Poisons

An Introduction for Forensic Investigators

David J. George

• Publisher: CRC Press
• Year: 2017
• ISBN:
  9781315354484
• Edition: 1
• Topic: Law
• Subtopic: Criminal Law
• Index: Law

A unique book on recognition and investigation

of criminal poisoning for investigators

of all backgrounds and stages of their careers.

Poisons: An Introduction for Forensic Investigators is a concise yet comprehensive overview of toxicants and unanticipated circumstances in which poisoning occurs. This book expands awareness of poisoning possibilities, heightens recognition of the toxic potential of many substances, and provides information to aid in focusing investigations.

Poisons discusses life-threatening toxic substances and agents that modify behavior to achieve criminal goals. These include drugs that facilitate sexual assaults and robberies, and those found in medical child abuse and drug-product tampering.

More than 230 case studies illustrate both unintentional and intentional poisoning and highlight situations where poisoning may not immediately be apparent. Information is included in pertinent criminal poisoning cases to illustrate the temperament of poisoners, their relationship to victims, their basis for poison selection, and their method of administration.

Since Poisons is written by a single author, the discussions, format, educational level, and terminology remain consistent to aid crime scene investigators, homicide detectives, forensic scientists, death investigators, toxicologists, medical examiners, attorneys, and students. The book's more than 650 references are an asset to frame knowledge as well as a resource to return to again and again.

Potential Poisons

II

The chemicals that are included in this section are substances that forensic investigators would likely encounter. These also serve as prototypes for other possible toxicants. These natural and man-made chemicals include medications, recreational substances, plant constituents, industrial chemicals, elements, and pesticides.

Each chapter provides a background on the substances discussed with emphasis on well-known features that receive widespread attention, and provides insight into the substance’s accessibility. Situations and circumstances that might be involved in exposures to the substances are highlighted along with symptoms of poisoning that might be useful for the recognition of poisoning by a particular substance. Case studies involving the toxicants are used to demonstrate the utility of the information provided. References for more specific information and in-depth reviews of various aspects of the toxicants are listed at the end of each chapter.

Arsenic

7

7.1 Introduction

Arsenic is probably the most well-known poison in the world. It has been used as a murder weapon for centuries, and remains a favorite poison for authors of murder mysteries. The mere mention of the word arsenic evokes an immediate association with poisoning. Arsenic is a naturally occurring element that everyone is exposed to in nontoxic concentrations every day. It can be found in soil, water, plants, and animals. Almost all foods, whether fresh or processed, contain arsenic. Arsenic has commercial uses and even some applications in current medical therapy. From a forensic standpoint, one should expect to find arsenic in biological as well as inert materials. The mere presence of arsenic is not generally concerning; it is the concentration or the amount of arsenic present in samples that is the prime consideration.

Arsenic has an affinity for sulfur-containing chemical structures that are involved in many important biochemical processes throughout the body. When arsenic binds to these structures, it blocks these processes and leads to toxicity.

7.2 Exposure Situations and Circumstances

Similar to most poisons, availability depends on an individual’s resources and sometimes their occupation. Arsenic is very toxic in doses that are easily mixed with food and beverages without altering their flavor or texture. It produces symptoms that are easily mistaken for natural diseases.

7.3 Symptoms of Poisoning

Initial symptoms of arsenic poisoning generally relate to the gastrointestinal system manifesting as nausea, vomiting, abdominal pain, and profuse diarrhea. These symptoms may be closely followed by psychosis, toxic cardiomyopathy, and seizures. Ultimately, arsenic affects all body systems: kidneys, liver, heart, lungs, muscles, and nervous system. The most frequent neurological manifestations of poisoning are muscle weakness, tingling sensations, and intense pain starting in the lower limbs and moving upward. This can be misdiagnosed as Guillain–Barré syndrome, which is an autoimmune disorder that alters peripheral nerves and produces similar symptoms. Suspected cases of Guillain–Barré syndrome with significant gastrointestinal symptoms might be indicative of arsenic poisoning and this possibility should be considered in the differential diagnosis of these patients.

7.4 Case Studies

Case: Bitter Coffee at Church Breakfast

In 2003, 16 members of a small church in Maine became extremely ill after consuming pastries and coffee after the morning service. They were hospitalized and one church member died. It was soon determined that the congregation had been poisoned with arsenic, and that the source of the arsenic was the coffee. Biological samples from all victims were found to contain high levels of arsenic. Some of the 15 survivors had permanent neurological damage. About a week after the poisoning, a church member committed suicide, leaving a note that expressed his intense guilt for the poisoning and described how it was done. He had gone to the church kitchen during that Sunday morning service and poured a solution containing arsenic into the coffee maker. His motives appeared to involve a long-held grudge with the church members about policies and ideas for change. The most recent incident had involved the selection of a communion table for the church. The poison was obtained from an old pesticide container stored in his barn. It is not clear whether he realized that the pesticide was an arsenic compound. His stated intention was to make the other church members ill. When he realized that he had killed one member and others were likely to die, he killed himself out of shame and remorse. The man had been a respected citizen and a contributing member of the church and the community. He had worked as a substitute teacher and nurse, and he was a member of the church’s historical committee. He was also an avid skier and runner. He lived alone on a farm that had been in his family for generations.

