Chain of custody management of post-mortem biological samples for toxicological examination: role of the Sector Room Biomedical Laboratory Technician in integrating the procedure in force at Abruzzo 02 local health authority
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Abstract
OBJECTIVE
Post-mortem toxicological analysis is a fundamental element in forensic medicine, essential for determining the involvement of toxic substances in the cause of death.
However, within Abruzzo 02 Local Health Authority (ASL), managing the chain of custody for biological samples collected from corpses remains a critical issue, with heterogeneity in operational practices and a consistent risk of compromising their evidentiary value in judicial proceedings.
This project proposes integrating and subsequently replacing the procedure currently in force in our Local Health Authority with a comprehensive protocol covering all stages (identification, sampling, transport, reception and storage of biological samples in forensic medicine), aimed at ensuring the integrity of the chain of custody through the central role of the Sector Room Technician.
MATERIALS AND METHODS
In line with the guidelines for sampling from living individuals issued by the Scientific Society SIBioC (Italian Society of Clinical Biochemistry and Clinical Molecular Biology – Laboratory Medicine), a standardized procedure was developed for the identification, collection, and custody of biological samples taken from corpses for medico-legal toxicological investigations.
From 2024, at the Chieti Morgue, this alternative process of collection and management of possible biological matrices (blood, vitreous humor, urine, and hair formations) obtainable during autopsies was implemented.
RESULTS
Based on autopsies carried out at the Chieti Morgue between 2022 and 2025, it is evident that most toxicological samples were taken by the Sector Room Technician, while a minority were handled (performed or not) by external operators, raising concerns about the quality of the chain of custody.
This led to the implementation of the alternative procedure with the custody chain form only from September 2024, the impact of which has not been quantified yet.
DISCUSSION
The hiring of the Sector Room Biomedical Laboratory Technician (TSLB), by virtue of their expertise in managing the chain of custody for biological samples in cases of cremation and gender-based violence, extends their role to post-mortem toxicological sampling intended for external laboratories.
This extension allows the Sector Room Technician to operate autonomously, supported by the authorization of the Forensic Pathologist, and facilitates a direct communication channel for the implementation of corrective actions.
This uniformity results in greater procedural attention, a reduction in the risk of operator-dependent errors and the prevention of legal disputes by Concerned Party Technical Consultants (CTP).
Nevertheless, concerns remain about the reliability of samples collected by external collaborators.
CONCLUSIONS
Although the procedure imposes a greater operational burden on operators, adopting this procedural approach, where necessary, could significantly enhance the consistency and legal robustness of forensic toxicological assessments.
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