Limits and pitfalls in a lethal infant cocaine intoxication

The case concerns the first Italian report of a fatal cocaine intoxication in an 8-month-old baby girl found dead in the cradle by her parents at 6 am on a summer day. At arrival to the emergency department, the doctors declared the baby dead and the Prosecutor Office ordered an autopsy and toxicological analyses. Despite no history of cocaine use/abuse by both parents, toxicological analyses evidenced a positivity to cocaine in the post-mortem blood, brain and liver. The legal physician concluded for a fatal cocaine intoxication. A crucial aspect to the Court was to discriminate between administration (accidental or voluntary) and intake (almost accidentally), due to different legal consequences for parents (i.e. voluntary homicide or inadequate supervision). In the here presented case discriminating the exact intake was almost impossible in terms of certainty. Such difficulty mainly derived from lacks in the investigation activities in the first hours following the death. Among all possible intake routes, the ‘most probable’ was the accidental one, mostly attributable to a cradle contamination. A lack in the site inspection protocol could strongly affect the case solution making it impossible to offer the Court a definitive ‘scientific’ solution to the case (based on scientifically irrefutable data).