Criminal Poisoning: Investigational Guide for Law Enforcement, Toxicologists, Forensic Scientists, and Attorneys (14 page)

Glaister J:
The Power of Poison
. William Morrow, New York, 1954, pp. 153–182.

Hubbard FM: http://en.thinkexist.com/quotations/when_you_consider_what_a_

chance...)

Rowland J:
Poisoner in the Dock.
Arco Publications, London, 1960, pp. 230–237.

Schonberg H:
New York Times
, October 8, 1972.

62

Criminal Poisoning

3.13. SUGGESTED READING

Kelleher MD, Kelleher CL:
Murder Most Rare: The Female Serial Killer.
Praeger, Westport, CT, 1998.

Pollack O:
The Criminality of Women
. Greenwood Press Publishers, Westport, CT, 1978.

Sparrow G:
Women Who Murder: Crimes and the Feminine Logic Behind Them.
Abelard-Schuman, New York, 1970.

Thorwald J:
Proof of Poison.
Thames and Hudson, London, 1966.

Victims

63

Victims

“Most signs and symptoms associated with natural disease can be produced by some poison, and practically every sign and symptom observed in poisoning can be mimicked by those associated with natural diseases.”

—L. Adelson

Most often the victim of poisoning will appear rather natural in death. In effect, poisoning is murder in slow motion, because it may take a long period of time, depending on the dose and the poison that has been selected as the weapon. Two major factors that determine lethality of a substance are (1) concentration and (2) duration of exposure.

4.1. WHO GETS POISONED?

Poisoning murders can be classified into a number of groupings, depending on the motive for homicide. There can be a suicidally motivated parent who wishes to take the children with him or her. A good example of this type of killing is the case of Johanna Maria Magdalena (“Magda”) Goebbels and her husband, Joseph (Third Reich propaganda minister), who, in 1945, used cyanide to murder their six children in Hitler’s Berlin bunker, as the Allied forces approached and the end of the Third Reich was near. Another example is the case of the parents at “Jonestown,” Guyana who participated in the mass suicide there.

Another type of poisoning death is an unintentional homicidal poisoning (manslaughter). This type of poisoning might result from an accidental drug overdose, as in the death of comedian John Belushi. Another interesting incident is the 1954 British case of Arthur Ford, who in his wish to sexually arouse two of his female office coworkers accidentally killed them with his use of cantharides (Spanish Fly).

From: Forensic Science and Medicine: Criminal Poisoning, Second Edition By: J. H. Trestrail, III © Humana Press Inc., Totowa, NJ

63

64

Criminal Poisoning

A death may also result from administration of a harmful substance to a child in order to stop what is deemed improper behavior (e.g., bed wetting, nail biting, or not following parental instructions). Several manslaughter deaths from the administration of powdered black pepper (
Piper negrum
) have been documented, and in one case this administration resulted in the aspiration death of a child (Cohle, Trestrail, Craham, et al, 1988).

One of the more discussed abnormal psychological conditions is what has become known as
Munchausen Syndrome by Proxy
. This condition was named after Baron von Munchausen, a famous German teller of fabulously unbelievable tales. This syndrome is a phenomenon in which a mentally ill parent administers poison to his or her child in order to draw attention to himself or herself. Such a parent enjoys being the center of attention, and by using a child as the object of a medical emergency, the parent in effect becomes the center of attention by proxy. The offender gets some personal psychological reward from having doctors listen and begins to exaggerate the symptoms. This type of poisoner is usually a mother, who may show many of the following characteristics (Levin & Sheridan, 1995):

• Comes from a background where she was ignored and unrecognized • Has a history of being abused herself

• May consider the relationship she had with her obstetrician the most intense, personal, and rewarding she had ever had and is attempting to transfer this role to the child’s pediatrician

• May have some nursing training

• May have a history of weaving false tales of medical problems.

This type of poisoning event is considered a form of child abuse. In most cases, the father is usually oblivious to the activities or may be in sub-conscious collusion with the perpetrator.

