Section VII.3: Staff and Training: Toxicology

  • The National Association of Medical Examiners (NAME), the Society of Forensic Toxicologists (SFT) and the American Academy of Forensic Toxicology (AAFT) recommend cross-training for all toxicology laboratory staff.

  • The Budget Analyst has determined that the amount of training on instrumentation and procedures should be increased for all personnel and that the additional training would improve the flow of work, eliminate the dependence of staff on a specific person to complete a test, and reduce turn-around time.

  • As such, the Chief Medical Examiner should (a) revise the position description for the Assistant Forensic Toxicologist I position to place a greater emphasis on training in the use of laboratory equipment used to conduct tests (b) develop a procedural manual for Toxicology staff; and (c) as recommended in Sections III and VI of this report, hire a qualified staff person to manage the Toxicology Laboratory.

  • Implementing these recommendations would improve the quality of the work performed by the Toxicology Laboratory and reduce the amount of time required to complete tests and determine the cause of death.

Background and Overview

The Toxicology Laboratory of the Medical Examiner is primarily responsible for providing comprehensive forensic toxicology services that assist in determining, or providing verification of the cause and manner of death. The FY 1996-97 budget for the Toxicology Laboratory, as estimated by the Budget Analyst, is $497,041, which includes (a) $365,695 for permanent and temporary salaries and fringe benefits; and (b) $42,041 for non-personnel costs such as materials and supplies, telephone, hazardous waste disposal and other expenses (see Section IV: Planning and Budget). The Toxicology Laboratory consists of the following authorized personnel: (a) 1.0 FTE Assistant Forensic Toxicologist II position; (b) 3.0 FTE Assistant Forensic Toxicologist I positions; (c) 1.0 FTE Forensic Lab Technician position; and (d) 0.5 FTE Forensic Laboratory Manager position, for a total of 5.5 FTE authorized positions, all of which are currently filled.

The annual salaries and authorized staffing levels for the Toxicology Laboratory, as reflected in the FY 1996-97 Annual Salary Ordinance, are as follows:

Class and Position Title

No. of
Authorized
Posistions

Biweekly
Salary
Range

Maximum
Annual
Salary

2457 Assistant Forensic Toxicologist II
2456 Asssitant Forensic Toxicologist I
2403 Forensic Laboratroy Technician
2459 Forensic Laboratory Manager		 1.0
30.
1.0
0.5		 $2,104 - $2,557
$1,862 - $2,264
$1,067 - $1,291
$1,818 - $2,209		 $66,738
59,090
33,695
57,655
Total 5.5

Staff Training and Qualifications

Our management audit of the Medical Examiner"s revealed several problems related to staff training in the Toxicology Laboratory. These include: (a) the current staff of Assistant Forensic Toxicologist I positions are not adequately trained in all aspects of laboratory procedures and the operation of equipment to perform all of the necessary duties; (b) a detailed procedural manual for the Toxicology Laboratory does not exist; and (c) given her qualifications, the existing Forensic Laboratory Manager is being underutilized by the Department. Remediation of these problems would significantly improve the quality and reliability of work performed by the Toxicology Laboratory.

Assistant Forensic Toxicologist I Positions

As noted in Section III (Toxicology) of this report, the Assistant Forensic Toxicologist II is a lower-level non-management position that was revised in response to the elimination of the Forensic Toxicologist position in FY 1993-94 and is responsible for supervising some of the functions of the Toxicology Laboratory. Duties of this position include assigning cases to lower level staff and performing some of the more complex toxicological analyses.

Also as noted in Section III of this report, the Assistant Forensic Toxicologist II is the only staff member who has been trained to utilize the 5890 Gas Chromatography/Mass Selective (GC-MS) equipment purchased in 1989. As a result, about 75 percent of the Medical Examiner"s toxicology cases, or 81.25 percent of all the toxicological tests performed, can be completed by only one staff person. In addition, because each Assistant Forensic Toxicologist I is assigned to a particular type of case (e.g. Medical Examiner, DUI, 11550, etc.), the specific procedures for conducting the analyses necessary to complete the testing for each type of case are known only to the staff person assigned to that particular type of case. As a result, if a particular staff member is absent, the analyses required to complete the toxicological tests assigned to that individual cannot be conducted. As noted in Section III, one reason for these inefficiencies is the absence of any cross-training, so that each staff person is familiar with the operation of all equipment and with the procedures involved in conducting all types of analyses. [1]

The minimum qualifications for the Assistant Forensic Toxicologist I position, as delineated in the Civil Service Commission"s position description, consist of:

  • Good knowledge of the principles and practices of toxicology, biology and chemistry with specific application to the analyses of body tissues and fluids, and

  • Ability to understand and use complex analytical and computer-assisted equipment; analyze and evaluate data collected in the course of investigations; assist in independent research; prepare scientific reports; and testify and provide technical information for forensic purposes.

