What do the following toxicology reports mean?
Specimen Submitted, Test, Results
Blood Heart, Volatiles, Ethanol, 0.37 %(w/v)
Blood Peripheral, Volatiles, Ethanol, 1.22 %(w/v)
Urine, Volatiles, Ethanol, 0.43 %(w/v)
Vitreous, Volatiles, Ethanol, 0.50 % (wv)

Dear lindalee3724-ga;

Thank you for allowing me an opportunity to answer your interesting
question.

What you are referring to appears to be a medical examiners report. In
my 23 years in law enforcement I have attended a number of autopsies
that reveal test results similar to the ones you have provided, so
from my experience (knowing no more about these test results that what
I can readily see) I'll first address the matter of terminology:

“Blood Heart” (or Blood/Heart) is a brief way of indicating, “blood of
the heart” or “a blood sample taken directly from the heart muscle
itself”.

“Blood Peripheral” could better be said as "Blood from a peripheral
region". It refers to a blood sample taken from a peripheral vessel
other than the heart such as an artery in the groin, neck, chest, etc.
It is a sample of the body's blood content at large.

“Urine” is the liquid waste matter excreted by the kidneys into the
bladder and expelled through the urethra.

“Vitreous” is short for “vitreous humor” which is the gelatinous
substance that fills the eyeball.

“Volatiles” refers to volatile organic compounds (VOCs). These are
compounds that might have been ingested or inhaled by an individual
and may be present in their system (usually post-mortem).

Now, the substances/tissues mentioned above retain a certain amount of
volatiles post-mortem and the can be analyzed using a chromatograph
and/or a mass spectrometer to determine the type and level of
volatiles if any are present. Certain combinations of the level of
volatiles in these substances/tissues, such as ethanol, would provide
a known signature consistent with intoxication, poisoning, overdose,
etc., and give investigators and fairly clear picture of either a
probable cause of death or at a minimum, the state of being of an
individual at a particular moment in time, say, at the time of death,
for example. This same test can be used to detect carbon monoxide,
fumes/inhalants (like accelerants, glue, paint, gasoline, etc.),
ingested material (like liquor, beer, wine, etc.), and so on. In this
case, ethanol refers to consumable alcohol (i.e. the type found in
liquor).

The measurements “%(w/v)” indicates “percent (weight by volume)”. As
explained here, it is “an abbreviation for "weight by volume," a
slightly confusing phrase used in chemistry and pharmacology to
describe the concentration of a substance in a mixture or solution.
The weight by volume is the mass (in grams) of the substance dissolved
in or mixed with 100 milliliters of solution or mixture. For example,
the concentration of fluoride in toothpaste is usually about 0.15%
w/v, meaning that there is 0.15 gram of fluoride per 100 milliliters
of toothpaste. Thus 1% w/v is equal to 1 gram per deciliter (g/dL) or
10 grams per liter (g/L).”
http://www.unc.edu/~rowlett/units/dictW.html

Ethanol is found in a number of other substances besides liquor. We
ingest it daily to some degree whether we know it or not. It is found
in peppermint, cosmetics, mouthwash, toothpaste, and other commonly
used substances. On initial glance, it does not appear that this test
results you have provided reveal extraordinary levels of ethanol, but
you might want to consult a pharmacist or a chemist for a more
reliable opinion on that particular issue.

Below you will find that I have carefully defined my search strategy
for you in the event that you need to search for more information. By
following the same type of searches that I did you may be able to
enhance the research I have provided even further. I hope you find
that that my research exceeds your expectations. If you have any
questions about my research please post a clarification request prior
to rating the answer. Otherwise, I welcome your rating and your final
comments and I look forward to working with you again in the near
future. Thank you for bringing your question to us.