Comments

The initial focus of the authorities was on the possibility of food poisoning, or an act of terrorism. The rural town where the poisoning took place had a population of about 650. The simultaneous poisoning of over a dozen people posed major logistic problems for medical care and investigative efforts.

Case: Toxic Potato Salad at Church Picnic

In 2015, 25 members of a small church in Ohio became extremely ill after eating at a potluck luncheon following the Sunday service. They were all hospitalized and one member died. It was soon determined that they had been poisoned with botulinum toxin, and the source of the toxin was home-canned potatoes used in potato salad served at the church luncheon. All of the poisoned individuals were treated with antitoxin. Some of the individuals required endotracheal intubation and mechanical ventilation. Except for the single fatality, all individuals recovered and were discharged from area hospitals within a period of about a week. The source of the botulism toxin was identified from questioning victims about the items they consumed and testing food samples found in trash bags. The potluck meal was a regular church event, which occurred every few months. More than 70 people ate at the meal with 25 developing symptoms of poisoning within days. The potato salad had been prepared with improperly home-canned potatoes. A boiling water canner was used rather than a pressure canner, which is necessary to kill Clostridium botulinum, which produces the toxin. This case was the largest botulism outbreak in the United States in 40 years.

Comments

This case is presented to provide a contrast to the previous arsenic case, which involved a church meal intentionally contaminated. Most exposures to toxic substances present difficult challenges for investigators due to the need for identifying the causative agent as quickly as possible to prevent additional poisoning and to properly treat symptomatic individuals. From these very similar circumstances in the two cases, one can appreciate the prospect for many potential toxicants that might result in group poisoning in similar situations.

Botulinum toxin is a neurotoxin that blocks transmission of nerve signals to skeletal muscles. Symptoms of poisoning include paralysis of eye muscles, difficulty swallowing, muscles weakness, and paralysis of respiratory muscles.

Case: Chemistry Classmates

Eric, 30, was a research scientist who lived in North Carolina with his wife, Ann, 30, and their 10-month-old daughter. They had met in a chemistry class while in college. Ann was working as a chemist with a pharmaceutical company and Eric worked in a university laboratory. In 2000, Eric became violently ill one evening while bowling with friends. His illness started shortly after eating a hot dog and drinking a beer. He was sick through the night, and the following morning his wife took him to a hospital. He gradually improved and left the hospital after several days. One week later, the illness returned and he was again taken to the hospital where he died a short time later. Testing of urine samples taken during his final days revealed that Eric had died from arsenic poisoning. The analytical results and circumstances of the death resulted in a homicide investigation. Early in the investigation police discovered that Ann had a relationship with a coworker, and they both had access to arsenic where they worked. The coworker was one of the individuals at the bowling event that preceded the first episode of the husband’s illness. About 4 months after Eric’s death, Ann’s coworker committed suicide. Prior to the suicide he had spoken to an attorney and provided details about his relationship with Ann and the poisoning. He indicated that Ann had poisoned her husband before his death and even injected arsenic into her husband’s IV bag while he was hospitalized. The progress of the case was initially hampered by the legal issues involved with attorney–client privileges and the availability of the confession to authorities. While the investigation was ongoing, Ann moved out of state and remarried. She was finally arrested in 2005 and charged with first-degree murder. She pled guilty to second-degree murder and conspiracy to commit first-degree murder, and she was sentenced to 25–31 years in prison. She admitted that she and her former coworker poisoned her husband by adding arsenic to his food and drinks.

Comments

This case illustrates how arsenic might be used in repeated poisonings, and that an individual with severe arsenic poisoning can be hospitalized and the poisoning not be recognized. The victim received an amount of arsenic in his food at the bowling event that caused severe toxicity but was not lethal. He was poisoned a second time with an amount that was again not lethal. The wife then administered more arsenic in his IV line while he was hospitalized. This pattern of experimentation with escalating doses of poisons is not unusual among reported poison murder cases that include spouses or others having daily access to the victims.

Case: Arsenic Suicide by Substance Abuser

In 2007, a 30-year-old woman living with her parents intentionally injected an arsenic compound intravenously. She had a 10-year history of using cocaine and heroin, and was frequently intoxicated with ethanol and other substances. Her initial symptoms of abdominal pain and vomiting were at first attributed by her parents to ethanol as they had often seen her markedly intoxicated. When the symptoms intensified over several hours, she was admitted to an intensive care unit of a hospital. Approximately 14 h after the injection, she had a sudden cardiac arrest that was unresponsive to resuscitation. At autopsy, organ examination, histopathological findings, and the presence of a high concentration of arsenic were consistent with arsenic poisoning. A few days after her death, a suicide note was discovered in her room.

Comments

The arsenic compound injected in this case was disodium hydrogen arsenic, which is a component of a fungicide used in gardening. The liquid fungicide product was regularly used by the woman’s parents. These arsenic-containing products are no longer popular and have been largely replaced by more effective and less toxic products.

Case: Tragic Accident

In 2003, tw...

Table of contents

• Cover
• Half Title
• Title Page
• Copyright Page
• Dedication
• Table of Contents
• Preface
• Author
• Section I POISON
• Section II POTENTIAL POISONS
• Section III POISONING
• Appendices
• Index