No autopsies allowed for covid positive deaths?

[Emergent]

I went to the funeral of a former coworker who died, and was covid positive. This person was in their 20s. I learned that the family had requested an autopsy that had been denied by the coroner. This was because the patient was covid positive. The family wanted to understand what contributed to this sudden death, the patient had been recovering at home and had sudden exasperation of respiratory issues, and had a cardiac arrest during the transfer. 

So, I can see a thriller movie in the future about someone who murders their significant other, who happens to be covid positive and recovering at home.

[MunoRN, RN]

4 hours ago, Emergent said:

Allnurses it's always been filled with people who take themselves too seriously. They like to hair split about one thing or another. Some people just like to argue. Or else they like being in an echo chamber and preach to their own personal choir. It's always good when you have one person to beat on, who maybe put their foot in their mouth or disagrees with the mainstream opinion. This covid section is filled with that type for some reason. The people who just want to get cheered on while telling people such exciting things such as, get vaccinated, and how horrible and heartless people are who have a different point of view. Because this is America, the home of the free and the land of the brave, and whoever disagrees with my opinion is very opinionated and a threat to the common good.

I don't recall the part about the scenario being potentially a plot to a thriller movie when I responded, I must have missed.  It appeared to be a sincere question about coroners refusing autopsies on people with Covid.  My apologies for taking time to try and answer.

[toomuchbaloney]

10 hours ago, MunoRN said:

I don't recall the part about the scenario being potentially a plot to a thriller movie when I responded, I must have missed.  It appeared to be a sincere question about coroners refusing autopsies on people with Covid.  My apologies for taking time to try and answer.

Perhaps the title of the thread should have better reflected the intention.  This title reflects concern that covid autopsies, or lack there of, might be evidence of a conspiracy or something nefarious. 

[phylsway]

ME refusal to perform  an autopsy on covid pts is not so uncommon. Family could have paid out of pocket(thousands of dollars)to have  an autopsy.

[Emergent, RN]

The only reason I posted here in the covid section is because it probably would have been moved here. This is a half serious thread about the possibility of a crime thriller plot, based on the premise that coroners don't have the time to do an autopsy on every covid death, and that it might present an opportunity for a husband or wife to do away with a spouse that they want to get rid of.

I thought I included all that in the opening post. I tried to make things readable for people, and not write a book. I put two paragraphs in the opening statement, the first was my introduction and background. And the second was my conclusion that this might be a really good premise for a murder mystery.

[heron, ASN, RN]

30 minutes ago, phylsway said:

ME refusal to perform  an autopsy on covid pts is not so uncommon. Family could have paid out of pocket(thousands of dollars)to have  an autopsy.

If medical records of the clinical course leading to death indicate a reasonably clear cause of death, why should taxpayers have to fork over those thousands?

[toomuchbaloney]

2 minutes ago, Emergent said:

The only reason I posted here in the covid section is because it probably would have been moved here. This is a half serious thread about the possibility of a crime thriller plot, based on the premise that coroners don't have the time to do an autopsy on every covid death, and that it might present an opportunity for a husband or wife to do away with a spouse that they want to get rid of.

I thought I included all that in the opening post. I tried to make things readable for people, and not write a book. I put two paragraphs in the opening statement, the first was my introduction and background. And the second was my conclusion that this might be a really good premise for a murder mystery.

And the title told everyone what the focus for discussion was...right? That focus was placed upon autopsies not being allowed on covid patients....

[heron, ASN, RN]

9 minutes ago, Emergent said:

The only reason I posted here in the covid section is because it probably would have been moved here. This is a half serious thread about the possibility of a crime thriller plot, based on the premise that coroners don't have the time to do an autopsy on every covid death, and that it might present an opportunity for a husband or wife to do away with a spouse that they want to get rid of.

I thought I included all that in the opening post. I tried to make things readable for people, and not write a book. I put two paragraphs in the opening statement, the first was my introduction and background. And the second was my conclusion that this might be a really good premise for a murder mystery.

Well … if you say so …

I have a pretty dark sense of humor, myself, but this went way over my head.

[londonflo]

14 minutes ago, Emergent said:

This is a half serious thread about the possibility of a crime thriller plot,

Robin Cook did a lot of medical thrillers I believe. Also "Blood and Money" is a great thriller about a physician  who may have/maybe not have killed his wife.  If John Hill was alive today hypothetically he could have infected his wife with Covid ....... instead of the books premise he infected her with a gram- or gram+ infection that evolved into sepsis. Btw this is a great book by Tommy Thompson. 

The physician had  strong ties to the hospital and all her micro samples were destroyed before results were known and the embalming  was done before the Medical Examiner did the autopsy.

 

[macawake, MSN]

16 hours ago, heron said:

I guess the “I know a guy who knows a guy …” approach really was a way to resurrect that tired old trope of phony death certificates and inflated numbers. Otherwise, why pull the victim card when other possibilities are presented?

That’s what I suspect as well.

