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Estimating postmortem interval is an important goal in medicolegal death investigations. Although several methods have been developed to achieve this goal, many of these require significant time and advanced expertise to generate a reliable estimate. Unfortunately these techniques do not provide much insight during the early stages of an investigation when critical decisions must be made regarding the allocation of investigative resources. An equation was recently developed to address this problem: provide a preliminary estimate of postmortem interval to initiate an investigation while more advanced techniques are conducted. To evaluate this equation, we used it to estimate postmortem interval at multiple indoor death scenes with known PMI in Nebraska and Hawai'i. This equation allowed us to accurately estimate PMI at 15 of 19 (79%) indoor death scenes. In Nebraska, this equation was accurate at 100% of the scenes. In Hawai'i, this equation was accurate at 60% of the scenes. All inaccurate estimates of postmortem interval were associated with at least 20% mass loss and a postmortem interval of ≥4 days. Although this equation was accurate at the majority of the death scenes attended, we conclude that more research is warranted, particularly the effect of climate on decomposition and the investigators' ability to accurately estimate soft tissue mass loss., (Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.)

In postmortem cases where the cause of death is hanging, toxicological analyses may be considered unnecessary by some medical examiners, toxicologists, and other persons involved in medico-legal investigations because the cause of death seems "obvious." To ascertain if toxicological analyses are necessary when the cause of death is hanging, all 102 hanging cases (25 females; 77 males) from 2011 to 2013 that came under the jurisdiction of the San Francisco Office of the Chief Medical Examiner were examined from a total of 3912 sudden, unexpected, or violent death cases in the same period. Suicide was the manner of death in 99 of these cases, with two accidental and one undetermined death. The average age of decedents was 43.9 years (median 41), the youngest was an 11-year old male and the oldest was an 86-year old female. Of the 102 cases, 33 had negative toxicology while 69 cases had at least one positive toxicology result. Females were equally likely to have negative or positive results (12 and 13 cases respectively), but males were 37.5% more likely to have positive toxicology (n=56) rather than negative toxicology (n=21). For females, alcohol, mirtazapine, venlafaxine, and trazodone were the top psychoactive substances in peripheral blood while THC, cocaine, hydrocodone, bupropion, olanzapine, doxylamine, quetiapine and dextromethorphan were also reported. For males, alcohol, THC, cocaine, amphetamine, methamphetamine, bupropion, and diphenhydramine were the top psychoactive substances in blood, but several other drugs were also found in individual cases. Our study of hanging cases over a 3-year period support the idea that complete postmortem toxicology investigation of hangings should be performed, even when the "obvious" cause of death is asphyxia due to hanging. Many of these cases involved psychoactive substances (most often alcohol and cannabis), and having such knowledge provides a better understanding of the circumstances surrounding the decedent's death, their possible state of impairment, including the possibility of a staged suicide if the decedent was too impaired to perform a self-hanging., (Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.)