Ethanol detected in a blood, urine or tissue sample may be produced after the specimen was collected or a person died. Certain findings can help an investigator to determine if the ethanol in a sample is "real" or an artifact.
Parameters:
(1) specimen handling
(2) history
(3) pattern in different samples
(4) bacterial or fungal contamination
(5) other chemical findings
Parameters
For In Vivo
For In Vitro
sample handling
frozen after collection, collection into 1% sodium fluoride or other preservative
storage in warm to cool environment for days or weeks
history
evidence of ethanol use
no evidence of ethanol use
pattern in different samples
in blood, urine, vitreous or other body fluids
present in some but not others
micro-organisms
absent or in small numbers
large numbers of yeast or fungi; less often bacteria
other chemical findings on gas chromatography
no evidence of other fermentation products
volatiles from fermentation present
where:
• Ethanol can be produced in refrigerated specimens but this may take weeks.
• Sodium fluoride prevents microbial growth by inhibiting certain metabolic steps.
• A typical example of in vitro production is a urine sample from a diabetic with a Candida urinary tract infection left at room temperature for some time.
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