The sudden and unexpected death of Prince at the young age of 57 naturally arouses curiousity as to the cause. Although he was a Jehovah’s Witness and reportedly abstained entirely from recreational drugs and alcohol, the fact that he was part of the popular music world immediately fueled speculation that drugs were involved. He supposedly had prescription painkillers, needed because he refused to have double hip replacement surgery due to the fact that it would require blood transfusions that are prohibited by his religion, and an overdose of these might be a possible cause.
News reports say that the full autopsy reports will take three to four weeks to be completed. I am a big fan of murder mystery stories, and at least on TV and in films about crime, the pathologists’ reports seem to come back within a day or even hours, enabling the sleuths to crack the case within days. In these days of high technology, this seemed plausible and I was curious as to why things took so much longer in real life.
It turns out that while a preliminary autopsy report may be available within a few hours and usually by the next day, the complete autopsy report may take several weeks and in complex cases up to three months.
Preparing a comprehensive toxicology report is also a pretty complicated process and takes time because it is a multi-step process that has to be done sequentially.
In post-mortem toxicology screenings, blood is drawn from various areas of the deceased person’s body. This initial test indicates what type of drugs, such as opiates or amphetamines, might be present.
The secondary part is where it becomes complicated.
If the screening test indicates the person may have had opiates in his or her body, further tests are required to figure out what kind of opiates and in what amount.
“You confirm the preliminary test,” said Douglas Rohde, supervisor of chemistry and toxicology at the Lake County Crime Lab in Ohio. “You confirm that drug is actually there. There’s not one test as seen in ‘CSI.’ There’s no quick test that gives you a positive identification and confirmation. The confirmatory tests can take days or weeks, if they have to be repeated.”
To confirm that a person had a type of drug in his or her body, the drug has to be separated from the blood or tissue.
This process could take several days depending on the types of drugs found in the body. And drugs could be present in very minute levels, in measurements like parts per million or parts per billion. Rohde likens it to searching for five black marbles in a pile of 1 million white marbles.
In the final step, the toxicologist reviews the evidence and determines whether drugs found in the body were enough to kill an individual. That report is submitted to the coroner or medical examiner, at least in the United States.
Cases involving Michael Jackson, Heath Ledger and Anna Nicole Smith were complicated because they had several different drugs in their bodies – some of the substances “weren’t in the regular menu in the toxicology lab,” Rohde said.
If foul play is suspected, the time of death becomes an important feature and in the absence of direct evidence, it is usually arrived at by examining the body. Here too, many factors come into play and the process can be quite laborious and getting a precise estimate quite difficult.
Both the time of death and the postmortem interval cannot be determined with 100% accuracy, particularly when a body is found in advanced state of decomposition or is recovered from fire, water, or ice. Therefore, time of death and PMI are given as estimates, and can vary from hours to days, or from months to years, depending on each particular case.
Evidence for estimating time of death includes physical evidence present in the corpse (postmortem changes, presence of insects, etc.), environmental evidence such as location where the body was found (indoors, outdoors, buried, burned, in water, etc.), and other evidence found at the crime scene (a stopped wrist watch due to a blow or impact, an answering machine record, a 911 call, phone calls received or made around the time of the assault, etc.), and finally, the historical evidence (habits and daily routine of the victim, relationships, existence of enemies, etc). The knowledge of the internal sequential changes a dead body undergoes in relation to the variations on the rate of their occurrence due to ambient temperature, humidity, and the presence of insects or other predators are all considered when estimating the time of death.
This is awkward for crime fiction writers who like to have tight time limits for greater dramatic effect
In her somewhat macabre yet humorous book Stiff: The Curious Lives of Human Cadavers, Mary Roach describes how forensic crime investigators use an open field where dead bodies are strewn all over the place under all kinds of conditions to see how they decompose. The rate of decay can vary widely depending on a whole host of factors. She describes walking gingerly among the stench of corpses in various stages of decay and paints a pretty gruesome scene.
So there you are. Real life is more complicated than what we see on TV. What a surprise.