dr. ronald e. henson, ph.d. expert - consultant beron consulting & labworks p.o. box 10706...
TRANSCRIPT
Dr. Ronald E. Henson, Ph.D.Expert - Consultant
Beron Consulting & LabWorksP.O. Box 10706Peoria, IL 61612-0706Ofc: (309) 360-5614Fax: (309) 243-1629e:mail: [email protected]
Web: http://www.beron.us© Dr. Ronald Henson, 2010
Blood Alcohol Testing
1. Hospital / Medical Blood Analysis(Clinical) = Stat - Approximate
2. Forensic Lab Analysis(Forensic) = Precise
Hospital / Medical Blood Analysis
1. Collection by Venipuncture2. Proper Labeling to Identify the
beginning of the Chain of Custody- Patient’s First and Last Name- Date/Time- Collector Id.- Unique Id.
3. Label Attached to Secure Tube(s) prior to Departure from Patient (stopper & side)
Hospital / Medical Blood Analysis
1. Serum / Plasma / Whole2. When blood is defined in statutes, whole
blood is the universal meaning.3. Hospital analysis is generally Serum
after the whole blood has been centrifuged4. Results must be converted to whole blood
equivalent by dividing 1.12 to 1.25. Illinoishas established 1.18 by Administrative RuleExample: .090 / 1.18 = .076
Hospital / Medical Blood Analysis
1. I.V. Administration at the time of draw2. The sample should be drawn from a
different site than the I.V. location 3. Dilution of the results is generally the issue
- Although, if lactate is administered, elevated lactate and LDH concentrationswill create falsely elevated alcohol levelsin Enzymatic Assay testing (non-issue forGC) (Thompson, W. et al, 1994)
Hospital / Medical Blood AnalysisSources of Error
1. Non standard kit (Grey / Red / Lavender/ Light Blue / Green)
2. BAC / SAC / PAC3. I.V.4. Skin Prep
- Non-Alcohol Swab (Verify)
Hospital / Medical Blood AnalysisSources of Error
5. Chain of Custody6. Enzymatic v. GC
- Approximation / False Positives / Elevated Results
7. Calibrations, Maintenance, Repairs, Certifications, Expiration Dates
8. Proficiency Examinations 9. Nurse / Phlebotomist Notes
Hospital / Medical Blood Analysis
Blood Testing
ISP Rules and Regulations
Section 1286.320 (d): Officers shall use DUI kitsprovided by the Department, if possible. If kits are not available, officers may submit two standard grey top vacuum tubes.
Blood Testing
Forensic Lab Analysis
Generally GC, GC/MS (do not assume) Headspace Direct Injection
Blood / Urine Test Kits Recall? Expiration? Seal Broken Prior to Use? Gray Stopper Tubes?
Sodium Fluoride / Potassium Oxalate
Alcohol Contaminated Swab More to follow…
Expiration / Bacteria Contaminated Neo-genesis formation issues
Forensic Lab Analysis
Venipuncture Median Cubital or other Superficial
Veins Arterial Blood will have higher
alcohol concentrations in the absorptive phase
Forensic Lab Analysis
Blood Draw Gray Top Vacutainer® is 10 ml
Should expect 9 to 10 ml Blood Draws < 9 ml may be problematic
BD Vacutainer® Blood Collection Tubes are made to draw within ±10% of the stated draw volume at the time of manufacture, in accordance with the National Committee on Clinical Laboratory Standards (NCCLS) (A1 - A3) Guidelines.
Draw method problems Partially evacuated container (potential for bacteria contaminates) Evaporation
Allow the vacuum in the tube to be exhausted Separate from the sleeve properly (to ensure against contamination)
Forensic Lab Analysis
Blood Draw Invert 8 to 10 times (from BD: Gently
invert, All BD Vacutainer tubes require immediate mixing following collection
Do not shake or vigorously mix, Hemolysis may occur
Hemolysis is the breakage of the red blood cell’s membrane
Corrective action is to redraw the specimen for accurate testing (Arzoumanian, L. (2003)
Forensic Lab Analysis
Blood Draw Credentials
Hospital Nurse / Phlebotomist
Witness Labeling / Evidence Seal (stopper included) Packaging Evidence Seal Transport Evidence Storage Chain of Custody Lab Receipt and Testing
Forensic Lab Analysis
Issues in Blood Alcohol Testing
In June, 1997, PDI (the Manufacture of the Blood Kits), provided aLetter that stated: “… hence, the product is alcohol free”.
In June, 1997, Nice Pak Products conducted an analysis of the swabIn questions and stated: “…No Alcohol was detected from sample B40600 lot 5C031EDC using our in house test method (NPTM314)”.
In March, 2007, a private consultant contracted an analysis of the PDI swab to PDC Laboratories, Inc in Missouri and foundEthanol and Isopropyl Alcohols in the Swabs.
Current Issues in Blood Alcohol Testing
In June, 2007, Illinois State Police Forensic Lab conduced atest using a GC/MS and confirmed the findings of Ethanol and Isopropyl Alcohols in the Swabs.
In July, 2007, Illinois State Police notified State’s Attorney Officesthat an emergency rule was submitted to change the section 1286.320that stated: “a disinfectant that does not contain alcohol shall be used to clean the skin where a sample is to be collected”.
The new procedural rule that is listed in the final publication in October, 2007, has been changed to state the following: “the blood sample should be drawn using proper medical technique”.
Discovery List (Limited to Collection Investigation)
Any telephone conversation records A swab sample for independent examination Chain of Custody Report Toxicology Evidence Form Photo Copy of the specimen “Box” label / Expiration Date and Lot Number A photo (copy is acceptable if readable) of each individual vacutainer tube label with lot number
and expiration date A copy of the hospital records, nurse notes and report (s) Photo Copy of the Certified Mail Label and Postal Printing on the specimen container Photo Copy of the Kit Integrity Seal and Kit Shipping Seal. A copy of the completed “Volatile Worksheet”. A copy of the GC report generated for all volatiles analyzed and ethanol. All refrigeration logs or reports, or other documents in whatever form, for all refrigerated
compartments in which the sample, controls, and standards used in or in relation to the analysis in this case were stored or kept at any time.
All records showing the exact amount of preservative that was contained in the vacutainer at the time of collection.
All records showing the exact amount of blood and preservative that was contained in the sample of Defendant’s blood at the time it was subjected to analysis.
Forensic Lab Analysis
