Aviva Trivia

An autopsy is a procedure performed on a non-living body in order to learn valuable clues as to the cause death.  The word ‘autopsy’ comes from the Greek words ‘auto’ and ‘opsis’, meaning ‘to see for oneself’.  Who performs autopsies and how?  Why does it take so long to receive results, and how is the determination of death made?  To understand the answers to these questions, an explanation of the procedure known as an autopsy is helpful.

Before an autopsy is considered, of course, a death has to occur.  An autopsy is often required when a death seems to be from mysterious or suspicious circumstances.  Whether a murder, suicide, or natural causes, often these can be determined by autopsy.  The police, a coroner, or even the family of the deceased can request an autopsy.  An autopsy will not adversely affect the possibility of an open casket at the funeral.

A coroner is usually a medical doctor, or pathologist, who investigates suspicious deaths.  A pathologist or pathology assistant usually performs an autopsy.  A pathologist is a medical doctor who specializes in normal and diseased human tissue.  He or she is responsible for examination of the tissue and may oversee the medical professionals who perform testing on blood and body fluids.  Tissue will be obtained from several or all of the body’s organs, including the liver, kidneys, heart, brain, skin and others.

Before making any incisions, the body is examined for any injuries or suspicious marks such as bruises, needle marks, wounds, or other conditions.  If, for example, a puncture wound is found, the length, width and depth will be measured.  The pathologist notes everything, often using a microphone and recorder. Once removed, the organs are weighed and measured, tissue samples taken and put aside for specific tests.  The contents of the stomach and intestines will be examined to determine what, if anything, the person had ingested prior to death.  Sometimes a time frame for the death can be estimated by the stage of digestion of anything found here.  After the autopsy, all the organs can be replaced in the abdomen before suturing the body. 

Blood and body fluids are sampled also.  If the deceased person had not been under treatment of a physician, routine blood testing will be done to check the general health of several of the body’s systems before death occurred.  If no apparent cause of death is found during the autopsy, such as a clot in the heart to indicate a heart attack, several samples will be tested for drugs or chemicals.  Often these samples cause a delay in autopsy results.

These samples are often sent to an outside laboratory that specializes in toxicology testing.  A procedure known as chain of custody is used to ensure any fluids sent to any other laboratories are not tampered with.  Specimens are placed in the proper containers and sealed with evidence tape, then placed in a sealed plastic bag for transport.  Anyone who handles the specimen, from the person who collected and placed it in the container and bag, to the courier who transports it, to the person who receives it at the testing facility, and the technologist who actually performs the tests, will sign the documents accompanying the specimens. 

There will be an initial screening for a long list of drugs including prescription, over-the-counter, and illegal drugs.  Screening may indicate the possibility of one or several specific drugs, or drug types, but is not considered conclusive.  Samples that have had an initial positive on a screening test will be further analyzed to determine exactly which drugs and the quantity of any drugs.   The initial screen is often a quick test for several specific drugs or drug types.  Screening tests can sometimes be falsely positive due to interfering substances present in the sample.  Screening tests cannot be used as legal evidence because they are not specific.  The confirming tests take longer and are very specific for each drug.

Depending on what type of drug or chemical produced a positive screen result, tests that are more specific will be performed.  There are several methods used, depending on which drugs or chemicals are suspected.  These specific test results are conclusive and can be used as legal evidence.  Not only will these tests reveal what drugs or chemicals are present in the body, but at what quantity.  It can be determined whether the drug or chemical level was enough to cause death.  If there is any question about the validity of a test, it will be repeated.  Everything is checked and rechecked.

Once the autopsy is complete, any organs that have been removed will be placed into the abdominal cavity, and the incision sutured closed. 

The pathologist or coroner receives all the results for the tests performed.  He or she will review all these results along with their own findings obtained from the physical examination of the body to come to a conclusion for the cause of death.  Once a conclusion is made, the official cause of death can be reported on the death certificate.  In most instances, an autopsy provides conclusive results for the cause of death.  It is unusual to be unable to make a conclusion regarding the cause of death after an autopsy, but it is not unheard of. 

In high profile cases, whether a murder or mysterious death of a well-known person, the pressure is on for a quick conclusion.  Not wanting any mistakes to be made, the pathologist or coroner is likely to take extra time in making the determination of cause of death.  This is especially true in a case of a young, seemingly healthy, individual who has passed away unexpectedly. It is in the best interest of everyone to make the correct determination the first time.  No one wants to have a body exhumed years later to check on something that should have been done the first time. 

In this day of microwave dinners and quick sound bytes of news, it seems that everyone wants a quick answer.  Determining the cause of death is a case when patience and persistence towards the truth must prevail.