The timely issue of euthanasia of the elderly and terminally ill by homicidal poisoning, in private homes as well as in nursing homes, came to national attention in the last decade. Dr. Jack Kevorkian’s fight for doctor-assisted suicide brought this type of poisoning to the forefront of nightly news around the country. Its popularity is also evidenced by the publication of the euthanasia guidebook
Final Exit
, and the existence of the “Hemlock Society,” which provides instructions for committing suicide to those wishing to end their own lives because of terminal illness.

The emphasis of
Criminal Poisoning
concentrates mainly on intentional homicidal poisoning, which is always considered first-degree murder because of the element of premeditation.

Victims

65

4.2. INVESTIGATIVE CONSIDERATIONS

What indices might the homicide investigator utilize to help him or her determine that a poisoning murder may have occurred? Investigators should look for friends or relatives who arouse suspicion, as well as suspicious circumstances that surround the death. Indicators might include the sudden death of the victim after eating, drinking, or going into the bathroom; or poison containers found near the deceased. In a suicide, the latter might well be the case, although it could be a murder masquerading as a suicide.

The antemortem (before death) clinical course might indicate that the deceased exhibited symptoms consistent with a poisoning, but it is easy for an investigator to be misled. One would think that an autopsy of the body would clearly reveal that the cause of death was other than natural, yet in many localities autopsies are not performed, owing to either the cost or availability of such a service, and the coroner or medical examiner normally lists on the death certificate his or her best judgment as to the cause of death.

4.3. DISTINCTIVE PATHOLOGICAL FINDINGS

Following are pertinent questions that the medical examiner should ask: • Does the victim exhibit no morphological changes that can be attributed to direct chemical action by a toxic agent? Poisonous substances that might be considered in such cases include the following: acute central nervous system depressants (alcohols, ethers, sedatives, chloroform, hypnotics, and so forth), chemical asphyxiant gases (carbon monoxide, hydrogen cyanide), organophosphate insecticides (OPIs) (malathion or parathion), and alkaloidal compounds (strychnine, opiates).

• Are systemic lesions present without obvious injury at the site of entry? Poisonous substances that might be considered include arsine and nitrobenzene.

• Is an injury present at the site of entry that does not exhibit remote or systemic evidence of direct cell damage? Poisonous substances that might be considered include those that cause immediate cellular necrosis (corrosives) or gaseous irritants (chlorine, sulfur dioxide).

• Are local and systemic injuries present? Poisonous substances that might be considered include heavy metals such as mercuric chloride, arsenic, antimony, and lead.

4.4. CLASSIC SYMPTOMS OF POISONING

Some visible clues that should alert criminal investigators and health-care workers that a victim may have been poisoned are as follows: 66

Criminal Poisoning

•
Hair loss (alopecia):
Often found as a result of chronic intoxication from the heavy metals (e.g., arsenic, antimony, and thallium). It is surprising how often this clue is overlooked.

•
Fever (hyperthermia):
Results from activation of the body’s defense systems.

•
Constricted pupils (miosis):
Often found as a result of opiate compounds (e.g., morphine, codeine, heroin), OPIs, and so forth.

•
Dilated pupils (mydriasis):
Can be found as a result of the solanaceous plant alkaloids, such as atropine, scopolamine, and hyoscyamine; as well as insulin; cocaine; nicotine; and so forth.

•
Odor:
Some poisons have characteristic odors that may be detectable on the victim. For example, arsenic smells like garlic, Vacor rodenticide smells like pea-nuts, and nitrobenzene smells like shoe polish.

•
Oral burns:
The mouth area or face may exhibit burns caused by caustics and corrosives compounds (acids and alkalis, such as sodium hydroxide [lye]).

•
Gastrointestinal effects (diarrhea):
May be caused by many poisons, especially the heavy metals.

•
Change in skin color:
Cherry red skin color results from carbon monoxide and blue (cyanosis) from nitrites (methemoglobinemia).

•
Vomiting (emesis):
Results from stomach irritation (arsenic, antimony, aconite, acids, alkalis, colchicine, cantharides, phosphorus, mercury, iodine
,
and so forth).

•
Injection tracks:
Can come from multiple administrations of poisons by the parenteral (injected) route.

