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: rhenson@beron.us Web: http://www.beron.us © Dr. Ronald Henson, 2010

Blood Alcohol Testing Hospital / Medical Blood Analysis (Clinical) = Stat - Approximate Forensic Lab Analysis (Forensic) = Precise

Hospital / Medical Blood Analysis Collection by Venipuncture 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 Serum / Plasma / Whole When blood is defined in statutes, whole blood is the universal meaning. Hospital analysis is generally Serum after the whole blood has been centrifuged 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 I.V. Administration at the time of draw The sample should be drawn from a different site than the I.V. location 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 Non standard kit (Grey / Red / Lavender/ Light Blue / Green) BAC / SAC / PAC I.V. Skin Prep Non-Alcohol Swab (Verify)

Hospital / Medical Blood Analysis Sources of Error Chain of Custody Enzymatic v. GC - Approximation / False Positives / Elevated Results Calibrations, Maintenance, Repairs, Certifications, Expiration Dates Proficiency Examinations Nurse / Phlebotomist Notes

Hospital / Medical Blood Analysis

Blood Testing

ISP Rules and Regulations 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? Sodium Fluoride / Potassium Oxalate Alcohol Contaminated Swab 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 Should expect 9 to 10 ml Blood Draws < 9 ml may be problematic 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 Witness 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 rhenson@beron.us www.beron.us THANK YOU!