Evaluation of medicolegal investigators' suspicions and positive toxicology findings in 100 drug deaths.

The performance of trained medicolegal investigators was evaluated in 100 consecutive drug deaths, which occurred from January 1978 to May 1980 in St. Louis City and County. Carbon monoxide deaths were excluded from the study. The toxic agent responsible for death, as indicated by scene investigators and the decedent's drug history, was compared to the actual toxicology laboratory findings. In 84 of the cases, the toxicant was correctly indicated by the investigators. In the remaining 16 cases, 12 were suspected to be drug deaths but the major toxicant was not indicated, and in 4 cases no drugs were suspected. The manner of death had no influence on the investigators' performance. This study demonstrates the value of trained medicolegal investigators in providing helpful information to the pathologist and toxicologist before autopsy and laboratory analyses in cases of drug deaths.