Transcript Dr. Ronald E. Henson, Ph.D. Expert / Consultant / CPCT

Dr. Ronald E. Henson, Ph.D.
Expert - Consultant
Beron Consulting & LabWorks
P.O. Box 10706
Peoria, IL 61612-0706
Ofc: (309) 360-5614
Fax: (309) 243-1629
e: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 Venipuncture
2. 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 / Whole
2. When blood is defined in statutes, whole
blood is the universal meaning.
3. Hospital analysis is generally Serum
after the whole blood has been centrifuged
4. Results must be converted to whole blood
equivalent by dividing 1.12 to 1.25. Illinois
has established 1.18 by Administrative Rule
Example: .090 / 1.18 = .076
Hospital / Medical Blood Analysis
1. I.V. Administration at the time of draw
2. 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 concentrations
will create falsely elevated alcohol levels
in Enzymatic Assay testing (non-issue for
GC) (Thompson, W. et al, 1994)
Hospital / Medical Blood Analysis
Sources of Error
1. Non standard kit (Grey / Red / Lavender/
Light Blue / Green)
2. BAC / SAC / PAC
3. I.V.
4. Skin Prep
- Non-Alcohol Swab (Verify)
Hospital / Medical Blood Analysis
Sources of Error
5. Chain of Custody
6. 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
Blood Testing
ISP Rules and Regulations
Section 1286.320 (d):
Officers shall use DUI kits
provided by the Department,
if possible. If kits are not
available, officers may submit
two standard grey top vacuum
tubes.
Forensic Lab Analysis

Generally GC, GC/MS (do not assume)
Headspace
 Direct Injection

Forensic Lab Analysis

Blood / Urine Test Kits




Recall?
Expiration?
Seal Broken Prior to Use?
Gray Stopper Tubes?


Alcohol Contaminated Swab


Sodium Fluoride / Potassium Oxalate
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


Blood Draws < 9 ml may be problematic





Should expect 9 to 10 ml
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
Issues in Blood Alcohol Testing
In June, 1997, PDI (the Manufacture of the Blood Kits), provided a
Letter that stated: “… hence, the product is alcohol free”.
In June, 1997, Nice Pak Products conducted an analysis of the swab
In 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 found
Ethanol and Isopropyl Alcohols in the Swabs.
Current Issues in Blood Alcohol Testing
In June, 2007, Illinois State Police Forensic Lab conduced a
test 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 Offices
that an emergency rule was submitted to change the section 1286.320
that 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”.
Forensic Lab Analysis

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.
Ron Henson
[email protected]
www.beron.us
THANK YOU!