CE UPDATE: FORENSIC PATHOLOGY—III
Chain of Custody: Its Importance
and Requirements for
Clinical Laboratory Specimens
R. Thomas Chamberlain, PhD, JD
The chain ofcustody may determine
whether evidence is competent and, therefore, whether it is admissible. Laboratory
reports and autopsy results are based on
specimens that must be shown to be free
oftampering before they can be allowed
into evidence and/or used as a basis for
testimony. Any report, result, or specimen
maybe used as evidence regardless of
whether the laboratory is forensic. The
chain ofcustody used to authenticate evidence can be done by written documentation with the use ofa single form or multiple forms including receipts. The chain
can also be established with oral testimony or a combination ofthe above. Depending on the type ofspecimen and the
importance attached to it by the court
may determine the specific requirements
ofthe chain ofcustody. Local custom in
the jurisdiction is important in determining the type ofdocumentation necessary.
From SmithKline Bioscience Laboratory, Hialeah,
FL 33014.
he chain of custody as it relates to
the laboratory can best be described as a series of documented
links between the obtaining of the evidence and the presenting of results derived from the evidence at a trial or judicial hearing. This linking of evidence can
be the major determining factor as to
whether evidence is admissible when securing clinical and/or anatomical specimens that may be transported to various
sites and handled by numerous individuals. Regardless of whether the evidence
will be used in a criminal ora civil proceeding, it is important to establish that
the evidence came from where it purports
and it has not been altered in such a way
that might affect its reliability.
Although many of us have testified as
factual and/or expert witnesses, we must
understand that our testimony may only
be relevant if it is based on real evidence
that has already been accepted by the
court. The acceptability of evidence may
vary with each jurisdiction. These differences will be illustrated with case examples and practical considerations. Regardless of the differences, one must understand the importance of the concept of
documenting where tissues/clinical specimens come from, how and by whom
T
they are handled, and if there is a likelihood of tampering.
Even though a laboratory does not
purport to be a forensic laboratory, any
results or documents from that laboratory could become evidence. Generally the
thoroughness in documenting chain of
custody of evidence will depend on
whether a case is civil or criminal. Typically when formal documentation (a
form) as to chain of custody accompanies
a sample, the case is criminal. Unfortunately, many times when a sample appears
at the laboratory, it is not known whether
the case is civil or criminal. The requirement for admissibility as to evidence can
vary greatly regardless of the type of trial,
since the ultimate issue of guilt in a civil
case requires a standard of proof by a preponderance of evidence and a criminal
case requires beyond a reasonable doubt.
As is the case many times for laboratory
evidence (eg, urine drug tests used in dismissal of an employee), courts may determine that the evidence is pivotal to the issue of guilt and may require strict documentation for chain of custody. However, in a criminal case where a blood sample to determine alcohol content was
drawn in an emergency room by a nurse,
the results of the blood alcohol determi-
Laboratory Medicine July 1989 477
nation were allowed into evidence when
"normal hospital operating procedures
were followed," which tended to show
"that there was a reasonable certainty that
the specimen tested was that of the accused."1 The normal procedure in this
case was the nurse placing the blood specimen in a refrigerator in the emergency
room, from which it was later picked up
by a medical technologist for analysis.
The vacuum tube had the name of the accused, time and date it was drawn, physician's name, and test requested (blood alcohol). Note in this case that the refrigerator was not locked and was accessible to
others in the emergency room.
dmissibility of Real Evidence
Real evidence, such as blood, tissues, bullets, and reports, must
meet two criteria before it is accepted by
the court (ie, judge). It must be relevant
and competent. Only a minimal degree of
relevancy is required to show the evidence is material to the issue being considered at trial. The competency requirement for evidence relates to whether the
sample or document is legallyfitand
qualified to be presented in court. A part
of the competency requirement will be a
chain of custody. Even though the evidence is admissible, it is up to the judge or
jury to decide how much weight is given
to the evidence. This is why some jurisdictions may establish minimal requirements
of admissibility and let cross-examination
guide the jury as to the weight of the evidence.2 One case expressing this view allowed into evidence a bullet identified by
an officer as coming from a victim. The
bullet was not marked by the officer, and
there was no documented chain of custody. However, a bullet can be more easily
identified as not having been tampered
with than a blood or urine specimen.
Therefore, it is highly unlikely this argument could be used on biological specimens.
