Excited Delirium Education, Research and Information

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Excited Delirium Specimen Kit

To preserve evidence of the occurrence of excited delirium, we have developed an in-custody death collection kit for obtaining regional brain samples for analytical testing of toxicologic, neurochemical and molecular markers of excited delirium.

This Excited Delirium Specimen Kit will ensure that appropriate regional brain specimens are taken with precision and uniformity across different locations.   Each kit includes; specimen bags and labels, one empty tube for serum, shipping containers, test order form, information and instruction sheets.  Each kit has a detailed description of the pathological brain site selection, procurement instructions, shipping instruction and mailing labels.

Identifying information will include case number, collection facility, medical examiner's name, person placing samples, date, time of death, and police case number. This information is collected using the Agonal State Form. The kit will have complete instructions, photographs and guidelines for ensuring proper dissection of brain regions at autopsy according to a standardized protocol.  After removal from the calvarium, the brain is photographed and viewed for gross pathology by the medical examiner.  The brain is sectioned in the coronal plane and care is taken to maintain structural landmarks and preserve integrity of the brain tissues.  Coronal slices are made of the hemisphere at the level of the basal ganglia. Enclosed reference diagrams and photographs of coronal brain slices ensure that the regions are taken at the appropriate site in the standard anterior to posterior plane of sectioning.

(SAMPLE 1)  The coronal block must include the anterior striatum (caudate, putamen and nucleus accumbens). 

(SAMPLE 2)  An additional block is sampled at the level of the amygdala. This block is adjacent to the one taken at the level of the striatum.  

(SAMPLE 3) A section should be included from the substantia nigra.

(SAMPLE 4) A small section of the cerebellar hemisphere is sampled and frozen for brain toxicology. 

Fill out and include the: Agonal State Form when shipping specimens.

We conduct toxicology in brain for all cases because many Medical Examiner Departments have limited toxicology resources.. Drugs that are susceptible to rapid chemical and metabolic hydrolysis in blood or plasma, such as cocaine and metabolites, are present in substantial concentrations in the brain, and are reported to be less susceptible to degradation than in blood. 

Cocaine or other drugs detected in brain but not in blood postmortem, ensures that, abused drugs will not be missed in the analysis. The brain sections are placed in freezer storage containers that are provided in the kit with attached labels and individually sealed.  For shipping and short term storage, the frozen blocks are packed  with dry ice in a Styrofoam container that will be provided as part of the specimen kit.  When brain sections are completely frozen, they are packed in the shipping container with dry ice, (minimum 15 lbs).   We will provide shipping labels and overnight instructions to facilitate delivery of specimens to the contract services provider for analysis.  Request for Excited Delirium Specimen Kits can be made on line. 1-800-UM-BRAIN. Fee for service information is available upon request.

To order a specimen kit from us fill out the: Specimen Kit Request Form and mail it to:

Margaret J Basile:

mbasile@med.miami.edu

 

 

 

 

 

 

 

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