What is an autopsy? How is it performed? What are the different types of autopsies? Get a detailed summary of the autopsy process and its significance in understanding the cause of death.

Autopsy: The Medical Examination of the Body After Death

An autopsy, also known as a post-mortem examination, is the medical examination of a deceased person’s body and internal organs. This procedure is carried out by a qualified medical professional, typically a pathologist, to determine the cause of death and gain insight into the individual’s medical condition.

Types of Autopsies: Coroner’s Autopsy and Hospital Autopsy

There are two main types of autopsies: a coroner’s autopsy and a hospital autopsy.

Coroner’s Autopsy

A coroner’s autopsy is performed when the coroner or police need information for legal reasons about the cause of death, such as in cases of suspected murder or suspicious circumstances surrounding the death.

Hospital Autopsy

A hospital (or non-coronial) autopsy may be performed if the immediate family gives their consent. This type of autopsy can help clarify the reasons for the person’s death and provide information to the medical profession about the deceased’s condition.

Reasons for Performing an Autopsy

Some of the common reasons for performing an autopsy include:

• Determining the cause of a person’s fatal illness when it is unknown or uncertain
• Evaluating the success or failure of a treatment method
• Providing information to family members in the case of suspected genetic illness
• Advancing medical knowledge about disease processes, such as atherosclerosis or sudden infant death syndrome (SIDS)

The Right to Refuse an Autopsy

The right to refuse an autopsy varies between hospital and coronial autopsies:

Hospital Autopsy

The immediate family has the right to refuse or agree to a hospital autopsy of the deceased. They may also choose to consent to an autopsy but limit the extent of the examination. They can also decide whether or not organs or samples taken from the body may be kept for further study.

Coronial Autopsy

The senior next of kin may object to the carrying out of a coronial autopsy, and the coroner must consider their request to reconsider if the request is made within 48 hours of the senior available next of kin receiving a notification from the coroner. If the coroner decides that an autopsy is still required, the matter may be appealed in the Supreme Court, but there is a limited time in which these objections can be made.

The Autopsy Procedure

The autopsy is performed in a manner similar to a surgical operation, with the following steps:

1. The autopsy is performed as soon as possible following the family’s consent, by a specially qualified doctor called a pathologist, assisted by a technician.
2. The body is laid out carefully on an examination table, and the pathologist first looks at the body, noting its appearance. Photographs and x-rays may be taken.
3. The pathologist makes a cut on the body from the collarbone to the lower abdomen to examine the chest and abdominal organs. Tiny tissue samples are taken from each organ for examination under a microscope and may also be sent for chemical analysis or microbiological culture.
4. The brain is usually examined, which requires cutting through the scalp and skull. This can take up to three weeks to complete properly.
5. Some organs may need to be kept for up to six weeks so that further tests can be performed in the pathology department.
6. After the autopsy, the organs are replaced, and the skin is stitched closed again.
7. The entire autopsy procedure can take up to three hours.

Tissue Samples and Organ Retention

Tissue samples taken from the body are usually kept by the laboratory for potential future analysis. Organs that have been retained for further testing are returned to the family, disposed of by the hospital, or kept for future medical research and training, according to the family’s wishes.

The Funeral Process

Once the autopsy is complete, the body can be collected by the family’s chosen funeral director. If some organs have been retained for further testing, the funeral may need to be delayed for a few days or weeks if the family wants the body to be whole before it is buried or cremated. In this case, the funeral director can arrange to embalm the body.

Autopsy Results

A preliminary report on the autopsy findings is available within the first few days, but the full results may take several weeks to complete as the various tests and analyses are conducted.

Autopsy – Better Health Channel

Summary

Read the full fact sheet

• An autopsy or post mortem is the medical examination of a body after death.
• A hospital (or non-coronial) autopsy may be performed if the immediate family give their consent.
• A coroner’s autopsy is performed if the coroner or police need information about the cause of death – for example, if the person was murdered or their death was suspicious.

An autopsy, or post mortem, is the medical examination of a body and the internal organs after a person has died. There are two types of autopsy – a coroner’s autopsy and a hospital autopsy.

Coroner’s autopsy

A coroner’s autopsy is performed if the coroner or police need information for legal reasons about the cause of death – for example, if the person was murdered or their death was suspicious.