As illustrated in the above scenario,
evidence is competent for admission if it
is properly identified and it is in substantially the same condition as it was at the
time of the incident.3 A blood sample on a
New Yorkfiremanwas excluded because
afiredepartment chauffeur, who was unidentified, kept the specimen over the
weekend (36 hours) before delivering it to
the laboratory.4 The decision by the trial
A
478 Laboratory Medicine July 1989
court to exclude the laboratory report on
the blood sample was upheld on appeal
because of a break in the chain of custody. The general proposition is that the
chain of custody must be established for
any blood sample before reports thereon
can be introduced into evidence.
stablishing a Chain of Custody
There are two main considerations
in establishing a chain of custody—
the span of time from seizure to laboratory or to trial and the individuals who
make up the links in the chain. In an Indiana appellate decision where a guilty verdict was affirmed against a defendant
who was convicted of driving while intoxicated resulting in a death, the chain of
custody was established since the court
could "reasonably conclude from the evidence that the specimen passed through
time and various hands in a relatively undisturbed fashion to a point where it is
subject to analysis."5 This particular case
involved an emergency room physician
who ordered a blood alcohol determination. The blood sample was drawn by the
emergency room staff nurse, and the sample was delivered to a medical technologist approximately 15 minutes later who
analyzed the specimen. This established
the authenticity of the real evidence
(blood sample). In federal jurisdiction
cases the applicable Federal Rules of Evidence (FRE 901 ) allows for authentication or identification by testimony, distinctive characteristics, and other means.
The Federal Rules of Evidence requires
sufficient evidence to establish authenticity. One need not exclude all possibility
that a specimen was tampered with, but
authenticity must be established by a reasonable certainty or reasonable probability.6
Uniqueness of real evidence may establish a reasonable certainty that a specimen
is what it is purported to be.7 Bullet fragments from a deceased person have been
admitted into evidence when they were
properly identified by the pathologist performing the autopsy.8 Items such as
blood, urine, and tissue, however, are not
so unique and identifiable that some form
of chain of custody will not be required.
Ultimately, in determining that the
chain has not been broken, an official
document that shows true continuity of
possession must be produced. This would
E
be a higher standard than establishing the
uniqueness of the evidence. Circumstances that may dictate the use of a documented chain of custody include the following types of evidence9:
1. Specimen is easily susceptible to tampering or substitution without changing
appearance, such as a blood specimen.
2. Specimen is identifiable but certain
characteristics are not noted that make it
readily identifiable, such as a gun without
a serial number.
3. Specimen's condition at the time of
seizure is a pivotal issue in the case, such as
a urine specimen for drug testing.
The basic requirements in a chain of
custody document might include the following: date and time of receipt, source of
specimen, condition of specimen, identification of those handling the specimen,
and disposition of specimen.
The actual chain of custody may be a
series of documents that could include
courier receipts, laboratory logs, and
work sheets. A legal presumption of continuity of evidence extends to the United
States Postal service and its employees;
however, this presumption does not extend to private couriers and mailroom
employees who are not postal employees.
Regardless of what may be used in the
chain of custody, it is best to consult with
prosecuting attorneys in the jurisdiction
where the evidence is to be used. An example chain of custody form for the collection of urine for substance abuse testing is shown in the Figure.
The proponent's burden of establishing whether the basic criteria of a chain of
custody has been met can be addressed by
the following questions: (1) From where
was the specimen taken? This should include geographical and physical location.
(2) Was it from a particular place? This
may establish uniqueness. (3) Has it been
properly stored? This will prevent decomposition. (4) Can transportation and delivery be substantiated?
xamples of Links in the Chain
Although a documentary chain of
custody is the best way to establish
the links, testimony can be used. It should
be remembered that testimony is subject
to cross-examination in order to discredit
it (impeachment). Anotherproblem with
testimonial or oral links is the potential of
all who touch the specimen being re-
E
CHAIN OF CUSTODY FORM
(URINE DRUG TEST)
Specimen Identification No.
Date Collected
Social Security No.
Faculty
Location
Collection Site Information
1. Amount Collected
. ml (approx.)
2. Temperature
3. Color Amber
°C (Within 4 minutes of collection)
Clear
Straw
Other
4. Any unusual appearance
5. Unusual behavior/appearance
6. Proper identification (Explain if not)
7. Recollection Required (Explain)
Chain of Custody
Signature
Date
time
No Signature Required
If Released By U.S. Mail
Date
Time
Signature
Date
Time
1. Employee Name (Printed)
2. Collection Site Person (Printed)
3. Received by
4. Received by
5. Received by
6. Received by
7. Received by
8. Received by
9. Received by
10. Received by
Approved Drug Testing Laboratory
1. Released by
2. Received by
3. Condition Received In
Other.
