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40973_7PATIENTADVOCACYForensicMedicine060516.pdf INFORMATION ABOUT POSTMORTEM EXAMINATION OR AUTOPSY You have been asked to read this booklet because someone close to you has died. On behalf of our staff, we would like to express our sympathy to you and your family following your loss. We

understand that this is a sad time for you and it may be difficult for you to consider a post mortem

examination. This booklet aims to help you to understand the reasons for undertaking a post mortem examination and gives details about what is involved and its potential value.

What is a post mortem examination?

This Latin phrase literally means ͚after death͛. A post mortem eǆamination is a medical eǆamination

carried out on the body after death. It is also called an autopsy (which means ͚to see for oneself͛).

What are the circumstances that require an autopsy? The autopsy is conducted on the request of investigating officers in cases of sudden, suspicious un-natural deaths and which are labelled as MLC cases. The circumstances that require almost always an autopsy:

1. Fire deaths, when the body is altered by fire.

2. Homicides or any cases in which another person is in anyway a possible factor in the

death.

3. Apparent suicides that are without clear evidence of intent, such as those without a

note.

4. Road traffic accidents and railway accidents.

5. In aircraft crashes.

6. Occupation related deaths.

7. Unwitnessed "accidents."

8. Accidents in which natural disease cannot be ruled out as a factor.

9. Deaths of persons in government custody.

10. Sudden, unexpected deaths.

11. Deaths during medical or surgical intervention.

Any other cases which law enforcement agency deems fit for post-mortem examination. What is the purpose of conducting post mortem examination? A number of things that may be determined from an autopsy are:

1. Establish decedent's identity.

2. Establish the cause of death.

3. Determine the mechanism of death.

4. Confirm the manner of death.

5. Confirm medical history.

6. Separate complicating medical factors.

7. Rule out disease or factors harmful to public health.

8. Facilitate adequate photography of wounds, if required.

9. Correlate wounding and object producing the wounds.

10. Determine time interval between wounds received and death.

11. Establish sequence of events.

12. Retrieve an article involved in mode of death, such as a bullet.

13. Obtain and examine trace evidence such as hairs, stains, and seminal fluid.

14. Obtain specimens for toxicology.

15. Establish order of death in situations where more than one family member has been

killed.

16. To document all injuries in order to answer any future questions that is unknown at

the time of the autopsy.

Who performs the post mortem examination?

Post mortem examinations are carried out by doctors specialized and trained in the field of forensic

medicine. The doctor may be assisted by a technician who is specially trained for this purpose. Where is the post mortem examination carried out?

Examinations are carried out in special facilities provided in the hospital mortuary. The body will be

removed respectfully from the place of death/cold storage to the place where the examination will be carried out. When will the post mortem examination be carried out?

The post mortem examination is usually carried out as soon as possible after death, usually within 2

to 3 working days following the death. The earlier the examination is held the more chance of it yielding useful information. The actual examination can take up to three hours. However, some post mortem examinations may take longer. Some samples which are sent to forensic science laboratory for investigations that are carried out after the post mortem examination may take several weeks.

What happens in a post mortem examination?

The full post mortem examination can be described in the following stages:

1. Receiving of request letter for conduction of post-mortem examination along with complete

inquest papers including brief history, statements, hospital documents, investigating officer͛s report etc.

2. Identification

3. The external examination

4. Internal examination

5. The internal examination consists of inspecting the internal organs of the body. This part of

the examination is like a major operation and usually takes two to three hours to complete.

6. Special examinations/tests and reports: This includes retention of tissue samples for further

laboratory investigations. An account of the findings is then written up by the doctor and later the results of any special examinations or tests and of the microscopic examination may be added. The timeframe for the availability of the final post mortem report varies but an effort is made to finalize the report as early as possible while following Delhi Govt. norms and is handed over to investigating police officer. Will the appearance of the body be affected by the post mortem examination? It is not normally obvious that a post mortem examination has taken place and the body can be viewed afterwards as if no such examination has been performed. Great care is taken with the external appearance of the deceased and most of the incisions will be hidden by clothes or hair. However, please be aware that the cause of death and the normal changes which occur after death may impact on the appearance of the body. Will a post mortem examination delay the funeral? Every effort is made to perform the post mortem examination in a timely fashion so funeral arrangements should not need to be delayed. The body is usually released to the relatives through police after the completion of post mortem examination.