Hospital autopsy

A hospital (or non-coronial) autopsy may be performed if the immediate family give their consent. In this case, the autopsy can help to clarify the reasons why the person died, or offer information to the medical profession on the deceased person’s condition. Some of the reasons for a hospital autopsy can include:

• In some cases, the cause of the person’s fatal illness may be unknown or uncertain.
• An autopsy can help determine the success (or otherwise) of a treatment method.
• An autopsy can give family members information in the case of suspected genetic illness.
• Medical science can learn about disease processes, such as atherosclerosis or sudden infant death syndrome (SIDS), or the prevalence of particular diseases.

The right to refuse an autopsy

‘Hospital’ and ‘coronial’ post mortems have differing rules around refusal rights.

Hospital autopsy

The immediate family has the right to refuse or agree to a hospital autopsy of the deceased. They may also choose to consent to an autopsy, but limit the extent of the examination. They can also decide whether or not organs or samples taken from the body may be kept for further study. Make sure you discuss these issues with hospital staff.

Coronial autopsy

The senior next of kin may object to the carrying out of a coronial autopsy and the coroner must consider their request to reconsider if the request is made within 48 hours of the senior available next of kin receiving a notification from the coroner.

Where the coroner decides that an autopsy is still required, the matter may be appealed in the Supreme Court. But there is a limited time in which these objections to a coronial autopsy may be made. Provisions about objecting to a coronial autopsy are contained in s26 and s79 of the Coroners Act 2008External Link.

The autopsy procedure

The autopsy is performed like a surgical operation. The steps may include:

• The autopsy is performed as soon as possible following the family’s consent.
• It is performed by a specially qualified doctor, called a pathologist, who is assisted by a technician.
• The room in which the autopsy is performed is very similar to a hospital operating theatre.
• The body is laid out carefully on an examination table.
• The pathologist first looks at the body, noting its appearance.
• Photographs and x-rays may be taken.
• The pathologist makes a cut on the body from the collarbone to the lower abdomen to examine the chest and abdominal organs.
• Tiny tissue samples are taken from each organ for examination under a microscope and may also be sent for chemical analysis or microbiological culture.
• In most cases, the brain is examined. This requires cutting through the scalp and skull. The brain is a very fragile organ – to examine it carefully and properly may take up to three weeks.
• Some organs may need to be kept for up to six weeks so that further tests can be performed in the pathology department.
• After the autopsy, the organs are replaced and the skin is stitched (sutured) closed again as happens after any operation.
• The post mortem can take up to three hours.

Tissue samples from an autopsy

Tissue samples taken from the body are usually kept by the laboratory. The samples are kept in the hope that technological advances may one day answer any remaining questions about the cause of death or the nature of the disease. Keeping tissue samples requires the specific consent of the deceased’s next of kin.

Organs that have been retained for further testing are returned to the family, disposed of by the hospital or kept for future medical research and training of medical staff, according to the family’s wishes.

The funeral

Once the autopsy is complete, the body can be collected by the family’s chosen funeral director. If some of the organs have been retained for further testing, the funeral may need to be delayed for a few days or weeks if the family wants the body to be whole before it is buried or cremated. In this case, the funeral director can arrange to embalm the body.

Autopsy results

A preliminary report is available within the first few days, but the full results of the autopsy are not usually available until around six to 12 weeks later. It may be best to arrange for the report to be sent to the family doctor, so that the next of kin can make an appointment to discuss the findings with their doctor. In other cases, the family could make an appointment with the pathologist.

Where to get help

• Your doctor
• Hospital staff
• Pathologist
• State Coroner’s Office Tel. 1300 309 519
• National Coronial Information SystemExternal Link

• The National Code of Ethical Autopsy Practice, Department of Health Victoria.
• Information for next-of-kin regarding non-coronial post mortems, Department of Health Victoria.

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What Is an Autopsy? A Forensic Pathologist Explains

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March 16, 2023

“I never speak to a happy family. I’m maybe speaking to them on the worst day of their
life—giving them some really horrible news.”

Dr. Gregory McDonald

Dr. Gregory McDonald, dean of PCOM’s School of Health Sciences and director of the MS in Forensic Medicine program, has served as the chief deputy coroner at the Montgomery County Coroner’s Office
since 2008. He has conducted thousands of autopsies, testified in hundreds of court
cases and has, as he described it, provided closure for many people.

