Clinical Symposium 4 - The coronial system and the medico-legal aspects of the autopsy

Question 1

What percentage of deaths (England and Wales 2021) were reported to the coroner?

Answer 1

33%

Question 2

What percentage of deaths (England and Wales 2021) had post-mortem performed?

Answer 2

39%

Question 3

What percentage of deaths (England and Wales 2021) had inquests opened?

Answer 3

17%

Question 4

What percentage of deaths (England and Wales 2021) had inquests conclusion?

Answer 4

14%

Question 5

What percentage of deaths (England and Wales 2021) had jury inquests?

Answer 5

1%

Question 6

What triggers a coroner’s duty?

Answer 6

If the body is within the Coroner’s area AND
The Coroner has reason to suspect:
The deceased died a violent or unnatural death
The cause of the death is unknown; or
The deceased died while in custody or otherwise in state detention

Question 7

What happens if the criteria for a coroner’s duty is met?

Answer 7

THEN
The Coroner must conduct an investigation
As soon as possible
To establish

              who died, when, where and how they came by their death

Question 8

What is the significance of an inquest?

Answer 8

Public hearing -The media & public are entitled to be there

Formality - Witnesses give evidence on oath/affirmation

Proceedings recorded - IPs can obtain a disc of the recording

Inquest Hearing - eye witnesses tell what they saw
Pathologist explains the cause of death
Experts opine on how it happened

Question 9

What responsibilities does the coroner have in post mortem examinations?

Answer 9

Control over the body (not ownership)

Power to order a PM S14(1) C&JA 2009

Power to move the body for PM purposes

Pathologist must report the result of the PM asap to the Coroner

Organ Donations: the Coroner has the power to object (not consent)

Question 10

What is the percentage dropped of cases reported to the coroner in 1995 to 2021?

Answer 10

22%

Question 11

Why has the number of coroner cases dropped?

Answer 11

Shortage of pathologists eg none in Lincolnshire
Poorly paid – derisory fee: £96.50;
£276.90 if ‘non standard’(eg paediatric)
Hospital focus on imaging in life
Fewer opportunities for doctors to train as pathologists
Not a significant part of the NHS ?
Alternatives to invasive PMs CT scans: 9150 in 2021 (11%)
PM quality issues -20% inaccuracies

Question 12

What percentage of PMs are CT scans?

Answer 12

11%

Question 13

What are two factor of the standard of proof?

Answer 13

1. Balance of probability
2. Beyond reasonable doubt

Question 14

Define witness of fact.

Answer 14

Can tell what they did/saw

Question 15

Define expert.

Answer 15

Can express opinions on matters within their field of expertise.

Question 16

What is the percentage of deaths in 2021 were ruled as an accident?

Answer 16

25%

Question 17

What is the percentage of deaths in 2021 were ruled as an natural cause?

Answer 17

13%

Question 18

What is the percentage of deaths in 2021 were ruled as an industrial disease?

Answer 18

8%

Question 19

What is the percentage of deaths in 2021 were ruled as open?

Answer 19

4%

Question 20

What is the percentage of deaths in 2021 were ruled as a suicide?

Answer 20

15%

Question 21

What is the percentage of deaths in 2021 were ruled as drugs or alcohol?

Answer 21

8%

Question 22

What percentage of deaths were ruled as narrative?

Answer 22

20%

Question 23

What percentage of deaths were ruled as a road traffic collision?

Answer 23

3%

Question 24

What do prevention of future deaths reports include?

Answer 24

Duty imposed on coroners
Written report after considering all the documents/evidence
ANYTHING revealed gives concern: risk of other deaths
Addressed to organisation/person with power to act
Action should be taken to prevent a future death
Must respond within 56 days
Coroner cannot compel action –BUT it is on the record
Copied to family/Chief Coroner/media