The title of the thread seems rather misleading to me. I’m assuming that it isn’t correct to claim that the autopsies aren’t allowed; I.e. forbidden, but rather that in some instances they won’t be paid for by the taxpayer. Those two scenarios are two different things. The wording of the title does indeed appear to suggest that something nefarious is afoot. Frankly, if it weren’t for that little question mark, I feel that the thread title is misleading enough that it borders on disinformation.
 

[macawake, MSN]

2 hours ago, heron said:

If medical records of the clinical course leading to death indicate a reasonably clear cause of death, why should taxpayers have to fork over those thousands?

This right here is why I don’t think murdering someone and trying to blame it on Covid, will make for a very exciting or plausible murder mystery. If the Medical Examiner works the same way in the U.S. as in my country, the only times they’ll choose not to perform an autopsy is when there is a documented illness with a clinical course and signs/symtoms at death that fit the illness and the documented severity of that illness very well. If there is any doubt or any suspicious circumstances surrounding the death, they will do the autopsy to rule out foul play and/or identify another unknown medical condition or accidents.

Covid isn’t any different than any other potentially serious illness. Sure, if you know someone who currently has a serious Covid infection, or has any number of potentially life-threatening conditions (cardiac, cancer, autoimmune diseases etc.) and feel like murdering them, and manage to somehow induce a fatal condition with the appropriate signs and symtoms, that could medically logically be caused by the disease the person has, then sure… brilliant plan on how to get away with murder. But as I said, it doesn’t have to be Covid. Any disease that can be fatal will do. 

Another reason why I don’t think a ”murder by Covid” movie will be made any time soon, is that we’re still in the middle of an ongoing pandemic that has cost millions of human beings their lives, with well over 700,000 deaths in the U.S. alone. I don’t think we’re at the stage where making Covid into entertainment is very likely. 

 

[NRSKarenRN, BSN, RN]

When a person is under physician/PCP care, medical records + lab works exist, death is a possibility of disease process, coroner usually does not get involved. Hospitals affiliated with medical schools, often perform autopsy on those unexpected deaths in a facility; I can remember "Dr. Mortimer"  being paged over head when this occurred in my hospital.  At start of the pandemic, with death suspected due to COVID and + lab results, autopsies discouraged due to decrease spread of virus and sheer number of deaths overwhelming coroners offices. Later in the pandemic, autopsies are performed on those with COVID + or suspected disease when meets states requirements for procedure.   Family can always request private autopsy to obtain more info re cause of death.

Stamford Autopsy Cost:

Quote

*You should be aware that autopsies are not covered by insurance.

Full Autopsy costs $3,800. This includes neuropathology workup (brain and spine) and detailed study of all the other organs. If the cost of full autopsy is too high, focused autopsies can be done to target only specific areas of the body and to answer specific questions:

• Chest-Only: $1500
• Abdomen-Only: $1500
• Chest and Abdomen: $2800
• Brain-Only: $1500

 

Things To Know - Autopsy 101 | Post Mortem | FRONTLINE | PBS

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...How to Get an Autopsy

In some instances, a person may have specified his or her desire for an autopsy, perhaps in conversation or by signing a personal directive. Most states require permission from a doctor, next of kin or other legally-designated party for the private autopsy to be performed.

But with regard to circumstances in which autopsies are required, the laws differ state to state. In certain cases, such as when there is suspicion of foul play, or when a death may be the result of an infectious or contagious disease with dire public health consequences, a medical examiner or coroner can legally order an autopsy without the permission of next of kin or other legally designated party. But these laws, as well as their implementation, vary. For example, according to the Virginia Office of the Medical Examiner, the cases that most often fall under its jurisdiction are deaths that occur when a patient is not under the care of a physician, sudden and unexpected deaths or suspected violent deaths (or deaths where violence cannot be ruled out). You can contact your medical examiner's office to inquire about the laws in your state.

A private autopsy by an outside expert can cost between $3,000 and $5,000. In some cases, there may be an additional charge for the transportation of the body to and from the autopsy facility.

Where To Get One

The National Association of Medical Examiners has this list of resources to help find private autopsies providers.

The College of American Pathologists also provides a list of board-certified pathologists that perform autopsies for a fee in 18 states.

Individuals can also contact local medical examiners and medical schools to perform autopsies, or obtain word-of-mouth referrals from hospitals, funeral homes and attorneys.

Collection and Submission of Postmortem Specimens from Deceased Persons with Confirmed or Suspected COVID-19.  CDC. Updated December 20, 2020. 

[turtlesRcool]

Interesting conversation. A few days ago, one of my colleagues told me about a patient who was recently transferred to her unit from ICU after being made comfort measures only (rapid progression of a non-COVID disease process, but I forget exactly what). Well, transport arrives with the patient, and goes to settle patient into the room, and comes out saying the patient isn't breathing or responding. At just that moment, family members come around the corner, hear the conversation, and that's how they learn their loved one apparently died during the brief transport from one unit to another. They then decide they want an autopsy. On a CMO patient. The nurse had no idea how such a thing was to be handled, and basically arced it up to management to deal with, so I don't know how the story ends. I understand the shock of it, and the desire for answers, but I really don't think the coroner was likely to get involved in this one.