Good_
Disposition of Urine Specimen
Frozen by
Name
Signature
Date
Time
Name
Signature
Date
Time
Name
Signature
Removed from Freezer for Re-analysis by
Time
quired to testify. Therefore, keep the
number of laboratory personnel handling
the specimen to a minimum. One trial
court determined that a proper chain of
custody of a blood specimen in a murder
case was established when testimony was
elicited from the drawing physician, the
police officer courier, the receiving crime
lab chemist, and the evidence officer who
subsequently delivered it to court.10
Although the testimony alone of a
technologist that he or she received seminal fluid from a physician, analyzed it, and
the results were reported may be acceptable,11 additional documentation may be
required when the specimen passes
through several hands within the laboratory.12 Intralaboratory documentation
might be handled by use of accession
numbers and work sheets with appropriate signatures. During laboratory offhours, drop boxes with controlled access
may be utilized.13
Although there may be apparent
breaks in the chain of custody, there are
many case illustrations of allowing the
evidence and letting the jury decide the
weight it may have on the issues. Noted
earlier was a 36-hour lapse in time that destroyed the chain of custody; however, a
lapse of eight days between the delivery of
a blood alcohol determination to the laboratory did not destroy the chain of custody when it was noted that the specimen
was locked in a refrigerator.14 Inability of
a pathologist to identify a particular medical technologist in his laboratory to
whom he gave a vaginal smear did not
break the chain.15 In another rape case the
prosecution's inability to produce the
particular nurse who gave the specimen to
a messenger in the emergency room hallway did not destroy the chain.16 Even
when the whereabouts of a specimen are
unknown (shotgun pellets removed from
body), a sealed container with appropriate labels can counterclaims of substitution or tampering, which is the purpose
of a chain of custody.
Destroyed by
Name
Reason for Destruction: Negative.
Date
Signature
Retained
Time
(Months).
Laboratory Director or Certifying Official
e A certified copy of the original chain of custody form, signed by the larjoratory director or laboratory
certifying official.
onclusion
The chain of custody can be established in several formats and does
not necessarily require an official form,
although this is the tightest form of documentation. Multiple documents including receipts and logs may be used along
C
Chain of custody form.
Laboratory Medicine July 1989 479
with testimony to establish a viable chain.
The security of the integrity of the evidence really determines the admissibility
and the weight of the evidence. The idea
is to safeguard against human error and to
assure fairness in showing that the evidence is what it is purported to be. The
strictness of the standard will be determined by custom in the jurisdiction and
the importance of the evidence to the ultimate question of guilt D
480 Laboratory Medicine July 1989
References
1. Turner v. State, 258 Ark. 425,527 S.W. 2d 580.
(S.Ct. Ark, 1975).
2. State v. Malone, 694 S.W. 2d 723. (S. Ct. Mo,
1937).
3. Dennison v. State, 259 Ala 424,66, So. 2d 552.
(S.Ct. Ala, 1953).
4. Amaro v. City of New York, 351 N.E. 2d 665.
(Ct.App.NY,1976).
5. Orr v. State, 472 N.E. 2d 627. (Ind App. 2, Dist,
1984).
6. West v. United States, 359 F. 2d 50. (8th Cir,
1966).
7. People v. Thibudeaux, 424 N.E. 2d 1178. (Ill
App, 1981).
8. United States v. Cloudman, 534 F. 2d 123. (Ct.
App. 8th Cir, 1976).
9. State v. Lunsford, 204 N.W. 2d 613. (S. Ct., la,
1973).
10. State v. Celestine, 443 So. 2d. 1091. (S. Ct, La,
1983).
Cert, denied 105 S.Ct. 224.
11. State v. Collins, 328 So. 2d. 674. (S. Ct. La,
1976).
12. State v. Chariot, 206 S.E. 2d 908. (S. Ct. App,
WVa, 1974).
13. State v. Pickering, 491 A. 2d 560. (S. V. Ct. Ma,
1985).
14. State v. McKinney, 605 S.W. 2d 842. (Ct. Crim.
App, 1980).
15. Mealey v. State, 347 A. 2d 651. (S. Ct. De,
1975).
16. State v. Crawford, 573 P. 2d 982. (S. Ct. Kan,
1977).