David Chao, MD: There Will Be No Surprise Tox Screen for Tiger Woods

As more details of the Tiger Woods accident emerge, one thing that won't happen is a report of alcohol, drugs or medication in his system as a definitive cause of the accident. I am not implying that Woods was or wasn't impaired. His previous issues are well documented but that should not infer anything to the current accident.

Typically, after any motor vehicle accident a toxicology screen is a part of the routine at the emergency room. Even if one was performed the results will never come out. First off, the sheriff has stated that there has not been a request for blood tests. The reality is that any tox screen for Woods would likely never be valid due to the circumstances.

In my medical experience, when a patient is trapped with a crush type injury as Woods' right leg was, it is routine for the paramedic to administer medication at the scene prior to extricating with the "jaws of life." or other tools.

I confirmed my thoughts with a fire battalion chief who stated the chances were "very high" that in a circumstance like Woods', the victim would get morphine or other narcotic medication administered. This is done to be compassionate due to the pain but also to calm the patient while he/she is freed and when he/she becomes unpinned the process of moving the victim can be very painful given the multiple fractures and crush injury.

Once medication is administered, any tox screen for legal purposes becomes null and void. Even if hypothetically the tests showed drugs distinctly different from that administered or its metabolites, for legal purposes is considered "tampered with" and cannot be used as evidence to incriminate. This was true back in my medical training days which included emergency room time and was confirmed by me to be currently true with ranking police officials.

Even if Harbor/UCLA performed a routine tox screen, which is commonly done to treat the emergency patient, those results can never become public due to HIPAA. The Sheriff's decision to not pursue blood samples is moot in this situation.

We previously discussed the misinformation around the Woods case including the real reason why his kids won't be visiting him in the hospital.  It is also a fallacy that tox screen results are coming.

Whatever the "black box" investigation shows, do not expect any chargers to come from impairment. Let's just hope the additional surgeries we indicated would happen and have been ongoing, are successful. The early key going forward is not the multiple fractures but the associated soft tissue injuries.