“We are very different from almost every other type of physician,” he said. “We have
different ways of measuring our successes.”

Other doctors, he explained, may have to occasionally deliver bad news but they also
may have victories where they save lives.

“Our victories are measured a bit differently,” McDonald said.

What is an autopsy?

An autopsy is a detailed examination of a body for the purpose of determining how
an individual died. The procedure may be done as part of a criminal investigation
or it may be performed at the request of family members.

According to McDonald, one of the main duties of a forensic pathologist is to testify
about autopsy findings in court.

“It sounds cliche, but it’s really true that we are a voice for these victims,” he
said.

McDonald recounted the case of a young boy beaten to death. He had to describe in
detail what had happened to the boy and how the child had died with the mother sitting
in the courtroom listening to his testimony. The mother later approached McDonald.

“She still had the grace and the dignity to come up to me and thank me for being a
voice for her child,” he recalled.

According to McDonald, autopsies most often lead to a determination of a natural death.
However, there are cases—skeletonized remains for example—that can potentially frustrate
even the most experienced forensic pathologists.

“There are times we’ve looked at everything we can look at and at the end of the day,
we don’t know what happened,“ he said. “An autopsy can only tell so much.”

Where is an autopsy performed?

An autopsy may take place in a hospital or, if circumstances warrant, it may be conducted
at a medical examiner facility or coroner’s office.

The Montgomery County Coroner’s Office (MCCO) where McDonald works will soon be opening a new facility which McDonald says
will improve their ability to process cases and serve the public.

“As society expands and the population begins to increase, you need an expansion of
the death investigation system,” McDonald said.

The death investigation system, he explained, provides a mechanism by which the cause
and manner of death can be determined in cases where the individual passes away in
an unnatural, unobserved or unexplained way.

“As it expands, we need more personnel to cover increased cases,” McDonald said. The
additional personnel ensure the investigations and notification of next of kin will
be handled in a timely manner.

The new MCCO facility will have expanded work space and updated equipment including
new tables, new x-ray equipment, better storage facilities and larger conference rooms
to better accommodate meetings with families as well as educational events for the
public.

When is an autopsy required?

According to McDonald, there are no hard and fast requirements. That, he added, is
a problem as there is a patchwork of different systems which may vary from state to
state or even jurisdiction to jurisdiction.

Even in Pennsylvania, some counties rely upon the local coroner’s office for death
investigations while others—Philadelphia, Delaware and Allegheny counties—have medical
examiners.

Generally speaking though, an autopsy may be conducted when questions exist regarding
how, when, where or why a person died.

Who performs an autopsy?

A medical examiner is a physician who has been specifically trained in forensic pathology, toxicology
and other related areas. In jurisdictions with a medical examiner’s office, the medical
examiner and assistant medical examiners are appointed to office and will often be
formally trained as forensic pathologists. They are responsible for conducting forensic
autopsies in their jurisdictions.

Coroners are elected to office. While they may often be physicians, they may not be
trained as forensic pathologists. Oftentimes, coroners will hire a forensic pathologist
on a contract basis to handle cases.

“We may also call in consultants to help us—like a forensic dentist or forensic anthropologist,”
McDonald said. “However, a forensic pathologist should always determine the cause
and manner of death.”

Who can request an autopsy?

Autopsies fall into two general categories: forensic and hospital-based.

A forensic autopsy is the more common type. When certain criteria are met, a medical
examiner or coroner will have jurisdiction, and therefore, the authority to determine
that an autopsy should be done. These criteria include deaths resulting from trauma
or violence, motor vehicle accidents, drug-related deaths or deaths where people are
not identified.

Hospital-based autopsies usually involve a natural death in a hospital or a home setting
in which family members request an autopsy be performed and sign a consent form.

How is an autopsy performed?

An autopsy is performed in two different phases—an external examination and an internal
one.

In the first phase, McDonald explained, the forensic pathologist will note any identifying
characteristics and any obvious signs of natural disease. The body will be assessed
for post-mortem changes including rigor mortis (stiffening of the joints and muscles)
or livor mortis (settling of the blood) which may help determine time of death. Other
factors including discoloration, bloating, skin slippage or insect activity will also
be noted. The external examination is documented with photography and the forensic
pathologist’s notes.

