Wardel Davis was a healthy young man when he died after a struggle with two Buffalo police officers Feb. 7 on the city's West Side, the attorney for Davis' family said.
"He was athletic," civil rights attorney Steven Cohen said. "The notion that he simply dropped dead ... it just doesn't happen."
An autopsy was conducted on Davis' body the day after he died, but police say the cause of his death won't be determined until the results of toxicology tests come back.
That could take up to two months.
Cohen said he wants to see those test results. He said he's had toxicology tests come back within a few days but he also acknowledged there are many different kinds of tests and levels of tests.
Pathologists and law enforcement say toxicology tests routinely take anywhere from a month to two months to complete.
So why do these tests take so long?
"There's no simple answer," explained Christine Giffin, Erie County's chief toxicologist.
The question has come up previously, particularly following high profile cases where the cause isn't immediately clear, such as last year's death of the singer Prince, whose death was eventually determined to be caused by a fentanyl overdose.
Guidelines from the National Association of Medical Examiners state that 90 percent of autopsies should be finalized within 90 days, according to a statement from the College of American Pathologists. They said some cases can take longer than normal if there's more than one drug submitted. Determining levels of drugs can also take time.
Giffin explained how toxicology tests work. She spoke in general about the process and did not comment on Davis' death, which is under investigation by a special unit of the state Attorney General's office that reviews police-involved deaths of unarmed civilians. Buffalo police are also conducting an internal probe of what happened. A representative from the AG's office was present for Davis' autopsy, which was conducted by the Erie County Medical Examiner's Office.
In Giffin's office, which is part of the Erie County Medical Examiner's Office, the tests take an average of about 60 days to complete, she said.
The lab handles toxicology tests for three kinds of law enforcement-related situations: as part of autopsies, for driving while drinking or driving while intoxicated cases and in sexual assault cases to determine whether the victim was given a drug. The postmortem toxicology tests performed for the county include those for the hundreds of opioid overdose deaths over the last several years.
All of the testing begins with four basic tests on samples taken from the body – blood taken from different parts of the body as well as urine if it's available. The initial tests screen for the presence of substances including alcohol, marijuana, cocaine and opiates.
"Some are very fast," she said. Others take longer. "Just to run the instruments takes 48 hours," she said.
The initial tests show whether a substance is present, but not how much.
A lab analyst reviews the test results, a process that can take a week. "Then every single analysis has to be reviewed by a second person," Giffin said. "That's how we ensure the quality of results."
And that's just the initial screening, which may be done on multiple samples taken from a body.
If a test comes up positive for a substance, such as cocaine or an opioid, a second test is done to confirm the result and then further testing is done to determine what specific kind of drug and the quantity of the substance in the system.
The testing can get more complicated – and time consuming – if there's more than one kind of substance detected in the initial tests.
Toxicology testing has been particularly challenging in the face of the opioid epidemic crisis, which has dramatically increased the need for toxicology testing, Giffin said.
"We do the best we can with the resources that we're given," Giffin said. "The county is very, very generous to us. But we are struggling with staffing."
Davis' girlfriend previously told The Buffalo News that Davis had a cold on the night of the struggle and that they had been planning on going to the hospital to get him checked out. But she also said he wasn't gravely ill and was generally healthy man who regularly played full-court basketball with his friends.
An attorney for one of the officers, Thomas H. Burton, said the officers were trying to handcuff Davis after he refused to put his hands up. He fled and they fought. The officers handcuffed Davis at the end of the struggle and when they tried to pull him to his feet, they realized he wasn't breathing. The officers uncuffed him and began performing chest compressions, Burton said.
Rev. Darius Pridgen, who is the president of the Buffalo Common Council, said he knows the tests can take a long time to come back but he understands how frustrating that can be for loved ones of the person who died, as well as the public.
"I do understand that when there are questions about how that person passed of wanting results, wanting answers as quickly as possible," said Pridgen. "I understand that. I sympathize with it.
But he added, "It's important for there to be a thorough investigation and for it to be very transparent."