Holly Lomas guest lecturer Flashcards
Certification of death
Medical Certificate of Cause
of Death (MCCD)
Completed by a doctor
Cause of death
Death certificate
Issued by Registrar of
Births, Marriages &
Deaths
Importance
Confirm that death had occurred and who has died
Given an indication of the probable cause of death
Support the bereaved
Assist with the appropriate investigation of sudden or unexplained deaths
Identify possible criminality prior to disposal of
the body
Legal process
Provide accurate statistical information to better
inform public health policy
Teaching & learning about disease and interventions
Who investigates deaths?
Independent judicial officer
Questions to be answered:
Who died
When they died
Where they died
How they died
Autopsy examination requirements
The cause of death is clearly unnatural, e.g. following a fall or an assault
The cause of death is potentially unnatural, e.g. linked to surgery or to
occupational exposures
The cause of death is not known, even if it is thought to be natural
The deceased died in custody or otherwise in the care of the State
Human Tissue Act 2004
Prohibits the examiner from keeping any human tissue, whole organs, and toxicology samples. However allowed to keep human tissue, whole organs, and toxicology samples with coroner approval if cause of death is undetermined.
Religion and cultures
No law to protect certain religions and culture against autopsy examinations
The law is in favour of Coroner, Coroners make final decision
Autopsy examination
Coronial
Suspicious circumstances or potentially unnatural death occurring in custody - Forensic examination - Performed by
a Home Office Registered Forensic Pathologist
Organ specific- performed by a specialist cardiac pathologist or neuropathologist
Maternal
Paediatric
Hospital/’Consented’
Types of examination and autopsy
External examination
Specialist radiological examination:
* X-ray
* Computerised tomography (CT)
* Magnetic resonance imaging (MRI)
Limited invasive autopsy
Full invasive autopsy
Coronial inquest
Public judicial inquiry
Reasonable suspicion that the deceased has died a violent or unnatural death
Cause of death is unknown
Deceased died while in custody or state detention
Some inquests require a jury to be present
Without a preceding autopsy examination
Consented autopsy
Not under HM Coroner’s jurisdiction
MCCD issued
Treating clinician may request a ‘hospital postmortem’ to further investigate the
cause of death, to improve knowledge of the disease or the effectiveness of the
treatment given
Requires NOK consent
The autopsy
Permission to proceed - Next of kin
Identification checks - Name, DOB, and first line of address
Background information
External examination - ID checks, height and weight, gender, age, and race.
More measurements in paediatric cases.
Jewellery, tattoos, and exogenous materials.
General body conditions
Radiological examination - MIR, X-ray, and CT
Internal examination - Y-shaped, modified Y-shape or I-shape incision.
Body cavities in situ
Individual organ examination
Written report +/- additional
investigation results
Additional investigations
Histology
Microbiology
Virology
Intimate swabs and sampling
Other swabs and sampling
Fingerprints
Anthropology
