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Sudden unexpected death is typically diagnosed in infants, children, teenagers, and young adults following completion of an autopsy that fails to identify a cause of death or when autopsy suggests a potentially genetic cause of death in an individual less than 40, such as cardiomyopathy or aneurysm. Such deaths may be a result of genetic abnormalities that are unable to be diagnosed by gross or microscopic inspection, but may be detectable by molecular studies. Unfortunately, the ability to perform postmortem genetic testing is frequently hindered by lack of an appropriate specimen following completion of an autopsy. This paper provides recommendations developed by the National Association of Medical Examiners with the assistance of genetic counselors. The recommendations establish procedures to facilitate postmortem genetic testing and DNA banking by health care professionals assisting families who have experienced sudden death in young relatives by clarifying proper sample acquisition and storage. Additionally, recommendations for discussion with surviving family members and test planning are provided. The objective of these recommendations is to ensure that postmortem samples suitable for DNA banking are retained, allowing at risk family members improved detection of potentially treatable genetic diseases.

Opinions based on toxicology results are dependent, in part, upon the quality of the specimen's acquisition, storage, and chain of custody. The responsibility for these factors is often delegated to tissue and eye bank technicians. These technicians are not employees of the medical examiner (ME)'s office and may have no documented training related to the proper acquisition and handling of retained toxicology specimens. Medical examiners and coroners often request tissue recovery technicians to provide them with these toxicology samples when the tissue recovery is performed before autopsy. This practice helps facilitate donation and is convenient for the ME, but there may be unexpected implications for both the technicians and the ME that deserve further consideration. This article highlights the relevant issues in the postmortem recovery of biological samples for toxicology analysis and makes recommendations for the practice.