The next phase involves examining the internal organs. That process begins with a
y-shaped incision in which the chest cavity is opened.

“At that point, we’re going to start to examine the different layers we’re seeing,”
McDonald said.

This examination includes looking for abnormal accumulations of fluids and any unusual
masses. The forensic pathologist will also inspect the organs while still in place.
When a gunshot wound is involved, the forensic pathologist will note the wound path,
which organs were struck by the bullet and the amount of blood loss internally. In
those cases, recovery of the bullet is critical.

“They are very important pieces of evidence,” McDonald said.

After the in situ examination is completed, the organs will be removed, examined,
weighed, dissected and sampled. In some cases, slides may be prepared for microscopic
examination.

During the internal examination, the forensic pathologist or autopsy technician will
also collect fluid samples including bile, blood, vitreous and gastric fluids.

After everything has been examined, the organs are placed back in the body.

“We do pride ourselves in the ability to do a complete autopsy but still allow the
family to have a funeral with an open casket if they opt to do that,” McDonald said.

How long does an autopsy take?

The time required to complete an autopsy can vary greatly depending upon the case.

”A case that does not involve a lot of injury or does not require a lot of specimens,
with the help of my technician, can be done in about an hour,” McDonald said.

More complicated ones, he added, can take up to eight hours.

What is an autopsy report?

Once the autopsy is completed and a determination is made regarding cause and manner
of death, the forensic pathologist will issue a report.

“Sometimes I know the cause of death and manner of death right after an autopsy,”
McDonald said. “Other times, if it is a drug death for instance, I might have to wait
until the toxicology results come in.”

The autopsy report is then turned over to the coroner for inclusion in the coroner’s
report. The coroner’s file may also include reports from forensic investigators, law
enforcement, emergency medical services personnel, medical records, dental records
and more.

Providing closure

While the results of an autopsy may sometimes reveal tragic or shocking information,
McDonald sees it as an important step in the grieving process for those left behind.

“I do think I can provide some closure for them,” he said. “You are able to inform
the family and they can move on with their lives and start the grieving process.”

Despite the difficult nature of his job, McDonald takes immense satisfaction in what
he does.

“When it’s something you really enjoy, it’s not work.”

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Pathological anatomical autopsy of a person: the nuances of the study

Pathological anatomical autopsy, which is also commonly called “necropsy”, is an autopsy of the body of the deceased (or stillborn) with further study of the internal organs. Most often, this procedure is carried out to determine the exact cause of death – because it can not always be established by external signs.

In what cases is a pathoanatomical autopsy used

If we consider the case of death in the bed of an old sick person, then necropsy is usually performed in rare cases – when the initiative comes from relatives.

An autopsy is an almost mandatory procedure when there is no confirmed cause of death. This is especially true in cases where representatives of law enforcement agencies arrived at the scene. If they have doubts that this death can be violent, then the body of the deceased is sent for necropsy without the consent of the relatives. In the absence of a petition from the Ministry of Internal Affairs, the relatives of the deceased may refuse to perform an autopsy.

Most often, an autopsy is refused at the will of the deceased or for religious reasons. Employees usually agree to such a requirement if:

• the deceased was seriously ill before death and died under medical supervision;
• there is a medical record of the deceased, in which diseases are registered that one way or another led to a fatal outcome;
• relatives can provide the results of a histological examination if the deceased had oncological diseases.

It is possible to have time to refuse an autopsy, that is, to submit an appropriate application, within three days after sending the body to the morgue. According to the law, an autopsy of the received body is carried out within 3 days after arrival, so you can not delay with the application.

Autopsy and forensic examination of a corpse

Necropsy should not be equated with a forensic medical examination of a corpse. There are two major differences between these two terms:

1. Forensic medical examination is an obligatory component after the opening of a criminal case. But necropsy is carried out upon the presence of a petition in writing from relatives or by the personal decision of medical staff, if biological death has been ascertained. If there are suspicions of a violent death (signs of the action of toxic substances, physical damage are found), then the body can be sent for a forensic examination.
2. The two methods use different tools. In addition, necropsy can be carried out in any organization (in other words, in different places). The most important thing is to have the appropriate permission to conduct this kind of autopsy.

