Death Investigation Flashcards

Question

Features of cellular death

Answer 1

``` Selective vulnerability to cessation of circulation - CNS - 4 mins - peripheral NS - 5 mins - muscle - 3 hours - blood cells - 6 hours - skin - 24 hours - bone, cornea - 48 hours Cells die and degenerate due to autolysis - by intracellular enzymes ```

Answer 2

``` Better than mechanical devices Rejection - host antibody attacks donor antigens Tissue typing for compatibility Immuno-suppression - rejection vs infection ```

Answer 3

``` Homologous - same patient - skin graft - bone graft - own blood Live donor - blood - bone marrow - kidney - part liver Cadaveric - heart and lungs - kidneys, liver - cornea - bone - sources - BS death due to RTA, SAH ```

Answer 4

Regulates removal, storage and use of human tissue Creates new offense of DNA theft Makes it lawful to preserve organs of deceased for transplantation Authorises museums to move human remains

Answer 5

Transplantation - use of parts of deceased body for transplantation, research etc - prohibits commercial dealings in human body parts for transplantation Post-mortem examinations - allows for authorisation of hospital post-mortems when alive or by family - non-legal cases for medical interest Tissue or organs no longer required for Procurator Fiscal purposes Defines nearest relative

Answer 6

Passed to stamp out body-snatching Anatomists needed a licence - issued by Home Secretary Responsibility for the proper treatment of all bodies dissected in the building Med schools had legal access to unclaimed bodies - deaths in prison and workhouses

Answer 7

Information - relatives, statistics, epidemiology, research Disposal of body - official recognition, registration and funeral Proof of death - grieving, insurance, litigation, benefits

Answer 8

``` Any Dr who knows cause of death Need not have attended in last illness Need not view body after death Whole death certificate given to informant (relative) 7 days to register death ```

Answer 9

Dr who attended during last illness (<14 days) or Dr who attended regularly during last illness and have viewed body Dr seeing body for first time may not certify Slip given to informant 5 days to register death

Answer 10

``` Use precise pathological terms - infarction, atherosclerosis, carcinoma Avoid imprecise terms - cardiorespiratory arrest, failure, come, old age Avoid abbreviations No need to fill every line 1a = immediate cause, due to 1b = antecedent cause due to 1c = antecedent cause due to 1d = underlying cause 2 = other influencing factors ```

Answer 11

A child that has issued forth from its mother after 20th week of pregnancy and which did not at any time after being completely expelled from its mother breath or show any signs of life Less than 20 weeks = miscarriage and does not need a death certificate

Answer 12

``` Death certificate Death registered Issued certificate of disposal Funeral arrangements - burial cremation Notification of disposal back to registrar ```

Answer 13

``` Application for cremation - issued by funeral directors - completed by relative in charge - countersigned by person in authority Medical certificate - completed by dr who issued death certificate Confirmatory medical certificate - completed by doctor registered > 5 years Authority from registrar Authority form PF/coroner Authority to cremate - issued by medical referee to crematorium ```

Answer 14

Detection of homicide Investigation of other unnatural deaths Protection of citizen's rights Statistics and audit

Answer 15

``` Expedient Thorough Impartial Respectful of relative's rights E&W - 20% population autopsy rate - 33% of deaths referred - 60% have autopsy Scotland - 10% population autopsy rate - 24% deaths referred - 40% have autopsy ```

Answer 16

Developed independently of E&W until union in 1707 then developed in parallel Duty of PF to inquire into sudden, suspicious, accidental, unexpected and unexplained death occurring in their jurisdiction In pursuance of public interest to eradicate dangers to health and life, allay public anxiety and ensure full and accurate statistics

Answer 17

``` Was death primarily natural or unnatural Any unnatural factors - assault - RTC - accident - fall Do not refer to PF because relative refuse permission for hospital autopsy ```

Answer 18

``` Uncertified death Outdoor death, residence unknown Violent, suspicious or unexplained Sudden and unexpected Accident involving a vehicle Any other accident Death at work Industrial accident, disease or poisoning Circumstances suggest suicide Poisoning - accidental or deliberate Death under medical care Defect in medicinal product Food poisoning or infectious disease Neglect or fault of another Abortion/attempted abortion Newborn child whose body is found Cot death - SIDS Suffocation or overlaying Death of foster child Death in legal custody - prison, police custody Drowning Fire, explosion, burns or scalds ```

Answer 19

``` Clinically unexplained Unexpected with regard to condition Attributable to diagnostic or therapeutic hazard Negligence suggested Death during anaesthesia Complication of anaesthetic or surgery ```

Answer 20

Was patient properly examined Were all due precautions followed Were there any special risks which should have been discovered

Answer 21

``` Criminal involvement - assault - RTA Unnatural - suicide - homicide - accident Medical mishap - accident - negligence ```

Answer 22

``` Delay in treatment Breakdown in communication Inappropriate medication Equipment failure Surgical mishap - accident - unusual difficulties ```

Answer 23

Breach of duty of care as a result of which there is damage to another Legal duty of care owed Breach of duty by omission or commission Provable causal link between action and harm Appropriate standard of care judged against body of opinion in filed

Answer 24

``` 2 doctor autopsy - homicide - suspicious - RTA 1 doctor autopsy - suicide - accident - some natural disease 1 doctor or view and grant - natural View and grant preferred - family objection All can be +/- toxicology ```

Answer 25

``` Make further inquires and precognition Involve other offices - health and safety executives - public health Close case on own authority Refer to Crown Office ```

Answer 26

``` Suspicious death Criminality involved Suicide Represents danger to public safety Medical mishap Where FAI (fatal accident inquiry) is mandatory - fatal accident at work - death in custody Where FAI have been requested by family Death of police officer Death due to fire or explosion Any other death causing concern ```

Answer 27

``` Mandatory under 1976 act - fatal accident in course of employment - death in legal custody At discretion of LA - gives rise to public concern - hospital negligence - public transport accident Determines who, when, where, how and why death occurred Does not apportion blame ```

Answer 28

``` Death in prison Death in police custody Death notifiable to government department Circumstances prejudicial to public Some RTAs ```

Answer 29

``` Murder Manslaughter Infanticide Death by dangerous driving Suicide with abetment May resume after clinical proceedings ```

Answer 30

Died from natural causes Died from industrial disease Died from dependence on drugs / non-dependent abuse of drugs Killed themselves - whilst in the balance of mind was disturbed Died as a result of accident/misadventure Was killed lawfully Was killed unlawfully - murder, manslaughter, infanticide Died as a result of attempted/self-induced abortion Was stillborn Died from want of attention at birth Open verdict