•
Skin speckling:
This looks like raindrops hitting the surface of a dusty road. It can be caused by chronic doses of arsenic.

•
Stomach cramps:
A classic sign of chronic poisoning.

•
Brittle nails and Aldrich-Mees lines (white transverse lines across the nail beds): Heavy metals can change the nail structure. These lines should not be confused with leukonychia, which are white spots resulting from traumatic injury to the nail, or the lunula, which is the normal pale area at the nail root.

•
Convulsions:
Caused by strychnine, organophosphate compounds, camphor, cyanide, and so forth.

•
Coma:
Caused by opiates, hypnotics, sedatives, carbon monoxide, carbon dioxide, ethanol, phenols, and so forth.

•
Paralysis (general or partial):
Results from alterations in the nervous system caused by botulism, cyanide, thallium, arsenic, and so forth.

•
Abrupt onset of symptoms:
Sudden appearance of symptoms in a previously healthy individual.

Table 4-1
summarizes these symptoms and the poisons that cause them.

With the correct determination that the victim has been the target of a poisoner’s efforts, the focus turns to the crime scene. The role of the investigator is then to gather evidence that will eventually lead to the source of the poison, and the poisoner himself or herself.

Victims

67

Table 4-1

Common Poisons and Their Symptoms

Symptom

Poison

Hair loss

Thallium, other heavy metals

Fever

Multiple poisons

Constricted pupils (miosis)

Opiates, organophosphate pesticides

Dilated pupils (mydriasis)

Alkaloids, insulin

Garlic odor

Arsenic, antimony,
etc.

Peanut odor

Vacor (rodenticide)

Bitter almonds odor

Cyanide

Shoe polish odor

Nitrobenzene

Oral burns

Corrosives (lye, acids)

Diarrhea

Heavy metals

Cherry red skin color

Carbon monoxide

Blue skin color (cyanosis)

Nitrites

Vomiting

Multiple irritant poisons

Injection tracks

Insulin, drugs of abuse

Skin speckling

Arsenic (chronic)

Stomach cramps

Multiple poisons

Nail changes (Aldrich-Mees lines, brittleness)

Heavy metals (arsenic)

Convulsions

Strychnine, cocaine, pesticides

Coma

Depressants, hypnotics

Paralysis

Botulism, heavy metals

Abrupt onset of symptoms

Multiple poisons

4.5. REFERENCES

Cole SD, Trestrail JH, Graham MD, et al: Fatal pepper aspiration. American Journal of Diseases in Children, 1988;142:633–636.

Levin AV, Sheridan MS:
Munchausen Syndrome by Proxy: Issues in Diagnosis and Treatment
. Lexington Books, New York, 1995.

4.6. SUGGESTED READING

Adelson L:
Pathology of Homicide
. Charles C Thomas, Springfield, IL, 1974.

Ferner RE:
Forensic Pharmacology: Medicines, Mayhem, and Malpractice
. Oxford University Press, New York, 1996.

True B-L, Dreisbach RH:
Dreisbach’s Handbook of Poisoning
, 13th ed. Pantheon Publishing Group, Boca Raton, FL, 2002.

Crime Scene Investigation

69

Crime Scene Investigation

“Murder is first conceived in the heart. But if it remains there—as it often does—it is no crime, though it may well be a sin. It is the acceptance of the idea of murder as a possible means of getting what one wants that is the decisive step. For most normal and sane people the idea is still-born. They smile to themselves and say ’What am I thinking of?’ The thought passes, and is lost in the limbo of forgotten fantasy. But if the thought is not forgotten? If it recurs? If it is first half-accepted and then embraced? From this point we have a woman who intends to murder and we pass to the field of strategy and tactics.”—Gerald Sparrow

Poisoners are very concerned about the detection of their crime, and although they can control most incriminating evidence of their crime, they cannot control autopsies, analytical toxicology, and exhumations (
see
Fig. 5-1
).

The prime directive for gathering evidence of poisoning at a death scene is to remember the proper chain of custody. Nothing can break a case assumed to be solid more easily than the defense being able to prove a reasonable possibility that evidence could have been tampered with before the trial.