Necropsy steps

According to the existing procedure, enshrined in the current Russian legislation, the autopsy is carried out according to the following algorithm:

1. Visual examination of a deceased person.
2. Autopsy and examination of body cavities.
3. Organ harvesting.
4. Examination of organs and tissues.
5. Collection of biomaterial for a number of different studies.
6. Return of the body to its original form.
7. Conducting laboratory research and examination of taken biomaterials using a microscope.

Visual inspection

Initially, even before the moment of autopsy, a visual examination of the body by specialists takes place. All found scars and various wounds, burns, scratches (and so on) are recorded in the appropriate document at the time the body arrived at the department.

Organ harvesting

After that, an autopsy of the body is carried out, internal organs and tissues are examined. They are then extracted for further research. At the same time, employees try not to damage them too much, since then they will need to be returned back to the body.

Here it is worth saying that in different countries there are significant differences in relation to organs. So, in the United States of America, organs are usually not sewn into the body, but simply disposed of. In Europe, this is prohibited.

Analysis of biological material

In addition to a general examination of the state of internal organs, they must be studied in laboratories. Based on the cause of death and medical indications received by health workers, the approach to research will differ: biomaterials can be taken from a variety of organs and tissues for analysis.

An example is the study of suspected death due to lung cancer. Lung tissues will be taken to search for tumors on them, as well as neighboring tissues and organs in order to detect cancer cells there. In the Russian Federation, after the end of the stage, the pathologist who supervises the necropsy draws up and signs the “Protocol of the pathological and anatomical autopsy”. He bears legal responsibility for the truthfulness of the testimony.

Body restoration and embalming

After the end of the study, the body is handed over to relatives so that they bury it. For this reason, it is necessary to carry out an autopsy with further prospects for the reconstruction of the body: all organs are placed in their proper places, incisions are sutured, the body is washed. As a result, the body retains its former shape, and the sewn incisions from necropsy are hidden under clothing or hair (if we are talking about research on parts of the skull).

This stage plays a special role during burial in open coffins – this practice exists in Russia, but is quite rare. This is done so that all relatives, friends, acquaintances can see the deceased and see him on his last journey, so the body must have a good appearance. With the right approach to necropsy, traces from the autopsy are invisible.

What is necropsy used for

The autopsy procedure lasts from 30 minutes to several hours. This period of time includes direct work with the body of the deceased. Analyzes and laboratory tests can take several days or even weeks. Conducting necropsy allows you to draw conclusions on the official cause of death: agree with it or refute it.

An autopsy is of great importance in medicine in general – its use allows improving the accuracy of statistical mortality, the correctness of diagnosing a disease, and evaluating the effectiveness of the treatment being undertaken.

Among other things, conducting a pathoanatomical study allows you to identify the diagnosis as accurately as possible and evaluate the work of individual doctors, medical institutions, medical higher educational institutions, and even the medical system of a state or region in general.

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Opening of the deposit. Big Russian Encyclopedia

TechnologiesTechnologies

Exploration of the mineral deposit, excavation to provide access from the surface to mineral deposits (PI) in the subsoil. The main goals of opening up the deposit are to prepare for the extraction of PI, to create transport links between production faces (the site of PI mining) and its reception points on the surface, to provide conditions for the safe movement of people, and to ventilate mines and mines. The main types of opening workings are capital trenches, vertical and inclined shafts, inclined transport exits and adits. The variety of methods and schemes for opening a deposit is determined by the variety of forms and conditions of occurrence of PI.

Penetration of a deposit during the development of PI by an open method (quarry)

Penetration of a deposit during the development of PI by an open method (quarry) is usually carried out with the help of capital trenches and half-tranches (mining and capital stripping), less often through shafts, adits, capital ore passes and other underground workings providing Fig. 1. Opening of a quarry field using ore slopes. Fig. 1. 1. Opening a quarry field using ore slopes. Transport connection between the points of loading the rock mass in the quarry and the points of its unloading on the surface (Fig. 1). Trenches are used to open deposits in flat areas, half trenches – in hilly areas. In some cases, a trenchless opening of the deposit is carried out (with the help of tower excavators and cable cranes, as well as suction dredgers). Depending on the configuration of the quarry field in plan, its depth, production capacity and the type of transport used, the route of the mine workings opening the quarry field can be simple (the quarry does not change its direction on board) or complex (dead-end, loop, spiral, etc.).

