Overview

Practical Forensic Pathology and Toxicology is a companion to the authors’ original book on the subject, Forensic Toxicology: Mechanisms and Pathology. This new volume addresses issues that forensic pathologists face when confronted by the suspected or demonstrated presence of drugs or toxins in their cases. Since such considerations include the need for a basic understanding of the direct physiological effects of potentially toxic agents, the authors highlight various connections and interaction between forensic pathology and toxicology. The book is written for both the practicing pathologist, and those in training, who may already have some knowledge of forensic medicine but are on occasion faced with issues that reach beyond a basic determination of cause and manner of death. Pathologists are expected to provide informed, well‑reasoned opinions explaining how a person died—which includes questions about any drugs, prescription medications, or otherwise that may have caused or contributed to death. As such, this book looks at the direct physiological effects of drugs and toxins, answering questions such as “Why does hypernatremia cause seizures?” or “Why can synthetic cannabinoids cause fatal complications, yet THC does not?” or the very timely “What is the mechanism by which an opiate overdose causes death?” Coverage primarily centers on the pathological derangements and physiological consequences of the actions of drugs and toxins, and the cellular mechanisms by which those pathological consequences arise. Organized using an organ system approach, sections are divided into major target organ systems and sections included for affected organs and tissues. While some drugs affect more than one organ system—and some patients will have multiple drugs present—the book’s categorization and organization take this approach to be readily usable for the reader. Case reports are included with additional patient data to show the effects of specific toxins and poisons both alone and in combination with natural disease. Color figures illustrate all aspects of drug or toxin impact on postmortem casework including the scene of death, the deceased persons, and the organs and tissues affected. Practical Forensic Pathology and Toxicology is an invaluable resource for practicing pathologists, toxicologists, and those training for those fields. It also serves as a useful reference for lawyers, judges, insurance companies, and other medical professionals who need to know, in light of what drugs are present in a particular case, what such compounds do, and how their presence (or absence thereof) is—or is not—related to an individual’s death.

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Dorothy E. Dean, MD is a Forensic Pathologist at the Hamilton County Coroner’s Office in Cincinnati, Ohio and is an adjunct professor at the University of Cincinnati College of Medicine in the Department of Pathology. One of her major interests is the evaluation of drug- and poison-related fatalities. She, along with Dr. Powers, co-authored Forensic Toxicology Mechanisms and Pathology (Taylor and Francis, 2016), as well as several scientific articles on the subject. Robert H. Powers, PhD is a professor at the University of New Haven Department of Forensic Sciences, where he has taught forensic toxicology at both the undergraduate and graduate level for over 10 years. He is active nationwide as a forensic consultant and expert witness for civil and criminal cases, with a particular focus on questions related to the potential of drug involvement in death cases, and drug and alcohol -related impairment issues. He is the co-author of many scientific articles as well as Forensic Toxicology Mechanisms and Pathology with Dr. Dean.

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