Recent developments in medicine and law

This article addresses important developments in the field of medicine and law during the period of September 2000 through August 2001. It does not discuss every reported case or piece of legislation but surveys some of the more significant developments in the medicine and law arena.     

Postmortem blood and vitreous humor ethanol concentrations in a victim of a fatal motor vehicle crash

A 20-year-old male was found on the passenger side of a small car after a collision with a semi-trailer truck. Postmortem blood, collected from the chest cavity, and vitreous humor samples were collected following harvesting of the heart and bones. Gas chromatographic analysis revealed a blood ethanol concentration of 0.32 g/dL and a vitreous humor ethanol concentration of 0.09 g/dL. The stomach was intact and full of fluid and food, but its contents were not collected. Possible explanations for the large difference between the two results include diffusion of ethanol from the stomach into the chest cavity, contamination of the blood sample prior to collection, and ingestion of a large quantity of ethanol shortly before death. This case demonstrates the importance of proper quality assurance procedures in collecting postmortem specimens and of collecting a vitreous humor sample for ethanol analysis in postmortem toxicology cases.     

Accidental drowning due to tropane alkaloid abuse

The cause of drowning deaths in good swimmers may be difficult to solve. After homicide, suicide and other kinds of immersion deaths have been ruled out, not only alcohol and narcotics, but also other psychotropic substances such as thornapple and angel's trumpet should be taken into consideration--at least in adolescents and young adults. The article reports on an accidental death by drowning under the influence of tropane alkaloids after consumption of a decoction of the flowers of angel's trumpet.     

The identification of sodium fluoroacetate (compound 1080) employing NMR spectroscopy

Nuclear magnetic resonance (NMR) spectroscopy was employed for the purpose of identifying samples of materials suspected of containing sodium fluoroacetate (Compound 1080). Acquisition of routine proton (1H) and carbon (13C) NMR spectra provided a straight-forward means for determining the presence of Compound 1080 in the samples and thus afforded a simple method for analysis and identification of this compound.     

Antitrust, health care quality, and the courts

Antitrust law represents the principal legal tool that the United States employs to police private markets, yet it often relegates quality and nonprice considerations to a secondary position. While antitrust law espouses the belief that vigorous competition will enhance quality as well as price, little evidence exists of the practical ability of courts to deliver on that promise. In this Article, Professors Hammer and Sage examine American health care as a vehicle for advancing understanding of the nexus among competition, quality, and antitrust law. The Article reports results of a comprehensive empirical review of judicial opinions in health care antitrust litigation between 1985 and 1999, with specific attention to courts' handling of quality and other nonprice concerns. Professors Hammer and Sage conclude that, although antitrust law cannot be expected to serve as the sole oversight mechanism for industries as complex and quality dependent as health care, courts have been successful incorporating some nonprice factors into antitrust analysis.