V Autopsy is a special type of scientific examination

of a dead body carried out under the laws of state

to 1) determine the cause of death whether
natural or unnatural
V 2)to determine identity of the person
V 3)to determine time since death
V 4)in new born infants to determine the question
of live birth and viability
V 5)in case of mutilated bodies to find whether they
are human and if human the probable cause of
death.
types of post mortems
V Medico legal
V Pathological
In a hospital attached to government /bmc
teaching institutions(medical college)
medico-legal post mortems are done by doctors
from Forensic medicine and toxicology dept and
Pathological post-mortems are done by
pathologists
Medico-legal post mortem is done in following cases

V deaths due to unknown poisoning,

V drowning,
V accidents-vehicular railway
V hanging
asphyxia due to unknown cause
V brought dead pts in casualty,
V Death due o fire arms injury
V Electric shock
V pts who dies in hospital within 24 hrs of admission
where doctors are not in the position to state cause
of death .
V Essential requirements for medico legal pm
V Authorisation : in earlier days it was given by
coroner but now days it is given by inspector or
sub inspector of police station
V A dead body challan and inquest report should be
handed over by investigating police officer to
medical officer for performing autopsy.
V Identification of dead body should be done by
constable to avoid p m on wrong dead body
V Visit the scene of crime if needed
V Examination of dead body internal and external.
V riteria for pathological post mortems
V Any pt died in hospital after 24hrs of admission and
still if treating doctor is not in a position to comment
the cause of death due to non conclusive reports ,if
pts has not responded to treatment
V For research studies like to find out cause for
metabolic disorder, genetic abnormalities.
V No invasive procedure like central line ;any operation
shouldn't have been carried out on pt.
panchnama/inquest report is not required.
V Only a request letter in the name of pathologist by
treating doctor is essential and superintendent and
hospital administrators are informed.
 Ä
 
 
Ä
  
V Psychologically, the autopsy provides closure by
identifying or confirming the cause of death. The
autopsy can demonstrate to the family that the care
provided was appropriate, thereby alleviating guilt
among family members and offering reassurance
regarding the quality of medical care
Ä
  




V The procedure can confirm the accuracy of the clinical
diagnoses and the appropriateness of medical care.
V The autopsy findings can be utilized to educate
physicians, nurses, residents, and students, thereby
contributing to an improved quality of care.
V According to Government Rule 2005.
V Post mortem can be carried out for 24 hrs i e
during night time also:
V where there is light source of 8 tube lights. And
the walls and floorings are covered with white
coloured tiles/ marble.
V If the doctor finds any suspicious cause after
external examination and reading inquest report
He can postpone the Post mortem till next
morning.
 —   
 
 

Any female who dies with in 7 years of married life

, p m should be done by 2 medical officers of
which 1 should be preferably female if available.
V Any complicative post mortem like suspected
rape ,fire arms (gun shot) ,death due to assault.
V If it is not possible to comment cause of death the
viscera has to be send to forensic medicine lab at
kalina santacruz Mumbai for chemical analysis,
V And for histopathology at J J group of hospital.
V Method for collection and storage of viscera
V All the desired organs like pieces of liver
,lungs,spleen,kidney ,pancreas,adrenals,brain are cut
and washed under running tap water to clear blood
and stored in plastic bottle containing 10% formalin
and send for histopathology.
V Stomach and small intestine with contents are stored
in plastic jar containing common salt and sent for
chemical analysis.
V Other items that can be sent for chemical analysis
are
Blood
Hair
Nail clippings
Vaginal and anal swab
V Every bottle labelled and sealed properly.
Name-¶Age/sex
P m no.
ADR no.
Viscera for HP/ A
V Final cause of death should be given after obtaining
histopathology report chemical analysis report and
assessment of medical records.
V After writing every cause of death it should always be
stated whether it is due to natural cause or unnatural.
V Eg.
Death duet to bilateral extensive pulmonary
koch·s(Natural).
Death due to drowning under water (Unnatural).
Evidence of ligature mark around neck however final
diagnosis after HP and A report. And assessment of
medical records.
V Ifthe body is decomposed and can not be moved
from that place then post mortem has to be done
V on the spot where the body is found on request
of police which is called spot post mortem.
 —  
 
 
Facilities for p m is available at every govt/ bmc
teaching institution
J J group of hospitals K E M SION AND NAIR
hospitals
V And also at 1)cooper p m center,
2)rajawadi p m center
3) bhagawati p m center.
All these p m centres are under direct control of
home ministry. And police surgeon is the in charge
of all post mortem centres .
 ˜  for
V p m report
V ause of death certi. For identified bodies and
Unknown /unidentified bodies ( pink colour.)
V Death certificate for in hospital pts
V Histopathology forms
V hemical analysis form
V Post mortem notes should be filled immediately
by doctor within 3 to 7 days in two copies , one
copy is kept as a medical record and other copy
should be collected by concern police station.
V After post mortem a separate certificate is issued
by concern police station for transporting the
body to the desired place for cremation.
V In metropolitan cities it is rule that no body
should be cremated without a cause of death
certificate.
 EMOLUMENT PAID TO DOTORS
To encourage doctors for doing pos mortems
Government has started paying doctors in following
way
V Doctor Rs.60/- per p m
V Asist. Doctor Rs.30/- ----··-----
V Attendant Rs. 20/-
V utter Rs 15/-
V Upto maximum of 30 post mortems per month
 MORTURY
After Death of pt in hospital and after post mortem the body
is sent to place called mortuary for temporary storage.. It
is preserved in a proper condition below 4 c until it is
disposed off.
V D
 
V Ground Floor is the best location for a Mortuary and
postmortem room. It should have suitable separate exit
and area should be protected from the view of patients
and public.
V Size of the department depends upon whether it is teaching
or non-teaching hospital
V . It has been estimated that in hospital, there is one death
per bed per year and the size of mortuary should be based
on this estimate.
    
with multiple compartments for storage of dead
bodies at the temp of below 4c.

   
There should be three to four separate tables with
large sinks and abundant water supply.
V Source of light should be adequate.
 ï —  

All viscera required to send to
histopathology and chemical analysis should be
preserved in proper container and stored in
steel cupboards.
   
V It should be provided with a table, two-three
chairs for patient·s relatives. A resting area for
medical officer should be provided with a
toilet, bathroom, and basin and facilities for
communication .
  
V To keep records of post-mortems notes,
inquest reports, letters received from concern
police stations,
V stock register of equipments and supplies.
V Separate register has to be maintained for
medico legal p m s and in hospital deaths.
 è  
V for storing instruments ,gloves aprons, chemicals,
stationeries.
V A room for morgue attendants with toilet and
bathroom.
V A waiting room for relatives.
V A room for police-equipped with telephone.
V è   
V Head of department professor ,associate
professor ,lecture in forensic medicine and
toxicology
V Medical officer
V Mortuary attendant for receiving dead bodies,
reports.inquest panchanama, for maintain record
V utter for performing post mortem
V Sweeper for cleaning p m room and premises
V