Reliability of data sources for poisoning deaths in Massachusetts.

The authors analyzed poisoning-related deaths in Massachusetts from 1986 and 1987 recorded in three datasets: poison center records, death certificate, and state medical examiner's office records. While 714 such deaths were found, 551 of these were prehospital deaths recorded within the medical examiner's office but not by the poison center. The poison center was not consulted in over 47% of the poisoning deaths occurring in Massachusetts hospitals. Conversely, 15% of deaths were reported to the poison center but were not found either in death certificate or medical examiner records. Concordance between all three datasets for recording the 163 poisoning-related hospital deaths was only 17%. The authors conclude that reliance on a single data source underestimates and potentially misrepresents both the numbers and types of poisoning deaths occurring in the state. They also believe the files of the medical examiner are an underappreciated, rich source of data concerning out-of-hospital deaths due to poisonings and intoxications. Their findings suggest that the regional poison center is an underused resource for the management of seriously poisoned patients. There is a need for a better working relationship between poison centers and area hospitals so that all serious intoxications and poisonings are reported to the poison center in a timely fashion.