When opening a deposit with the use of hydromechanization tools, mine workings not only open access to PI deposits, but also create a water area for the operation of floating dredgers or dredging equipment. Depending on the type of opening workings, a deposit is opened by a pioneer pit (development is carried out in the form of a sector within a quarry field with subsequent filling with groundwater), a trench-channel (development is carried out into the contour of the deposit, water is filled from a nearby water source) and flooding of the surface of the deposit ( carried out when the quarry is located above the water level in the water source, the rise of water is carried out by dams, pumps, etc. ). In the latter case, the space filled with water is preliminarily covered with special dams.

Penetration of a deposit during the development of PI by an underground method

Penetration of a deposit during the development of PI by an underground method depends on the shape and conditions of occurrence of ore bodies, veins and layers. It can be carried out by simple or combined methods. Rice. Fig. 2. Staged opening of underground deposits. Fig. 2. 2. The stages of opening underground deposits. Simple methods include opening a mine field by main vertical and inclined workings and adits (with auxiliary and ventilation vertical and inclined shafts, inclined transport exits, adits), passable from the surface immediately to the entire depth of the deposit (Fig. 2 a, b). Combined methods are different combinations of simple methods, due to the specifics of the mining and geological conditions of occurrence and the large depth of development (Fig. 2 c, d). The method of opening a deposit determines the stages of opening (single-stage or multi-stage opening), the magnitude of the first and subsequent stages, the location of the main (concentration and operational) horizons. Forms ore and cargo flows, the location of industrial sites, transport, energy, heat and other communications, the procedure for dewatering and dewatering the deposit.

In contrast to the opening of coal and other seam deposits, the opening of ore deposits is characterized by a variety of spatial arrangement of workings in the rock mass. This is due to the fact that all coal seam deposits, as a rule, have a relatively constant material composition of PI, consistent and correct linear parameters and occurrence sizes, which are easily amenable to geometric and analytical description. Each ore deposit has its own characteristics, mining and geological characteristics and complex morphology, which requires an individual solution to the issues of opening and preparation, the order and sequence of extraction of PI.

In the underground mining of copper pyrite, sulfide and uranium deposits, the broken ores of which are prone to spontaneous combustion, and the dust is explosive, it is advisable to separately ventilate the excavation and preparation areas. For such conditions, a combined method of section-block opening of a deposit in a mine field with flank or central ventilation of each section has been developed. For this purpose, special shafts are passed and equipped, which, in addition to supplying fresh air to the block section, can perform a number of auxiliary functions. The issuance of ore to the surface from all sections is carried out centrally through the main skip shafts. The sectional-block method of opening a deposit is also used for salt and flooded deposits, with large mine fields, with a significant depth of development, when fans are ineffective. In addition, in case of water breakthrough, spontaneous combustion of broken ore, collapse of host rocks and explosion of sulfide dust or gas, it is possible to quickly isolate a section (section) or a wing of the mine field by means of sectional-block water and gas protection or fire protection bridges and separately operate and ventilate the rest of the mine field.

Opening of alluvial deposits

Opening of alluvial deposits (diamonds, gold, tin, rare earth elements, etc. ). The ease of occurrence of alluvial deposits predetermines a small number of opening methods and schemes: vertical and inclined shafts and motor vehicle exits (buried placers), adits and open trenches-ditches (terraced placers).

In mountainous areas, a simple method of opening with adits is used to mine terraced placers and flooded primary ore deposits. Adits are also used for preliminary drainage of deposits and permanent drainage. With a placer depth of up to 10 m and a significant water inflow (which makes it difficult to drill vertical and inclined workings and increases the cost of drainage), the opening of deposits is carried out by open trenches.

Combined complex staged opening of deposits

Pic. Fig. 3. Scheme of a complex stage-by-stage opening of ore-bearing areas of the deposit. Fig. 3. Fig. 3. Scheme of complex staged opening of ore-bearing areas of the deposit. Combined complex staged opening of deposits consists in progressive-successive development and association of closely located groups of deposits of the ore field and remote ore-bearing sections of the deposit (Fig.