which led Aberdeen men and women of all classes to accept the popular stereotype of domestic woman are examined, as are the difficulties the WSPU encountered because its campaigning activities clashed with its own concept of woman, a difficulty shared by other women's association in Aberdeen.     

From trust on intimacy: A new inventory for examining erikson's stages of psychosocial development

A new inventory for examining the first six of Erikson's psychosocial stages is described. The self-report questionnaire, developed in a pilot study of 97 adolescents and tested in a study of 622 adolescents, has 12 items for each subscale. Measures of reliability and validity are reported. It is concluded that the Erikson Psychosocial Stage Inventory (EPSI) is a useful measure for researchers interested in development from early adolescence and in mapping changes as a function of life events.This research was supported by a grant from the Education Research and Development Committee.Received Ph.D. from University of Melbourne. Current research interests are adolescent adjustment, ethnicity, and sex-role psychology.Received Ph.D. from University of Melbourne. Current research interests are effects of unemployment and adolescent adjustment.Received Ph.D. from Florida State University. Current research interests are sex-role psychology and adolescence.     

Civil liability of private security: Enforcer of moral obligations to right legal wrongs

The private security industry in the United States now has approximately twice as many personnel as does the public police. Private Security personnel have authority over the liberty, and sometimes the lives, of customers and employees. Often they exercise this awesome responsibility with little if any background and training. In most instances private security personnel are not considered law officers or peace officers and are, therefore, not bound by the same rules and regulations that apply to public police. More and more frequently, untrained or minimally trained, and basically unqualified security officers are taking actions against customers and employees which are excessive and unreasonable. Without the Constitutional protections which would be available if the act were committed by a public police officer, the only recourse for a private individual against reckless and wanton conduct on the part of private security personnel is a civil action, seeking compensation for the inconvenience caused or injuries received. The courts have found that companies and their security personnel have an obligation to be reasonable in their investigations of suspected criminal violations by employees and customers. Failure to conduct a proper and reasonable investigation will open the individual directing the investigation, and the company authorizing it, to liabililty for the injury their improper actions have caused. Civil liability suits have become the moral enforcer for improper and excessive conduct by private security personnel.     

Entrapped on the Web? Applying the Entrapment Defense to Cases Involving Online Sting Operations

Many law enforcement agencies are currently responding to the problem of online crime by establishing proactive investigative units that track criminals on the Internet. Not only do these specialized teams face problems in the area of emerging technology, they are also faced with handling emerging legal issues. The current research examined the issue of the entrapment defense, and how previously established physical realm doctrine could be applied to the investigation of online crimes such as child pornography. Relying on previous case law it would appear that entrapment claims related to online sting operations involve consideration of: a) did the law enforcement officer continuously contact the suspect with the intention of trying to convince the individual to engage in a particular type of behavior, b) how long was the relationship between the undercover officer and the suspect, and c) how much, if any, reluctance to commit the criminal act did the suspect provide evidence of?