Autopsy

Introduction

An autopsy, also known as a postmortem examination or necropsy, is a thorough examination of a body. An autopsy is frequently used by investigators to help explain a cause and manner of death of a person.

Who are Pathologists?

Pathologists are specialized doctors who perform autopsies. When the reason of death is thought to be a criminal matter or when the cause of death can’t be determined medically at that time autopsy is required.

How to become Forensic Pathologist?

Forensic pathologist career required candidates to have some specific academic qualifications, which are:

  • The candidate must opt  Science in Class 12th with the PCB.
  • He/ She must hold an MBBS degree from a recognised medical college.
  • After MBBS, the candidate can go for MD with specialisation in Pathology.
  • B.Sc in Pathology followed by a Master’s degree can also help candidates to pursue a career as a Forensic Pathologist
  • The candidate must gain some experience by working as an intern at a morgue, medical examiner or lab assistant.
  • With certain experience, the candidate can apply for job roles as a Forensic Pathologist whenever Vacancies are out for this particular post.

The average pay scale of a forensic pathologist in India is Rs 10 Lacs per Annum.

What is the Process of Autopsy?

An autopsy begins with an outer examination of the body to look for any wounds, markings or trace evidences. After searching the body thoroughly pathologist will next make a Y incision from the shoulders to chest and then down to the pubis. The rib cage above the heart and lungs is removed in order to remove these and other organs from the body and to inspect them and weigh them. Stomach contents are also examined to determine what and when anything consumed by the deceased. Samples of organ tissues and bodily fluids are also collected and preserved by pathologist for further examinations. After then the back of the skull is opened with a saw so that the brain can be examined. After complete examination of whole body and its internal organs pathologist stitch chest and abdomen and also sew scalp after replacing the skull.

Purpose of Autopsy

A pathologist’s primary purpose during an autopsy is to ascertain the manner and cause of death.

Categories of Death

Manner of death (MOD) has 5 categories:

  1. Natural- Due to Natural disease processes.
  2. Accident- Due to injury when there is no evidence of intent to harm
  3. Homicide- Due to a volitional act of another person with the intent to cause fear, harm or death and some negligent acts.
  4. Suicide-Due to injury that occurred with the intent to induce self harm or cause one’s own death.
  5. Undetermined- Inadequate information regarding the circumstances of death to determine manner.

There are Three modes of Death:

1. Coma – When death results primarily from the failures of the vital centers of the brain.

2. Syncope – When death results primarily from the failure of heart.

3. Asphyxia – When the respiratory function of lungs stops as a result of lack of oxygen.

Cause of Death:

The damage, ailment or disease that caused death of person, such as a puncture wound to the heart or cardiac failure due to heart attack, is referred as the cause of death.

Time of Death

A pathologist also tries to figure out the time of death. In some circumstances, determining the exact moment of death is challenging and necessitates the examination of various factors. As a result, pathologists use known changes in the body after death to estimate the time of death. Body temperature, lividity, rigidity and the contents of stomach are among the alterations.

The temperature of the body declines at predictable rate until it reaches the temperature of the air. The rate at which the body temperature drops is affected by air temperature, wind, the amount of clothing worn, and even the deceased’s body weight.

The term “Lividity” or Ligor Mortis refers to the purplish area on the body that appears after settling of blood. If the body is lying on its back then back and hips develop lividity.

Rigor Mortis is stiffening of the body that occurs 2 to 6 hours after death, with the neck and jaw being the first to stiffen. Rigorousness ends after 24 to 80 hours (depending on the surrounding) and muscles begin to relax. The pathologist can determine when the last meal was taken by examining gastric (Stomach and Intestine) contents and their position in the digestive tract. When all of these data combined, it can produce a picture that aids in determining the time of death.

Autopsy Findings

The results of autopsies can be crucial in determining the cause of death. Human or pet hair, fibers, carpets, or cars, as well as soil or dust particles, can all be used to determine where a victim was at the time of death. Body injuries may also aid in determining the cause of death organ examinations can reveal if death was caused by natural causes or if foul play was involved.

            For example, narrowing of blood vessels around the heart and blood clots in the lungs indicate that the victim died as a result of disease. A head injury could be indicated by blood inside the skull. Strangulation can be indicated by damage to the hyoid bone. A pathologist can typically pinpoint the events that transpired in the last few hours of a person’s life by examining all of the signs.

Sources & References

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Pollanen MS. Deciding the cause of death after autopsy–revisited. J Clin Forensic Med. 2005 Jun;12(3):113-21.

Kotabagi RB, Charati SC, Jayachandar D. Clinical Autopsy vs Medicolegal Autopsy. Med J Armed Forces India. 2005 Jul;61(3):258-63.

Banwari M. An erroneous opinion on a cause of death in a forensic autopsy: a case report. Afr Health Sci. 2017 Dec;17(4):1246-1249.

SIMPSON K. THE INVESTIGATION OF OBSCURE DEATHS. Can Med Assoc J. 1964 Oct 17;91:845-50.

Benbow EW, Roberts IS. The autopsy: complete or not complete? Histopathology. 2003 May;42(5):417-23.

Menezes RG, Shetty BS, Rastogi P, Padubidri JR, Babu YP, Nagesh KR, D’Souza DH, Shetty M, Monteiro FN, Dsouza HL. The Mangalore aircrash of 22 May 2010: practical problems related to identification of the dead in a populous developing country. Med Leg J. 2012;80(Pt 4):151-4.

Nadesan K. The importance of the medico-legal autopsy. Malays J Pathol. 1997 Dec;19(2):105-9.

Patowary A. The fourth incision: a cosmetic autopsy incision technique. Am J Forensic Med Pathol. 2010 Mar;31(1):37-41. 

Hiss J, Kahana T. Medicolegal investigation of death in custody: a postmortem procedure for detection of blunt force injuries. Am J Forensic Med Pathol. 1996 Dec;17(4):312-4.

Skowronek R, Chowaniec C. [The evolution of autopsy technique–from Virchow to Virtopsy]. Arch Med Sadowej Kryminol. 2010 Jan-Mar;60(1):48-54.

Authored by:

Anupama Singh,

MA, LL.B.

Nehru Gram Bharti Deemed to be University