Autopsy

Forensic Medicine

1. AUTOPSY 1

2. Synonyms: Post Mortem Necropsy Thanatopsy 2

3. 3 Post------after Mortem------Death External examination of dead body without incisions, fluids can be collected with the help of needle . e.g. Blood, bile, Urine Post Mortem POST MORTEM

4. 4 Auto --- Self Opis --- view / Examination (self examination) It may be defined as, The detailed scrutiny of both external surfaces and internal contents of dead body after opening its cavities including further examination, such as histology, biochemistry and toxicology of collected material. AUTOPSY

5. NECROPSY Necro ---- Dead Opsy ---- examination / to see (Examination of Dead) Thanatopsy : Thantopsy : Thantose  means death opsy  view or to see. 5

6. AUTOPSY TYPES: Medical /clinical/ pathological / hospital autopsy. Anatomical autopsy Psychological autopsy Postmortem examination Virtual Autopsy Medico-legal autopsy 6

7. i.MEDICAL /ACADEMIC AUTOPSY: 7 Carried on a patient who dies in a hospital during course of treatment .

8. Objectives 1. To determine the cause of death. 2. To confirm or establish the clinical diagnosis 3. To evaluate the effects of treatment given during life. Performed by a pathologist with consent of relatives. 8

9. II.ANATOMICAL AUTOPSY It is performed to study normal structure of human body. Mostly on unclaimed dead bodies Anatomist and medical students perform this. 9

10. III. PSYCHOLOGICAL AUTOPSY 10 It is undertaken on alleged cases of suicide to know about the mental status of deceased at the time of death. It is perform to know about :  Background of person His habits ,mental status, personality, character. Relation to others Sources of collection of information are Family members, friends, professional colleagues, teachers and physicians NOT THE POLICE ..

11. IV.Postmortem Examination Examination of external surfaces of corpse by inspection without giving incision for systemic examination. However specimen of body fluids like blood bile urine may be collected. 11

12. V. Virtual Autopsy It is a postmortem examination without compromising the integrity of the body, even without collection of sample. Due to some reason or disease the autopsy of dead body is not possible then by the help of radiological examination we can detect the cause of death. Methods X-rays, ultrasound, CT scan MRI. 12

13. VI. MEDICO-LEGAL AUTOPSY Essential examination of dead body, to rule out or establish foul play in death . 13

14. II. MEDICO-LEGAL AUTOPSY 14 It is perform in pursuance of law to establish the cause and manner of death and also to establish or rule out foul play.

15. HISTORY: The medicolegal autopsy was first time introduced in 1302 AD in ITALY. This procedure was carried out by physician (BARTOLONEO DE VARIGNANA) and surgeons. Autopsy Performed by specialists in developed countries. In Spain, Germany, Scotland, by two specialists. In Pakistan mostly by Untrained medical officers . 15

16. OBJECTIVES OF MEDICOLEGAL AUTOPSY TO ESTABLISH To determine identity of deceased. To establish cause and manner of death, To establish and rule out foul play. To determine time since death. To identify weapon, person or poison responsible for death. In case of new born infant to determine issue of live or still birth and viability. 16

17. CORPUS DELICTI 17 In a criminal charge of homicide. Positive identification of victim Proof of death by criminal act of accused . This is collectively termed as CORPUS DELICTI.

18. It is performed by medicolegal expert but due to lack of qualified experts, all authorized medical officer of Govt. can perform it. It is performed under section 174 CrPC of Pakistan and police rules 1934 section 25.34 and 25.36 18

19. AUTOPSY RATE AUTOPSY RATE It is proportion of autopsies carried out on deaths notified to the authorities. AUTOPSY INDEX It is the proportion of medico-legal autopsies carried out on total deaths in a community. 19

20. PRE AUTOPSY FORMALITIES/ Protocol OF AUTOPSY VISIT OF SCENE OF CRIME TRANSPOSITION OF CORPS REGISTRATION OF DEAD BODIES STORAGE OF DEAD BODIES LEGAL FORMALITIES OTHER FORMALITIES PLACE OF PERFORMING AUTOPSY 20

21. A. VISIT OF SCENE OF CRIME 21 Not done in our country but in European countries the autopsy surgeon visits the scene of crime. The action done there are Cordening of scene. Position in relation to surrounding objects 3. Presence of or position of weapons, blood stains, marks of struggle 4. Preservation of foot prints and other trace evidence. 5. Photography of scene.

