Impact of a Drug Overdose Decedent Toxicology Testing Legislative Mandate on Informing Coroner Death Investigation and Certification Practices

Research output: Contribution to journalArticlepeer-review

Abstract

Objective: To (a) determine the impact of Kentucky’s (KY’s) mandate requiring postmortem toxicology testing of coroner cases; (b) identify the influence of coroner experience and training, jurisdiction size, budget, and location on postmortem testing requests; (c) identify facilitators/barriers for postmortem toxicology testing requests and listing the specific drugs involved in drug-poisoning deaths on death certificates. Methods: A modified Dillman approach was used to deliver the survey to KY’s elected coroners between April and May 2016. Responses stratified by identified influence factors were compared using χ2 tests and Fisher exact tests. Results: Fifty-eight percent of coroners reported that drug overdose investigations had changed since the mandate was enacted. Statistically significant differences in responses were found when stratified. Sixty-three percent of coroners reported always using testing results to complete death certificates. Conclusions: Uptake of the mandate for postmortem toxicology testing of all decedents is not yet complete. Policy Implication: Without uptake of the mandate, surveillance efforts may result in undercounting of drug overdose deaths and the involvement of specific drugs. Mandates for enhanced training and modification of funding structure for medico-legal death investigations could facilitate uptake.

Original languageEnglish
Pages (from-to)66-80
Number of pages15
JournalAcademic Forensic Pathology
Volume9
Issue number1-2
DOIs
StatePublished - Mar 1 2019

Bibliographical note

Funding Information:
This manuscript was supported by Cooperative Agreement Number 5 NU17CE002732-04-00, funded by the Centers for Disease Control and Prevention. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the Centers for Disease Control and Prevention or the Department of Health and Human Services. The authors have indicated that they do not have any other financial relationships to disclose that are relevant to this manuscript

Funding Information:
This manuscript was supported by Cooperative Agreement Number 5 NU17CE002732-04-00, funded by the Centers for Disease Control and Prevention. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the Centers for Disease Control and Prevention or the Department of Health and Human Services. The authors have indicated that they do not have any other financial relationships to disclose that are relevant to this manuscript

Publisher Copyright:
© 2019 The Authors.

Keywords

  • Coroner
  • Drug overdose
  • Forensic pathology
  • Mandate
  • Survey
  • Toxicology

ASJC Scopus subject areas

  • Pathology and Forensic Medicine

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