What determines if a patient is autopsied?

[HealthShepherd]

Hello everyone.

For those of you who work in hospitals - what is the process for deciding on an autopsy? Is it something that family members can request, or entirely at the doctor's discretion?

In my unit (NICU), most deaths are expected... i.e., they happen as a result of a decision to withdraw care... I've been wondering how it works in an area like med-surg where you occasionally walk into a room and discover the patient dead.

Thanks, Rhymeswithlibrarian

[nurse2033, MSN, RN]

My hospital has a set of specific criteria. The coroner's office that covers you should also be able to supply the criteria. Usually things like within 24 hours of surgery or 24 hours of admission but I'm sure it varies.

[BrnEyedGirl, BSN, MSN, RN, APRN]

I work ER, we have to call the Coroner's office for all deaths, to release the body. Those who are unwittnesed trauma, or any unexpected death are usually autopsied, and of course anything that is suspect of foul play.

[sharpeimom]

not a hospital nurse, but when my healthy 52 year old athletic father dropped dead totally unexpectedly, the coroner said it was probably his heart. he had spent a week at the cleveland

clinic being thoroughly tested because he and his cousin had been in a private plane crash a few

months before (caused by unexpectedly strong tailwinds) and both had been pretty banged up.

all tests on every part of his body had come back negative, he drove home and died the next evening.

his internist and our next door neighbor and friend who was a cardiologist were determined to find a

cause.

for that reason, an autopsy was ordered. no cause was determined. his heart and vessels were fine.

sometimes, the m.d. just has to know why.

[Penelope_Pitstop, BSN, RN]

Our hospital likes to perform autopsies on certain cases, but unless it is a medical examiner's case, the family has a right to refuse the autopsy.

[Belle Epoque]

Hospitals have their own criteria like death occurring within 1 week of an invasive procedure or major trauma, death under anesthesia, during or after surgery, death following an unscheduled readmission, maternal postpartum death, death related to occupational exposure, stuff like that.

In LTC every 10th death is an automatic coroner's case.

I've had families of patient's with rare diseases prearrange autopsy when death occurs, for scientific data, etc.

[Neveranurseagain, RN]

When my husband died (of a medical incident) I requested a private autopsy done. It cost about $6000 and was done at the mortuary. Thought it was kinda weird that you call 1-XXX-AUTOPSY. They even have a gift catalog!!!!????

Gift Catalog

[LG1137]

In my state, a doctor had to be willing to sign a death certificate, otherwise it became a coroner's case. Also, treatment by a physician within 20 days of death made that an "attended" death, and the doc could sign the cert, if he was willing (prob wouldn't if he saw the pt just one time ever). MOST ER death were coroner's cases, depending on the relationship with the coroner's office at the time. (There were some deaths that were not reported that should have been). There are also different types of autopsies. A basic autopsy, which I have seen performed in the garage of a mortuary (yes, for real), and a forensic autopsy, which is what you might see depicted on a reality TV show about coroner's investigations. And also the cases mentioned by previous posters.

That's all I know. Bye for now.

[caroladybelle, BSN, RN]

Certain cases are reported to the coroner by law - not all of those actually get autopsies. The coroner/medical examiner may determine that no autopsy merited.

Other cases are requested by family and/or physician, generally for rare illness or when cause of death is in question. If requested by family with no foul play/error suspected, they pay the fees which can be high.

In addition, some teaching facilities require staff to actually attempt to push for autopsies. It is done so rarely that fewer new MDs get adequate experience or expertise. One hospital actually has special personnel to request them. This is less likely in a nonteaching facility, where they are generally done only if requested or required for cause.

[Penelope_Pitstop, BSN, RN]

When my husband died (of a medical incident) I requested a private autopsy done. It cost about $6000 and was done at the mortuary. Thought it was kinda weird that you call 1-XXX-AUTOPSY. They even have a gift catalog!!!!????

Gift Catalog

Dagnabbit! You tell me this *after* I complete my Christmas shopping...

[sharpeimom]

dagnabbit! you tell me this *after* i complete my christmas shopping...

don't forget that valentine's day is just around the corner...:redbeathe

[indigonurse]

I noticed that there was a list of when to call the coroner in the policy and procedure book.