Validity testing of commercial urine cocaine metabolite assays: II. Sensitivity, specificity, accuracy, and confirmation by gas chromatography/mass spectrometry

A comprehensive validity assessment study was performed on eight commercial urine assays for detection of cocaine use. Sensitivity, specificity, and accuracy of each assay were evaluated by analyzing, in random order and under blind conditions, specimens spiked with known drug concentrations and clinical specimens obtained from human subjects after intravenous cocaine use. Commercial assay results were compared with gas chromatography/mass spectrometry (GC/MS) assay of the same specimens for benzoylecgonine. All of the assays examined were determined to have utility in screening for cocaine use, with the exception of the KDI Quik Test, which was not a reliable test for detection of cocaine use. Major differences in sensitivity, specificity, and confirmation rate by GC/MS were noted among the assays, differences which should be taken into consideration when implementing a urine screening test for cocaine use or interpreting test results involving use of these assays.     

Remedies for Dishonest Assistance

The paper considers the nature of claims against dishonest assistants and the various money remedies those claims may evoke. Dishonest assistance is a form of civil secondary liability whereby the assistant is held jointly and severally liable along with the trustee whose misconduct he assisted. This is the sense in which dishonest assistants are said to be accountable as constructive trustees. In order to understand remedies available against dishonest assistants it is accordingly necessary to understand the corresponding remedies against defaulting trustees and what it means for them to be accountable. The paper examines the two different types of compensation that may be awarded against defaulting trustees—substitutive and reparative—and observes that the same two types of compensation may be given against dishonest assistants in appropriate cases. It also explores the circumstances in which trustees and dishonest assistants should be accountable for profits and whether they should ever be liable to pay exemplary damages. A strict application of the theory of civil secondary liability produces controversial results in connection with these latter remedies.     

Wischnewski revisited. The diagnostic value of gastric mucosal ulcers in hypothermic deaths

Hypothermia is defined as a subnormal body temperature. In this article, hypothermia refers to the loss of core temperature from exposure. When death results from hypothermia, a series of gastric mucosal erosions known as "Wischnewski ulcers" (1) frequently occur. In examining case material of the Onondaga County Medical Examiner's Office, a characteristic pattern of these ulcerations was seen that was indicative of severe physiologic stress and/or hypothermia. While not pathognomonic of hypothermia, the incidence of the erosions in a specific pattern has been closely associated with deaths in which hypothermia played a significant role. In hypothermia, the erosions, usually shallow and approximately 0.1-0.5 cm in diameter, are set in lines with roughly equidistant spacing, thereby forming a pattern of rectangles with the corners marked by the ulcerations.