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dc.contributor.authorTormey, William Patrick
dc.date.accessioned2013-03-19T15:09:20Z
dc.date.available2013-03-19T15:09:20Z
dc.date.issued2012-10
dc.identifier.citationCannabis misinterpretation and misadventure in a coroner's court. 2012, 52 (4):229-30 Med Sci Lawen_GB
dc.identifier.issn0025-8024
dc.identifier.pmid23155125
dc.identifier.doi10.1258/msl.2011.011087
dc.identifier.urihttp://hdl.handle.net/10147/274182
dc.description.abstractA 37-year-old, one-pack-per-day tobacco smoker collapsed and died at home. At autopsy, he had an occluded left anterior descending coronary artery. Δ(9)-Tetrahydrocannabinol-carboxylic acid was found in his urine but no cannabinoids were detected in his blood. Misadventure was the inquest verdict on the basis of the urinary cannabis, with acute myocardial infarction as the primary cause and cannabis as the secondary cause of death. Such a conclusion is a misinterpretation of the evidence when the time duration for cannabis as a trigger for myocardial infarction is at most two hours. The absence of cannabis in the blood likely places the time since inhalation at more than two hours. The role of tobacco smoking as a trigger was ignored. Cotinine, the biochemical marker of tobacco smoke, should be added to the standard toxicological screen in the guidelines on autopsy practice of the Royal College of Pathologists.
dc.language.isoenen
dc.rightsArchived with thanks to Medicine, science, and the lawen_GB
dc.subject.meshAdult
dc.subject.meshCoronary Occlusion
dc.subject.meshDeath, Sudden
dc.subject.meshForensic Pathology
dc.subject.meshHumans
dc.subject.meshMale
dc.subject.meshMarijuana Smoking
dc.subject.meshSmoking
dc.subject.meshTetrahydrocannabinol
dc.subject.meshTime Factors
dc.titleCannabis misinterpretation and misadventure in a coroner's court.en_GB
dc.typeArticleen
dc.contributor.departmentChemical Pathology, Beaumont Hospital, Dublin 9, Ireland. billtomey@gmail.comen_GB
dc.identifier.journalMedicine, science, and the lawen_GB
dc.description.provinceLeinsteren
html.description.abstractA 37-year-old, one-pack-per-day tobacco smoker collapsed and died at home. At autopsy, he had an occluded left anterior descending coronary artery. Δ(9)-Tetrahydrocannabinol-carboxylic acid was found in his urine but no cannabinoids were detected in his blood. Misadventure was the inquest verdict on the basis of the urinary cannabis, with acute myocardial infarction as the primary cause and cannabis as the secondary cause of death. Such a conclusion is a misinterpretation of the evidence when the time duration for cannabis as a trigger for myocardial infarction is at most two hours. The absence of cannabis in the blood likely places the time since inhalation at more than two hours. The role of tobacco smoking as a trigger was ignored. Cotinine, the biochemical marker of tobacco smoke, should be added to the standard toxicological screen in the guidelines on autopsy practice of the Royal College of Pathologists.


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