MEDICO-LEGAL ASPECT OF POISONING

PoisonA substance capable of destroying life, either by chemical action on body tissues or physiologically by systemic absorption

Applied or administered with the intention to kill

Essential element in law: Intent in administration

The quantity doesnt affect culpability, nor is the law concerned with the quantity in which the substance acts.

Toxicological analysis is not confined to the stomach because:The GI tract is only one of the means of entry.The poison might have passed out of the stomach after significant period of time has elapsed from ingestion to death.Poison could have been introduced post-mortem to conceal the real cause of death.There must be a demonstration of absorption of the poisonous agent except in usage of strong corrosive agent.Toxicological analysis must be done BEFORE Embalming & Putrefaction.

Recommended Organs to be Saved for Suspicious Poisoning

Poison to be TestedOrgans to be Submited1. Arsenic (Acute Poisoning)Liver, kidney, stomach contents2. Arsenic (Chronic Poisioning)Liver, urine, hair3. AlcoholBlood, liver, kidney, urine, brain4. Cyanide or HCNStomach and liver5. Carbon MonoxideBlood placed in sealed container6. AlkaliStomach and contents, esophagus7. Morphine & other alkaloidsStomach and contents, liver, urine8. BarbituratesBrain, liver, kidney, urine9. PhosporusStomach, liver, kidney10. LeadKidney, liver, bone11. PhenolLiver, kidney, stomach12. PesticideStomach and contents, liver, blood13. AntibioticLiver, blood14. Kerosene, gasolineBrain, liver, lungs, blood

Circumstances Affecting Action of Poison:Method of administrationIdiosyncrasyAgeHabitDoseFatal Dose smallest dose known to cause death.6) State of the Stomach and Kidneys

S/Sx to suspect poisoning:Sx appear suddenlySx appear at the state of healthSx appear after taking food/medicineSx occur at the same time for several persons who partake the food/drug at the same timeSx are getting severe or steadily improvingDetection can be done on:Food takenContainerVomitusExcretions

Failure to detect poison does not show that the substance is absent.

To confirm suspicion of poisoning:Obtain information from the victim, family members, or police and peace officers.Obtain sample of the vomitus, urine, and other bodily discharges for analysis.Observe the pt for other developments of the symptoms and progress of the condition.Request a fellow physician to assist and observe the pt if necessary.

In case of Poisoning, the medical witness must answer the ff:What is the actual cause of death?Why is the death attributable to poisoning rather than to disease?What is the maximum fatal dose of the poison of the poison alleged to have caused the death?If the actual symptoms do not resemble the expected symptoms, what explanation can he give?Was the dose taken by the victim necessarily fatal?

To answer the above questions, the physician must know & report on the ff:History and Symptoms During life:History of any previous suicidal attemptsHistory of his mental conditionHistory of business, marital, and social failuresPresence of persons having grudge against himPossible source of the poisonTime of actual administration of the poisonNature and actual time of occurrence of the symptomsOrder of occurrence of symptomsIf the victim died, note the exact time of death and the period of time from ingestion to death.Inquire on the presence of vomitus, urine & other bodily discharges for analysis.Date, time, place where the victim was last seen alive.

To answer the above questions, the physician must know & report on the ff:2) Post-mortem ExaminationExternal Post-Mortem ExaminationInternal PostMortem ExaminationClassification of Poisons:CorrosivesIrritantsNarcoticsDepressantsPoisons w/ are Exito-Motor in actionPoisnous & Irrespirable GasesContact PoisonsVulnerants

Food PoisoningState of ill-health resulting from food which has some abnormal or noxious content.

Botulism poisoning due to ingestion of food stored and prepared in unsatisfactory conditions and eaten without cooking.

Laws on Poisons and Other Poisonous Substances in the PhilippinesProvisions Relative to Dispensing of Violent Poisons (Sec. 755, Revised Administrative Code)Provisions Relative to Dispensing of Less Violent Poisons (Sec. 756, Revised Administrative Code)Receptacle for Poisonous Drugs (Sec. 756, Revised Administrative Code)