White Paper – Information Sharing Between Medicolegal Death Investigators and Toxicology Testing Services

White Paper – Information Sharing Between Medicolegal Death Investigators and Toxicology Testing Services


December 2023


The National Institute of Justice (NIJ)—in partnership with its Forensic Technology Center of Excellence (FTCOE) at RTI International and the National Center for Health Statistics, Centers for Disease Control and Prevention (CDC)—convened a virtual Medicolegal Death Investigation Data Exchange Working Group (MDI-Data-WG) beginning in September 2020. This working group was formed to: 

  • Document the types of data that are commonly exchanged with public health and public safety partners and determine collective usage points for medicolegal death investigations (MDIs); 
  • Provide recommendations on how to improve the naming process for emerging drugs; 
  • Guide the drug mapping/classification process; and 
  • Recommend needed enhancements to the operation of exchanging forensic data with other organizations. 

The goal of this whitepaper is to support policies and procedures within an organization, agency training on the importance of information sharing between medicolegal death investigation offices and Organ and toxicology testing services, and also to disseminate community awareness and collaboration efforts to improve how MDI data are exchanged and modernized. The audience includes practitioners, forensic laboratory and medical examiner/coroner leadership, and any interested entity that contributes to data exchange for death investigations. 

From 1999 to 2021, more than 1 million people in the United States (U.S.) died from a drug-intoxication, with 106,699 occurring in 2021 alone. Drug intoxication deaths—from pharmaceutical or illicit drugs—are the leading cause of unintentional injury deaths in the U.S. Medicolegal death investigation offices work with toxicology laboratories to identify substances that may be relevant in establishing a decedent’s cause and manner of death. It is imperative to proactively establish cooperative relationships and information sharing to ensure the best possible outcome for families, health care organizations, toxicology testing services, MDIs, and other key data users. 

Funding for this Forensic Technology Center of Excellence report was provided by the National Institute of Justice, Office of Justice Programs, U.S. Department of Justice (15PNIJ-21-GK-02192-MUMU). This work was also supported by the Centers for Disease Control and Prevention (Contract Number HHSM500201200008I, Task Order Number 200-2016-F-91567).

The opinions, findings, and conclusions or recommendations expressed in this report are those of the author(s) and do not necessarily reflect those of the U.S. Department of Justice or the Centers for Disease Control and Prevention.

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