How It Is Done
Before the actual autopsy, as much
information as possible is gathered about the person who died and the events
that led to the death. This includes reviewing medical records and consulting
with the person's doctors about previous medical problems. Other information
may be gathered by interviewing family members, investigating the area where
the person died, and studying the circumstances surrounding the death.
Depending on the circumstances of the death, law enforcement and the medical
examiner's or coroner's office may be involved in the investigation.
Procedures done during the autopsy may vary depending on the
circumstances surrounding the death, whether the medical examiner or coroner is
involved, and what specific issues are being evaluated during the
autopsy.
The autopsy begins with a careful examination of the
external part of the body. Photographs may be taken of the entire body and of
specific body parts. X-rays may be taken to evaluate skeletal or other
abnormalities, confirm injuries, locate bullets or other objects, or to help
establish identity. The body is weighed and measured. Clothing and valuables
are identified and recorded. The location and description of identifying marks,
such as scars, tattoos, birthmarks, and other significant findings (injuries,
wounds, bruises, cuts), are recorded on a body diagram.
A complete
internal examination includes removal of and dissection of the chest,
abdominal, and pelvic organs and the brain. The examination of the trunk
requires an incision from the chest to the abdomen. The removal of the brain
requires an incision over the top of the head. The body organs are examined
before removal, then removed and examined in detail.
In some
cases, organs may be placed in a preservative called formalin for days to weeks
prior to dissection. This is particularly important in the examination of the
brain for certain types of diseases or injuries. Tissue samples are taken from
some or all of the organs for examination under a microscope. Samples of blood,
organs, and body fluids may be removed and preserved to test for the possible
presence of drugs or infection or to evaluate chemical composition. Samples may
include blood from the heart or blood vessels,
vitreous gel from the eyes,
bile from the gallbladder, contents of the stomach,
urine, and tissues from organs, such as the liver.
Completion of
the autopsy may require examination of tissues under a microscope, further
investigation of the circumstances of death, or specialized tests (such as
genetic or toxicology tests). The tests performed may vary based on the
findings at the autopsy dissection, the circumstances of death, the questions
asked about the death, and the condition of the tissues and body fluids
obtained at autopsy. Toxicology testing is not generally performed in every
autopsy, particularly those not required by law. Genetic testing is not usually
done unless the family has been consulted. A written report describes the
autopsy findings. This report may address the cause of death and may help
answer any questions from the deceased person's doctor and family.
If the autopsy was required by law, after the autopsy is completed, the
pathologist, coroner, or medical examiner completes and signs the cause and
manner of death on the death certificate. If the autopsy was not required by
law, the doctor caring for the person prior to death often signs the death
certificate and may complete it before the results of a family-requested
autopsy are known.