The autopsy Flashcards
Name the two types of autopsy
Hospital and Medico-legal
Explain why the hospital autopsy is performed
- to find accurate cause of death
- audit into accuracy of clinical diagnosis
- education of students to correlate clinical signs and pathology
- research into the causes and mechanisms of disease
resource allocation - to get stats on disease incidence
What are the two types of medico-legal autopsy?
coronial
forensic
Why is the medico-legal autopsy performed?
- determine cause of death
2. collect evidence useful in prosecution of those associated with the death
Which type of autopsy is more frequently carried out?
medico-legal (>90%)
Which deaths are referred to the coroner?
- presumed natural - where the cause of death is unknown AND they were not seen by a doctor in the past 14 days
- presumed iatrogenic - peri/postoperative deaths, anaesthetic deaths, abortion, complications of therapy
- presumed unnatural - accidents, industrial death, suicide, unlawful killing, neglect, custody deaths, people in receipt of war/industrial pensions
Who can refer the deceased for an autopsy?
doctors registrars of BDM relatives police anatomical pathology technicians
Who can perform a coronial autopsy?
histopathologists
forensic pathologists
Who performs hospital autopsies?
Histopathologists
For what reasons can forensic pathologists do a coronial autopsy?
any reason that involves the participation of a third party
For what reasons can a histopathologist perform a coronial autopsy?
natural deaths drowning suicide RTDs accidents fire deaths industrial deaths peri/postoperative
For what reasons can a histopathologist NOT perform an autopsy?
homicide
death in custody
neglect
What is the role of the coronial autopsy?
WHO was the deceased
WHEN did they die
WHERE did they die
HOW did they die
What is the role of the coroner?
WHO was the deceased
WHEN did they die
WHERE did they die
HOW did they die
What are the main steps of an autopsy?
history/scene external examination evisceration internal examination reconstruction
What additional steps can be done in an autopsy?
microbiology toxicology genetics histology radiology digital photography
What are the key steps of a digital autopsy?
history/scene
internal examination
digital autopsy
reconstruction
What does the external examination involve?
identification
disease and treatment
injuries
List some methods of identification of the deceased
formal identification gender body habits tattoos and other body modification clothing jewellery
What are the steps of evisceration?
Y-shaped incision open all body cavities(remove ribcage) examine all organs in situ remove thoracic and abdominal organs remove brain
Give examples of organs examined in the internal examination
heart and great vessels lungs, trachea, bronchi liver, pancreas, gallbladder spleen, thymus, lymph nodes GU tract endocrine organs CNS
Is consent from pt’s relatives needed for a hospital autopsy?
Yes
Consent from pt’s relatives is needed for a coronial autopsy. T or F?
False - it is a legal requirement
What was stated in Coroner’s rules 1984
- autopsy to be done ASAP
- autopsy to be done on appropriate premises
- autopsy to be done by a pathologist with suitable experience
- findings should be reported promptly and only to the coroner
What are the amendment rules 2005?
retention of materials in coronial autopsy:
1. pathologist must tell coroner precisely what materials have been retained
2. coroner authorises retention and sets disposal date
3. coroner informs family of retention
4. the material can either be returned to the family, retained for research/teaching or disposed respectfully
the coroner informs the pathologist of the family’s decision and the pathologist keeps a record. The autopsy report must declare retention and disposal
What does the coroners act 1988 allow the coroner to do?
- the coroner can order an autopsy where the death is likely due to natural causes to avoid the need for an inquest
- the coroner can order an autopsy where the death is clearly unnatural and an inquest is needed
so this means an coroner can order natural and unnatural deaths to come for autopsy
what did the Coroners and Justice Act 2009 state?
- system of medical examiners
- coroner can defer an inquest and launch an investigation
- inquests have conclusions and not verdicts
