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Abstract: Traditionally in England and Wales it has been in the domain of doctors to pronounce ‘life extinct’. The recent implementation of recognition of life extinct (ROLE) procedure in England and Wales has permitted other health care workers undertake this role in selective cases. A momentous case that changed a medico-legal role is presented. [Copyright &y& Elsevier]

Abstract: Rotenone is a pesticide and a piscicide derived from the derris root. The mechanism for the cytotoxicity is at mitochondrial level affecting cellular respiration. A suicide by rotenone poisoning in an adult is described. An innovative laboratory methodology was developed for the principal requirement of the Coroner to determine a positive or negative result to assist in the investigation of the death. The antemortem concentrations detected were 4.05 ng/ml [0.00405 ppm] in the blood and 0.55 ng/ml [0.00055 ppm] in the serum. Toxicity in human is rare and therefore the interpretation of the toxicology results is complicated by the unavailability of a data bank. The cause of death was attributed to rotenone toxicity based on the circumstantial evidence and expert pathological opinion on a balance of probability acceptable under the Coroners Act 1988 and Coroners Rules 1984 in England and Wales. The forensic clinicopathology of rotenone toxicity is discussed. [Copyright &y& Elsevier]