A5010857033- Opioid Use Disorder Treatment
- Poisoning and overdose treatments
- Pharmaceutical Practices and Patient Outcomes
- Forensic Toxicology and Drug Analysis
- Autopsy Techniques and Outcomes
- Restraint-Related Deaths
- Cardiac electrophysiology and arrhythmias
- Genomics and Rare Diseases
- Emergency and Acute Care Studies
- Substance Abuse Treatment and Outcomes
- Forensic Entomology and Diptera Studies
- Suicide and Self-Harm Studies
- Voice and Speech Disorders
- Genomic variations and chromosomal abnormalities
- Treatment of Major Depression
- Patient Safety and Medication Errors
- Respiratory and Cough-Related Research
- Genetics and Neurodevelopmental Disorders
- Decision-Making and Behavioral Economics
- Traumatic Ocular and Foreign Body Injuries
- Tracheal and airway disorders
- Injury Epidemiology and Prevention
- Pain Management and Opioid Use
- Infant Health and Development
- Gun Ownership and Violence Research
Office of Chief Medical Examiner
2023-2024
John Gill Technology (United Kingdom)
2024
Gilson (United States)
2024
Kelly Services (United States)
2024
Lucas Research
2024
Reade
2024
University of California, Los Angeles
2023
Dade County Medical Examiner Department
2007-2018
In this case report, we present an evaluation of the distribution postmortem concentrations acetyl fentanyl in a fatality attributed to drug. A young man who had history heroin abuse was found deceased at his parents' home. Toxicology testing, which initially screened positive for by ELISA, subsequently confirmed gas chromatography-mass spectrometry specific ion monitoring (GC-MS SIM) analysis following liquid-liquid extraction. No other drugs or medications, including fentanyl, were...
Abstract Background Whole-exome sequencing (WES) has become an efficient diagnostic test for patients with likely monogenic conditions such as rare idiopathic diseases or sudden unexplained death. Yet, many cases remain undiagnosed. Here, we report the added yield achieved 101 WES re-analyzed 1 to 7 years after initial analysis. Methods Of cases, 51 were disease and 50 postmortem “molecular autopsy” of early Variants considered reporting prioritized classified into three groups: (1)...
Abstract Objectives/Hypothesis: Obesity as measured by body mass index (BMI) has been shown to correlate with incidence and severity of sleep disordered breathing (SDB), but the actual mechanism underlying this relationship not defined. Pharyngeal obstruction from posterior displacement a large, fat laden tongue is one that may explain link. The objective study characterize content within then determine whether weight percent BMI other metrics obesity. Study Design: This cross‐sectional...
Feedback reduces opioid prescriptions Most people addicted to opioids began taking them because they were legally prescribed. Little attention has been paid changing physicians' prescribing behavior. Using a randomized controlled trial format, Doctor et al. monitored the effect of notifying physicians who had patient die overdose within 12 months prescription. The received an injunction prescribe safely from their county's medical examiner. This intervention led reductions in high-intensity...
Summary We identified SCN1A variants in 2 infants who died of sudden infant death syndrome (SIDS) with hippocampal abnormalities from an exome sequencing study 10 cases SIDS but no history seizures. One harbored SCN 1A G682V, and the other had cis : L1296M E1308D, a variant previously associated epilepsy. Functional evaluation heterologous expression system demonstrated partial loss function for both G682V compound L1296M/E1308D. Our represent novel association between , extending spectrum...
The Scripps Molecular Autopsy (MA) study seeks to incorporate genetic testing into the postmortem examination of cases sudden death in young (< 45 years old). Here we describe results from first two study, which consisted whole exome sequencing (WES) a cohort 50 predominantly San Diego County. Apart individual description cases, analyzed data at cohort-level, brought new perspectives on causes death. We investigated advantages and disadvantages using WES compared gene panel for cardiac...
In 2010, 6,599 poisoning suicides were reported in the United States (US). While medications remain primary substances involved completed suicides, successful fatal poisonings with non-pharmaceutical occur some regularity. The goal of this study was to identify caused by self-poisoning a large US county over last 12 years.A US-county medical-examiner's database queried for all which exposure non-pharmaceuticals listed as cause death from 2000 2012. Substances categorized specific toxin when...
Prior work has demonstrated that personalized letters are effective at reducing opioid and benzodiazepine prescribing, but it is unclear whether If/when-then planning prompts would enhance this effect. We conducted a decedent-clustered trial which randomized 541 clinicians in Los Angeles County to receive standard (n = 284), or comparator 257) version of letter with prompts. found significant 12.85% (6.83%, 18.49%) 8.32% (2.34%, 13.93%) decrease the primary outcomes morphine (MME) diazepam...
Laryngotracheitis caused by human parainfluenza virus (HPIV) and not complicated bacterial superinfection rarely causes sudden unexpected death in infants toddlers, especially the absence of stridor a barking cough. We therefore describe 15-month-old white male who died suddenly unexpectedly with clinical pathological features laryngotracheitis culture-proven HPIV-1 infection. Given presence mucosal inflammation extending into vocalis muscle larynx without associated significant narrowing...
Abstract Pediatric deaths that occur because of environmental neglect often involve 4 common scenarios: (1) hyperthermia due to exposure, (2) ingestion an accessible drug or poison, (3) unwitnessed/unsupervised drownings, and (4) unsafe sleep practices. Given the same fact pattern, manner death will vary from accident homicide undetermined based on local custom and/or certifier's training experience. Medical examiner/coroner certifications are administrative public health determinations made...
Therapeutic (or non-toxic) post-mortem naproxen blood and liver concentrations have not been previously described. Peripheral were compared with central in 20 cases collected at autopsy from decedents determined to taken therapeutic dosing of naproxen. Blood specimens initially screened for alcohol simple volatiles, drugs abuse, alkaline, acid/neutral drugs. Naproxen, when detected by the drug screen, was subsequently confirmed quantified a high performance liquid chromatography procedure....
This randomized clinical trial evaluates the effect of prescriber notifications a patient’s fatal overdose on opioid prescribing, including decreases in morphine milligram equivalents, new patients taking opioids, and high dose, at 4 to 12 months after notification.
In recent years there has been a growing concern among patients and clinicians about dependence on prescription medication. Reports of an ‘opioid epidemic’ in the United States have sparked fears similar problem arising UK. This article will explore how can assess manage risks medication with potential for abuse.