Best regards;
Tutuzdad-ga


INFORMATION SOURCES

Professional experience

INFOPLEASE.COM
Vitreous: http://www.infoplease.com/search.php3?query=Vitreous&in=dictionary
Urine: http://www.infoplease.com/search.php3?query=urine&in=dictionary

VOLATILES IN PHARMACEUTICALS
http://home.swipnet.se/~w-12348/
http://home.swipnet.se/~w-12348/hemsida.htm#ref
http://home.swipnet.se/~w-12348/drogsign.htm

UNITS
http://www.unc.edu/~rowlett/units/dictW.html


SEARCH STRATEGY


SEARCH ENGINE USED:

Google ://www.google.com


SEARCH TERMS USED:

“BLOOD HEART”

 “BLOOD PERIPHERAL” 

“URINE”

“VITREOUS

“VOLATILES” 

ETHANOL

“%(w/v)”

---

Clarification of Answer by tutuzdad-ga on 16 May 2003 19:09 PDT

In view of what the commenter below has offered. let me clarify my
comment to make sure we are all on the same school of thought here:

From my many years on law enforcement I can tell you that indeed the
levels show in your example exceed that which is commonly accepted as
legally intoxicated. However, my comment with regard to "extraordinary
levels" refers to that which would be universally considered fatal.
Since your question seems to relate to a medical examiners report I
assumed you wanted to know if indeed the ethanol level was
indisputably the cause of death in this individual.

The commenter suggested that such levels as you have suggested are
incompatible with life - As a law enforcement officer, I have
personally witnessed individuals bearing a blood alcohol load of .370%
who were obviously impaired but very much alive, so this statement by
the commenter is in fact false. This lelvel "could" prove fatal in
some individuals particularly if they had underlying problems, or fell
unconscious and asperated, but it is definitely possible to survive
with such a level in one's system. While the level is high, I would
not look upon it as a definite cause of death.

Take a look at this explanation of blood concentration and effects at
each level:

http://www.uwec.edu/counsel/pubs/blood.htm

You can clearly see that .450% is universally accepted as a fatal
concentration of blood alcohol.

Regards;
tutuzdad-ga

Dear lindalee3724-ga; 

Permit me to clarify an important point with regard to the
interpretation of the specific alcohol levels cited.

In most states the level of ethanol required to sustain a
legally defined finding of intoxication is .08%.

I think we need to look at the ethanol level found in the
blood removed from the heart since in a deceased individual
there is pooling within the peripheral blood which renders
the level found there unreliable.


The heart blood ethanol level:

   "Blood Heart, Volatiles, Ethanol, 0.37 %(w/v)"

represents a level that is more than 4.5x the legal
limit for intoxication and, in fact, represents an
extraordinary level which would almost always be 
incompatible with life.

Regards,
Raisondetre.ga

To Viewers of the Google Answers Site,
     
     On May 13, 2003, I posted a comment in the hope that it might
be useful to lindalee3724-ga who posted the original question or
to any reader who uses this forum for education or entertainment,

     Now I see that my comments have been mischaracterized,

     I wish to make the following points clear:

     (1) It would have been grossly inappropriate and foolhardy to 
          comment upon or suggest the cause of death in the 
          absence of having the full autopsy report available to
          me. Irrespective of the usual relationship between a finding
          of a blood alcohol level of 0.37% and outcome, I was careful
          not to make any such comment or suggestion.

    (2) There is an enorrmous difference between "almost always"
         and "always". The expert here chooses to misquote me. 
         An ethanol level of 0.37% is almost always
         incompatible with life.

     On another issue. The comment, of the expert,

     " However, my comment with regard to 'extraordinary
       levels' refers to that which would be universally considered fatal.
       Since your question seems to relate to a medical examiners report I
       assumed you wanted to know if indeed the ethanol level was
       indisputably the cause of death in this individual."

is incomprehensible, In my opinion, it is so bereft of reason
or logic as to be bizarre.

     You be the judges.

Regards,
Raisondetre.ga

While a layman's opinion is always welcomed and sometimes even bears
some significance, I'm sure that published research such as the one I
offered from the University of Winconsin easily speaks for itself.

http://www.uwec.edu/counsel/pubs/blood.htm

Regards;
tutuzdad-ga