Dead sober or dead drunk?

May be hard to determine

Assessing the validity of an alcohol concentration in a postmortem blood sample can be complex. Appreciating the difficulties, some experts challenged the result of 38 mmol/l (175 mg/100 ml) found in Mr Henri Paul, the driver of Princess Diana's car in her fatal car crash. In the current review of the Hillsborough football stadium disaster, by Lord Justice Stuart Smith, the meaning of alcohol concentrations in those deaths is also likely to be disputed. Although the technical aspects of measuring ethanol in body fluids are much the same in the living and the dead,1 the interpretation of results obtained from necropsy samples is confounded by several problems.

The two most important are microbial alcohol production and alcohol diffusion from gastric residue or airways contaminated by vomitus. Distinguishing between alcohol ingestion in life and microbial production after death is a common problem.2 Within a few hours …