Detection of amitriptyline, nortriptyline and bromazepam in liver, CSF and hair in the homicidal poisoning of a one-month-old girl autopsied 8 months after death

We reported on the death by poisoning of a one-month-old baby that had followed the death of one of her sister (due to cyamemazine overdose). Exhumation of the corpse was done 8 months after burial and revealed the presence of amitriptyline. Parent drug and its metabolite were analysed by HPLC-MS/MS in positive ionisation mode on a C(18) analytical column using a gradient of acetonitrile and 2mM formate buffer at pH=3. Quantification is based on the main ion m/z=233, the common product ion of nortriptyline (MH(+), m/z 264), amitriptyline (MH(+), m/z 278) and nortriptyline D3 used as internal standard (MH(+), m/z 267). Amitriptyline and nortriptyline in the liver were measured at a concentration of 29.8 and 3.6 μg/g, respectively. Hair analyses revealed the presence of amitriptyline and nortriptyline at concentrations of 1811 and 43 pg/mg, respectively, while complementary analyses showed the presence of bromazepam in the hair at a concentration of 740 pg/mg, thus documenting previous administrations. The mother confessed later having used the drinkable form of the pharmaceutical LAROXYL(?) by pouring the content of a 20 ml bottle (at 40 mg/ml) into the feeding-bottle of her child. The milk was sweet but still bitter and following the testimony of a close relative, the whole family helped to feed the crying baby.     

The Impact of Children on Legal Actions Taken by Women Victims of Intimate Partner Violence

Successful criminal or civil legal system response to assaults against intimate partners (intimate partner violence; IPV) usually rely on the victim’s participation in the legal process, including having contact with the prosecutor, filing charges, and/or applying for an order of personal protection. Using data abstracted from criminal and civil legal system records for a county-wide cohort of 990 female IPV victims over a 4-year period, we examine the impact of having children, and of specific child factors, on victims’ engagement with the criminal prosecution of their abusive partners and/or seeking a personal protection order (PPO) in the civil court system. Having children increased victim’s contact with the prosecutor and applications for PPOs, but did not increase her likelihood of wanting to file or drop charges. Findings support prior work suggesting both the importance and complexity of children on mothers’ decision-making. Policy makers and service providers may want to assess survivors’ thoughts about the role children play in their decision-making. Additionally, by offering survivors interventions to help their children address the impact of IPV exposure, survivors may be more willing to engage with services.