22. B.TRANSPOSITION OF CORPSE The dead bodies should be transported to mortuary rapped in plastic bags ,tied on both ends, with all its belongings 22

23. C.REGISTRATION OF DEAD BODIES On receipt of corp. authorized staff should make entries in two registers General Register Autopsy Register 23

24. columns of general register are Serial numbers Date and time of receipt of corpse Name and ID of diseased Name and No of police officials and his police station Date and time of delivery of corpse 24

25. columns of autopsy register are Yearly No. Autopsy No. Name, date and time of autopsy. Details about specimen collected and lab where sent. Provisional /final conclusion regarding cause of death. 25

26. STORAGE OF DEAD BODIES There are two types of storage.. Long term at -20 C [for preservation] Short term +4 C[for autopsy purpose] 26

27. LEGAL FORMALITIES SECRUITINY OF POLICE PAPERS Authorization orders /police docket Inquest report The copy of FIR Form ,,,,,( alf . bay. Jeem .) Initial MLC /treatment notes/ hospital notes. Lab/X-ray/ MRI etc. reports. Any operation notes. (All papers must be examined & signed). 27

28. Authorization 28

29. Examination of police papers Police docket  police request for autopsy or it is a requisition submitted by the investigating police officer to a medical officer while handing over the dead body for a postmortem examination. CONTAINS: FIR Complete information name, age, sex, height Number of injuries & location State of body, State of clothing's Site of recovery, Sketch of area Weapon, Apparent cause of death. 29

30. Inquest report Inquest report is a report which contains Available Hx of the case. Circumstances under which body was found. Opinion of witnesses & the police officer regarding injuries, manner of their causation, cause of death & any indication of suspected foul play. 30

31. Inquest report Three types of printed forms depending upon apparent manner of death  1. Form A. For those types of deaths which appear to be natural 2. Form B. For those cases in which death has occurred due to assault. 3. Form C. For those cases in which death appears to be due to poisoning 31

32. OTHER FORMALITIES Identification:- The dead body should be identified prior to autopsy, this is necessary because in a mortuary where serial autopsies are done chances of performing autopsy on wrong body do exist.  This can be prevented by appropriate identification. If known confirm identity by police or by relatives always take signature of identifiers. Write name with address, & No of police officer with police station. 32

33. Identification IF UNKNOWN 1Ask the police to take photographs 2.Note particular of dress worn and tailor tag, belongings ,facial features, and identification marks 3.Note the finger print details Giving an advertisement on newspaper. 33

34. INITIAL MLR / TREATMENT NOTES Where there has been a period of treatment between an act of violence or between the accident and death. Such documents are necessary as to enable the doctor to concentrate on the organ or the part of body most suspected & likely to serve as a guide to retain or send appropriate part to FSL 34

35. PLACE OF PERFORMING AUTOPSY MORTUARY: is a room or a building usually part of the hospital to which dead bodies are taken to be kept for until their burial or some other disposal. Autopsy room is that part of the mortuary where dead bodies are dissected. 35

36. Dr.Mudaser Hussain Abbasi/Department of Forensic Medicine & Toxicology 36

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39. INSTRUMENTS COMMONLY USED IN AUTOPSY 39 Surgical blade/knife Scissors Probe Dissecting forceps Cartilage knife Rib shears Chisel Hammer Saw Bone forceps Skull elevator Brain knife Scalpel Knife Measuring jug Weighing machine Magnifying lens Trays (steel)

40. INSTRUMENTS COMMONLY USED IN AUTOPSY 40 Surgical hand gloves Sewing material Preservatives Labeling / sealing material