Harold Shipman Case

On January 31, 2000, Dr. Harold Shipman was convicted of murdering 15 of his patients, as well as, forging a will of 1 of them. The evidence against him was that he had killed them by administering lethal doses of either morphine or diamorphine, more commonly known as heroin. Shipman had been convicted for fraudulently obtaining drugs in order to support an addiction when he was
29. As a result of his past addiction, the police considered that he had obtained heroin illicitly for his killings just as he had obtained the drugs 1975 to feed his addiction. Another way that Shipman may have obtained the drugs is that, he would issue prescriptions for patients, those who required the drug and those who did not, retaining some or all

These discrepancies included prescriptions dispensed but not listed in the medical records; prescriptions dispensed for recently dead patients; the amount of drugs, recorded as delivered to the patients’ homes by nurses, being less than that dispensed; and unused diamorphine being taken from patients’ homes for destruction by Dr. Shipman. From 1993 to the time of his arrest in 1998, the police estimate that some
20,000 mg of prescribed diamorphine was available to Dr. Shipman. the police targeted incidents in which Dr. Shipman was with the deceased hours before death, as corroborated by documents or witnesses. They looked also for some of the following elements: an alteration of the medical records, fabricating a relevant clinical history to support the stated cause of death; inconsistencies between the stated cause of death and the medical history; an unsolicited visit by
Dr. Shipman on the day of death; inconsistencies between the cremation certificate and the investigative facts; mistruths told by Dr. Shipman to family and friends of the deceased; Dr. Shipman either finding the body or being present at the time of death; and death in the physician’s rooms, of which there were 5 throughout a 2-year period. By the time of the

The purpose of postmortem analysis for drugs and alcohol is ordinarily to determine as accurately as possible the concentration of the agents that existed in blood at the time of death, since blood and plasma levels are used to assess the effects and determine the likelihood of any drug toxicity. In certain circumstances, such as decomposition, a valid blood concentration of drugs or alcohol cannot be determined or results are questionable. A thorough understanding of the tissue distribution and postmortem stability of drugs is essential for forensic toxicologists, not only for selecting appropriate specimens for analysis of drugs in corpses, but also for correct interpretation of drug levels in postmortem fluids and tissues, and how seriously individuals have been poisoned by the drugs. Heroin, after being injected, is rapidly metabolized in blood to 6-monoacetylmorphine with a half-life of approximately 3 min; its conversion is completed within 10-15 min (1,2). 6-
Monoacetylmorphine is further deacetylated, presumably in liver and other tissues, to