Why toxicology reports take so long.

Previously published Slate articles made new.
July 14 2009 10:58 AM

What Makes Toxicology So Slow?

Why it's taking so long to investigate the death of Michael Jackson.

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Michael Jackson's casket at the singer's public memorial service

Michael Jackson's toxicology report might come out this week —a full fortnight after his death. What's taking so long? Last year, after Kanye West's mother died of unknown causes, Juliet Lapidos explained why this laboratory process often drags on for weeks and even months.

Kanye West's mother died of unknown causes on Nov. 10, but her toxicology report wasn't released until last Thursday. (It was inconclusive.) Meanwhile, the toxicology report for Duvall, Wash., resident Miguel Tamayo-Fajaro, who died Friday night in a gruesome traffic accident on Interstate 405, will not be ready for weeks. If the techies on CSI: Miami can whip up toxicological statements in no time, why does it take so darn long in the real world?

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Because there's a backlog. Analysts typically work on multiple cases at the same time, and they're always behind schedule due to staff shortages. For example: The 20-person team at the Washington state toxicology lab, which will handle the Tamayo-Fajaro screening, handles approximately 10,000 cases per year. To make matters worse, toxicologists often serve two masters; when they're not in the lab, they're at court offering expert testimony. In Washington state, lab scientists may spend as much as two days a week on the witness stand while their blood samples languish in a refrigerator.

Thorough tox reports require lots of effort. First off, labs try to collect at least 25 mL of heart blood, 10 mL of peripheral blood, and 50-gram tissue samples from the subject's brain, liver, and kidney. An analyst then carries out an alcohol screening and a generalized immunoassay test, which can detect broad-based drug groups like opiates or tranquillizers. In the event of a positive drug test, the analyst must complete a confirmation procedure, designed to ferret out the exact nature of the offending substance. Next, a supervisor reviews the analyst's report and either approves the conclusions or requests more tests. This whole process, barring glitches or lengthy tests for hard-to-detect drugs like neuromuscular blockers, could take just a couple of days ifanalysts were able to devote themselves exclusively to a well-preserved specimen. (They rarely get this opportunity.)

Not every case proceeds up the lengthy toxicology queue in the same amount of time. Labs handle screening requests for living as well as deceased subjects, and the living get first priority. Some evidence gets rushed to the top of the list because of an upcoming court date or because it might shed light on an ongoing investigation.

Occasionally, state-owned toxicology labs outsource tests to private companies, which are far better staffed and have a quicker turnaround. NMS Labs in Willow Grove, Pa., for example, employs about 200 scientists for 40,000 cases and averages seven to 11 days for a toxicology report. Some private institutions operate a first-come, first-served queue; at others, clients pay more for rush jobs than a case on the back burner.

Got a question about today's news? Ask the Explainer.

Explainer thanks George Johnston of the Washington State Patrol, Kevin Jones of the Washington State Toxicology Lab, and Robert Middleburg of NMS Labs.

Juliet Lapidos is a former Slate associate editor.

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