We recommend revising the position description for the Assistant Forensic Toxicologist I position in order to emphasize the skills required to utilize all of the equipment and instruments used in the Toxicology Laboratory. Specifically, the Assistant Forensic Toxicologist I position should:,ul>

  • Possess a bachelor"s degree in a scientific discipline such as chemistry, biochemistry, toxicology, pharmacology, etc.; and

  • Have previous experience working in a toxicology or pharmacology setting.

Revising the position description for the Assistant Forensic Toxicologist I classification would result in the hiring of staff who are better qualified to perform all the various analyses needed and to operate all the equipment utilized by the Toxicology Laboratory. This would reduce the amount of time required to complete toxicology examinations and would improve the reliability of results.

Other Staff Training and Qualification Problems in the Toxicology Laboratory

The following staff training and qualification issues and problems are discussed in greater detail elsewhere in this report:

  • The failure to develop a detailed procedural manual for the Toxicology Laboratory results in inconsistency in protocols, a staff that is inadequately informed about routinely used analytical and administrative procedures, and the isolation of duties (see Section III: Toxicology).

  • Based on standards set forth by the Society of Forensic Toxicologists (SFT) and the American Academy of Forensic Toxicology (AAFT), the Chief Medical Examiner does not have sufficient time to manage and supervise the Toxicology Laboratory as detailed in these guidelines (see Section III: Toxicology and Section VI: Organization).

  • Given her qualifications, the existing Forensic Laboratory Manager is being underutilized. Although the existing Forensic Lab Manager meets the SFT/AAFT guidelines for directing a toxicology laboratory, in that she has a Ph.D. in pharmacology, a bachelor"s degree in chemistry and 10 years of experience as an assistant forensic toxicologist, she currently performs primarily clerical duties, such as answering the telephone, preparing the annual report and ordering supplies, which should be performed by lower level clerical staff. The Forensic Laboratory Manager could and should serve as the Forensic Toxicologist for the Medical Examiner (see Section III: Toxicology and Section VI: Organization).

Conclusions

The National Association of Medical Examiners (NAME), the Society of Forensic Toxicologists (SFT) and the American Academy of Forensic Toxicology (AAFT) recommend cross-training for all toxicology laboratory staff.

Because of the lack of training in the Toxicology Laboratory, 81.25 percent of toxicological tests performed can only be conducted by the one staff person trained in the use of the equipment, and the analyses required to complete testing for certain types of cases assigned to a particular individual cannot be conducted if that individual is absent from work.

Also, based on interviews with Toxicology staff, the Budget Analyst has determined that the three Assistant Forensic Toxicologist Is currently employed by the Medical Examiner do not possess the extensive chemical background necessary to perform all of the toxicological analyses and to operate the equipment utilized in the Toxicology Laboratory.

As such, the Chief Medical Examiner should (a) revise the position description for the Assistant Forensic Toxicologist I position to place a greater emphasis on the need for an extensive background in chemistry or a related discipline, such as biochemistry, toxicology or pharmacology; (b) develop a procedural manual for Toxicology staff; and (c) as recommended in Sections III and VI of this report, hire a qualified staff person to manage the Toxicology Laboratory.

Implementing these recommendations would improve the quality of the work performed by the Toxicology Laboratory and reduce the amount of time required to complete tests.

Recommendations

The Chief Medical Examiner and/or the Forensic Toxicologist (once reinstated) should:

VII.3.1 Revise the position description for the 2456 Assistant Forensic Toxicologist I position to provide a greater emphasis on the ability to complete toxicological tests, independently and familiarity with the equipment and instruments used in conducting such tests.

Costs/Benefits

There would be no costs involved in implementing this recommendation.

The benefits would include the hiring of staff who are better qualified to perform all the various analyses needed and to operate all the equipment utilized by the Toxicology Laboratory. This would reduce the amount of time required to complete toxicology examinations and would improve the reliability of results.

Footnotes

1. This observation was also made by the CAO in its 1990 review of the Medical Examiner"s Office.