Coroners Act and HTA Flashcards
How do you verify death in the hospital (8)
No response to verbal or painful stimulus
No palpable carotid pulse
No heart sounds (2 minutes)
No breaths sounds (2 minutes)
Pupils fixed and dilated (non-responsive to light)
DOCUMENT in medical notes (date and time)
Notify Consultant, discuss cause of death for certificate, arrange for family to be notified etc.
DO NOT add messages/drawings/R.I.P.
What does MCCD stand for
Medical Certificate of Cause of Death
How do you document the cause of death (4)
1a is the ultimate cause of death
1b causes 1a
1c causes 1b
Part 2 - other diseases related to cause of death, but not related to 1a-c
What should you avoid when documenting the cause of death (4)
Abbreviations
Question marks
Vague terms
Modes of death
What was the result of the Shipman enquiry regarding documentation of cause of death
The inquiry found major flaws in the systems that govern death registration, the prescription of drugs and the monitoring of doctors
What are you essentially stating when completing a cremation certificate
That further examination of the body is not required
What are the three types of autopsy
Consented (hospital) autopsy.
Forensic autopsy.
Coroner’s autopsy.
Why are hospital autopsies carried out (5)
To determine: extent of disease, response to treatment, occult disease.
To support: teaching/training, research/audit.
Why is a forensic autopsy carries out (2)
Coroner’s rules.
Police involvement.
Why is a Coroner’s autopsy carried out
Coroner’s rules
Who conducts a forensic autopsy
Forensic pathologist
Who conducts a coroner’s autopsy
General pathologist.
What does the coroner do?
A coroner is an independent judicial office holder, appointed by a local council. Coroners usually have a legal background but will also be familiar with medical terminology. Coroners investigate deaths that have been reported to them if it appears that:
The death was violent or unnatural
The cause of death is unknown, or
The person died in prison, police custody, or another type of state detention.
What is the coroner concerned with? (4)
Who died.
When did they die.
Where did they die.
How did they die.
What deaths should be referred to the coroner (6)
Unknown cause of death Not seen by a Dr during last illness or last 14 days During or within 12 months of pregnancy Death in custody While detained under Mental Health Act
Death due to: Suicide Accident/trauma Industrial disease Medical/surgical treatment Abortion Anaesthetic care Lack of medical care murder Self-neglect
What are some key laws regarding the Coroner (4)
Coroners Rules 1984
Coroners Act 1988
Coroners and Justice Act 2009
Coroners (investigations) Regulations 2013
What is required in order to conduct a hospital autopsy
Patient/Family member’s consent
What is essential with regards to consent
Capacity to consent
Who does the Mental Capacity act protect
Protects people who cannot make decisions for themselves
What does the mental capacity act presume
That people have capacity - you have determine incapacity
What is required for a patient to be deemed to lack capacity (4)
They cannot:
Understand the information relevant to the decision.
Retain the information.
Use or weigh that information as part of the process of making the decision
Communicate the decision
What was the Alder Hey organ scandal
Involved the unauthorised removal, retention, and disposal of human tissue, including children’s organs, during the period 1988 to 1995
What resulted from the Alder Hey organ scandal?
Redfern Report led to the Human Tissue Act 2004
New law on informed consent.
Review of coroner’s system.
Trusts had to employ bereavement counsellors
What did the Human Tissue Act 2004 create
Human Tissue Authority
What is the Human Tissue Authority
The Human Tissue Authority (HTA) is a watchdog that supports public confidence by licensing organisations that store and use human tissue for purposes such as research, patient treatment, post-mortem examination, teaching, and public exhibitions.
What does the Human Tissue Act deal with
Deals with consent, performance of autopsies and storage of material retained, as well as the collection and retention of material taken from the living.
You need consent for examination, removal, storage and ANY type of use – teaching, research, audit, clinical governance etc…
What are the three key clauses of the Human Tissue Act (3)
16 (2) b –a post mortem examination
16 (2) c – The removal from the body of a deceased person of relevant material of which the body consists or which it contains for a scheduled purpose other than transplantation
16 (2) e – The storage of the body of a deceased person or relevant material which has come from a human body for use for a scheduled purpose.
What activities require consent to use biological material from a decreased person (5)
Clinical audit. Education or training related to human health Performance assessment Public health monitoring Quality assurance
Who is required to consent for pathology specimens for the coroner’s autopsy
The coroner, but can also gain consent from family
