No Lab in America Can Test for the Alleged Murder Weapon

The prosecution in the Meggan Sundwall trial says insulin killed Kacee Terry. That is the foundation of their aggravated murder case. Insulin is the weapon. Without it, the texts are ugly but not criminal. Without it, the seven hours in that room become something a jury might struggle to categorize. The entire theory of this case runs through one substance.

On Day 2 of testimony, the state called Scott Larson. Forensic toxicologist. Twenty years in the field. Board certified since 2010. Reviews roughly 12,500 cases a year at NMS Labs. He is exactly the kind of expert you call when you need a jury to understand what was in someone's blood and what it means.

Larson walked the jury through State's Exhibit 13, his toxicology report on Kacee Terry's hospital blood drawn August 12, 2024. Oxycodone at 34 nanograms per milliliter. Therapeutic. Oxymorphone at 2.7, a metabolite of the oxycodone breaking down in her system. Promethazine at 370, consistent with someone taking over-the-counter allergy medication for a couple of days. Alprazolam at 100, the high end of therapeutic but not unusual for a regular user.

Three central nervous system depressants. All at levels that a 20-year forensic toxicologist called unremarkable for someone with tolerance. He told the jury he would not have expected these drugs to cause death absent special circumstances.

Then the prosecutor asked the question that matters: does insulin qualify as a special circumstance? Yes. Larson called it a "more obvious potential cause of death" than the drug grouping.

So far, so good for the state. They needed the drug overdose theory eliminated, and Larson did that cleanly. Insulin stands alone as the probable cause of death. That is what the prosecution paid for with this witness.

But then came the part the jury will not forget.

He looked into it for this case. He could not find one.

The Gap Nobody Talks About

Think about what that means. Not just for this case. For every case.

Insulin is one of the most accessible lethal substances in existence. It is present in millions of American homes. It requires no prescription if you know someone who uses it. It mimics a natural substance the body produces on its own. And according to the state's own forensic toxicologist, no forensic lab in the country can confirm whether synthetic insulin was present in a dead person's blood.

The analytical challenge is real. Larson explained it: there is both insulin your body makes naturally and synthetic insulin administered externally, and the science has trouble telling them apart. Add blood stability issues on top of that, and you have a substance that is essentially forensically invisible.

That does not mean insulin homicides cannot be prosecuted. They can, and they have been. But every single one of those prosecutions has to bridge the same gap this one does. The state cannot hand the jury a lab report showing exogenous insulin in the victim's blood. They have to prove it some other way.

How Prosecutors Bridge the Gap

In the Sundwall case, the state has the glucose monitor data. Nineteen readings over ten hours showing Kacee Terry's blood sugar dropping from normal to levels consistent with unconsciousness. They have text messages spanning years discussing insulin as a method. They have the timeline, the seven hours, the fact that nobody called 911. They have 283 deleted messages and Sundwall's admission that she deleted them.

That is a lot of circumstantial evidence. But it is all circumstantial. The one piece of direct chemical proof that would make this case airtight, a toxicology result confirming synthetic insulin was in Kacee Terry's blood, does not exist. Cannot exist. The science is not there.

The defense knows this. Scott Williams did not miss the opportunity on cross-examination. He confirmed that all three drugs in Kacee's system are orally ingested, reinforcing that she was self-administering medications. He walked Larson through half-life math to establish that drug levels were higher hours before the blood draw. And he got Larson to acknowledge that alprazolam at 100 nanograms per milliliter sits at the threshold his own stock reference materials associate with death in multi-drug combinations.

Williams is building something. Not an alternative cause of death, exactly. More like a fog. If the drugs were higher earlier, if three CNS depressants were working together, if Kacee had access to all the insulin in that house, if her DNA is on the syringes and Sundwall's is not, if the police mishandled evidence at the scene, and if no lab on earth can confirm the murder weapon was there... that is a lot of "ifs" for a jury being asked to convict beyond a reasonable doubt.

What This Means Going Forward

The medical examiner and the endocrinologist have not testified yet. Those witnesses will determine whether the prosecution can close this gap. The ME ruled manner of death undetermined, not because the cause is unknown but because the ME could not determine who administered the insulin. That ruling is a defense anchor that will surface in every medical expert's testimony.

The endocrinologist will likely address the glucose monitor data directly. Nineteen readings. The timeline of Kacee's blood sugar decline. Whether the pattern is consistent with external administration versus self-injection. That testimony may be the prosecution's best shot at proving insulin was the weapon without a lab result to confirm it.

But here is the thing I keep coming back to. This gap is not unique to Sundwall. Every insulin-related death investigation in this country hits the same wall. Every prosecutor building an insulin homicide case faces a jury and says, in effect, "Trust the circumstantial evidence, because the direct chemical proof cannot be obtained." Some juries accept that. Some do not.

The system asks us to prove guilt beyond a reasonable doubt. When the alleged murder weapon is a substance no forensic lab in America can confirm was present, the definition of "reasonable" is doing a lot of heavy lifting.

WATCH THE FULL TESTIMONY Forensic Toxicologist Reviews Kacee Terry's Blood Results in Sundwall Murder Trial

I am not calling this case one way or the other. The trial is ongoing. Witnesses remain. The medical examiner and endocrinologist could change the picture entirely. But what Larson said on that stand is something every person watching this trial needs to sit with. The prosecution is asking the jury to convict for murder using a weapon that cannot be forensically verified. Whether the rest of the evidence is strong enough to carry that burden is the question this trial will answer.

And it is a question that goes far beyond Provo, Utah.