An autopsy, more formally known as a postmortem medical examination, is used to help determine the cause and manner of death and is often requested or ordered if the cause of death is not clear or is suspect, the decedent died under unexpected or unusual circumstances, the decedent was young, an autopsy may assist in medical research or knowledge, or if the grieving family may consider (now or in the future) bringing a claim for medical negligence related to the death. Sometimes the family may have no say in whether an autopsy is performed, especially if a crime is involved or the state or local medical examiner determines that an autopsy is necessary, for various reasons.
How Is An Autopsy Performed?
Most autopsies in the United States are conducted by qualified pathologists. The typical autopsy begins with an external examination of the body during which the weight and height of the body are measured and recorded, and identifyng marks such as tatoos and scars are noted and described. The scope of an autopsy may range from the examination of a single organ to a very extensive and comprehensive examination: the standard scope of an autopsy is often considered to be the examination of the chest, abdomen, and the brain.
The internal portion of an autopsy begins with a Y-shaped or U-shaped incision made from the shoulders, joining over the sternum, and then continuing down to the pubic bone. The rib cage and abdominal cavity are then exposed by separating the skin and underlying tissue. The neck and organs within the chest are exposed by removing the front of the rib cage. The trachea, thyroid gland, parathyroid glands, esophagus, heart, thoracic aorta, and lungs are then removed, followed by the intestines, liver, gallbladder, bile duct system, pancreas, spleen, adrenal glands, kidneys, ureters, urinary bladder, abdominal aorta, and the reproductive organs.
The brain is removed by making an incision in the back of the skull, from ear to ear. The scalp is then cut and separated from the underlying skull and is pulled forward. A vibrating saw is used to remove the top of the skull and the brain is then lifted in its entirety out of the cranial vault. The spinal cord is removed by removing the anterior or the posterior portion of the spinal column.
After removing the organs from the body, they are separated from other organs, weighed, measured, and further dissected, with small samples being made into slide preparations for examination under a microscope. Fluid samples may be obtained and tested. Organs and tissues may be photographed, cultured, and/or preserved and stored for future investigation, review, and research. The autopsy concludes by the incisions made during the autopsy being sewn closed. The organs removed during the autopsy may be returned to the body or they may be subjected to further investigation for diagnostic, research, or teaching purposes.
Autopsy rates in the United States have fallen from about 50% of all deaths in the 1950s to 10% in the late 1990s, with even lower rates at non-academic hospitals in the United States (the Joint Commission for Accreditation of Hospitals eliminated in 1970 the requirement that a hospital needed to have an autopsy rate of 20% in order to be accredted).
When Are Autopsies Important To Medical Malpractice Claims?
Numerous research studies have consistently reported that in 20% to 40% of autopsied patients, there were significant, treatable conditions that were not clinically diagnosed but were detected by autopsy, despite the ever-increasing use of increasingly sensitive imaging and laboratory testing. That may mean that a patient died due to medical negligence (e.g., the failure to timely and appropriately diagnose and treat a treatable medical condition that would have saved the patient’s life) that may not have been discovered by the decedent’s family if an autopsy had not been performed. On the other hand, an autopsy may confirm that the cause of death was not due to medical negligence or the autopsy may discover an undiagnosed condition that led to the patient’s death that was not caused by a breach of the standard of care in treating the patient. In either situation, an autopsy may help the surviving family members to deal with their loved one’s death, knowing what really occurred and that the death was not preventable.
While many medical malpractice wrongful death lawsuits may be filed where an autopsy was not performed (especially if the cause of death can be determined with relative precision and confidence without an autopsy having been performed), there are circumstances where the results of a comprehensive and properly performed autopsy are necessary in order for the medical malpractice plaintiff to satisfy his/her burden in proving medical negligence, causation, and injuries.
Where the cause of injury or death due to medical negligence may not be provable because an appropriate autopsy was not timely performed, the grieving family may have much difficulty in finding a medical malpractice lawyer to investigate and/or proceed with a medical malpractice case.
Often it is not the family’s fault that an autopsy was not performed (i.e., no one suggested to them that an autopsy should be performed, they were not timely informed that an autopsy was an option or available to them, they could not afford to pay the cost of an autopsy, or they requested but were refused an autopsy).
When Should The Family Consider Requesting An Autopsy?
Most of the time, the cause of death of a family member is caused by a single event or a series of events that can be logically determined and explained. However, if the explanation of the cause of death or the events leading up to death do not make sense to the surviving family or are known to the family to be incomplete or false, then the family should promptly consider requesting that an appropriate autopsy be promptly performed. If the family chooses to have an autopsy performed, the family should consider who will perform the autopsy (if it is suspected that a hospital’s medical negligence may have caused or contributed to the death, then the family should consider having the autopsy performed by the local medical examiner, if available and appropriate, or having a private autopsy performed instead of allowing the hospital to have its employee or staff member perform the autopsy).
In any event, it is important not only for a potential medical malpractice claim but also for the psychological well-being of the surviving family members that the appropriate decisions regarding an autopsy of their loved one’s body be made before their ability to make decisions regarding an autopsy is precluded by time or events. If a medical malpractice wrongful death claim is subsequently filed where an autopsy was not performed, the medical malpractice defendants are likely to argue that they are not responsible for the death and point to the lack of an autopsy to shoot holes in the medical malpractice plaintiff’s claims of medical negligence.
If you suspect that a family member’s death may be due to medical negligence, you should promptly find a local medical malpractice lawyer in your U.S. state who may advise you regarding whether an autopsy is beneficial or required in order to investigate a medical malpractice wrongful death claim, and to assist you in arranging for an appropriate autopsy.
If your family member or other loved one died while receiving medical treatment in a hospital or elsewhere, and you suspect that the cause of death may involve medical negligence, you should promptly seek the legal advice of a local medical malpractice lawyer in your U.S. state who may investigate your medical malpractice wrongful death claim for you and represent you in a medical malpractice case, if appropriate.
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