Postmortem Examination | Protocol & Procedure



Postmortem Examination | Protocol & Procedure

All the doctors employed by Health Department, Government of the Punjab working at any Teaching Hospital, District Headquarter hospital, Tehsil Headquarter Hospital and Rural Health Center are authorized to conduct Postmortem Examination. Doctors working at Basic Health Units are not authorized to conduct Postmortem examination.

 

Postmortem examination should be conducted on the written request of Superintendent of Police or another officer authorized on his behalf.

 

Date and time of arrival of the dead body at the hospital should be recorded.

 

Police record, request Form, FIR, Police docket, injury statement should be read very carefully by the Examining Medical Officer before commencing Postmortem Examination.

 

The Postmortem Examination should not be delayed after receiving the complete police papers.

 

During Postmortem Examination, police officials accompanying the dead body are not allowed in the mortuary.

 

The Performa of Postmortem Examination should be filled completely, starting from the identification of the deceased.

 

In known dead bodies, name, father’s name, age, sex, address, caste etc. should be noted.

 

Name of two (2) identifiers should be noted by the Medical Examiner with their father’s name, address and relationship with the deceased. These persons should identify the body in the presence of the doctor.

 

If the body is unidentified, maximum information pertaining to identification should be noted, e.g. sex, length, complexion, color of hair & eyes, tattoos, deformities etc should be recorded.

Names of the Police Constables accompanying the dead body should be recorded with their numbers.

 

Postmortem examination is also conducted to determine the cause of death which may be due to ante mortem trauma, diseases and poisoning.

 

Presence of decomposition/ putrefaction cannot be accepted as a plea not performing a complete Postmortem Examination.  In such cases use of a Mask is recommended.

External Examination of body should be detailed noting:

 

a)      General characteristics of the dead body Including eyes, nostrils, mouth and other body orifices.

b)      Clothes and other personal effects present

c)      Postmortem changes, e.g. hypostasls, Rigor mortis, decomposition, Mummification etc. Hands should be examined for cadaveric spasm & anything grasped in them.

d)      Injuries present of the body particularly any marks of ligature on the neck, wrists and ankles.

e)      Length, breadth and depth of Injuries, presence of any foreign body in them. All the bones should be examined for fractures.

 

Presently, the postmortem examination at night is permitted by the Government If sufficient artificial light is present / available.

 

Internal examination should be thorough. All three cavities i e. head, chest and abdomen should be opened and examined in every case.

 

The chest cavity and abdomen should be opened by chin to pubes incision. The scalp should be opened by ear to ear incision.

 

External Postmortem Examination is an incomplete procedure. Cause of death should not be given without full, internal examination of the body.

 

In suspected deaths due to asphyxia, dissection of the neck should be undertaken after examination of the chest and skull cavities to avoid postmortem artifacts.

 

The organs of the body should first be examined in situ, noting any Pathology, Injury, collection of blood/fluid etc. Afterward each organ should be dissected separately.

 

In case of Fire arm injuries, Radiological Examination of the body should be conducted (If facilities are available) for record, and to facilitate the search for the bullet / pallets.

 

Special precautions should be taken in cases where the history of the case suggests death due to Embolism (e.g. In criminal abortion, Pneumo-thorax e g. in blunt chest trauma).

 

To determine the cause of death as suspected poisoning, appropriate specimens should be sent to Chemical Examiner, Government of the Punjab for detection of poison.

 

To determine cause of death from Pathology or to differentiate ante-mortem trauma from postmortem injuries appropriate specimens should be sent to Pathologist / Histo-pathologist to Govt. of Punjab for detection of poison.

 

Cause Of death should be commented upon clearly, in simple language stating the underlying mode of death. Accidental, homicidal & self-inflicted injuries should be commented.

 

If multiple injuries are present, it should be stated which of the injury / injuries has led to the death of the person individually or In combination.

 

Time elapsed between injury and death should be assessed from site and gravity of trauma, vital signs present in the injury etc.

 

Time between death and Postmortem Examination is to be calculated from Postmortem changes observed in the dead body.

 

After completion of Postmortem Examination, dead body along with signed police papers, carbon copy of Postmortem Examination Report and clothes of the deceased should be handed over to accompanying police officials and receipt should be taken by the Medical Examiner on the Postmortem register.

 

Body after Postmortem Examination is to be handed over to the relatives by the police officials.

In case where there is a material difference in the description of external wounds on a dead body as stated by the Police in the injury statement and those observed by the Medical Examiner or where there are no marks of injury observed on the body whereas marks have been described by the police the matter should be reported to the Distract Administrative Officer who should communicate the same to the Superintendent of Police and District and Session Judge.

 

In cases of female dead bodies, the Postmortem Examination should be conducted by Female Medical officer who should, beside other examination must look for evidence of physical and sexual assault, evidence of pregnancy or any interference with it.

 

In relevant cases, the female genital tract may be sent for chemical examination if indicated.

In cases of new born / infants intra uterine age should be assessed, Signs of still or live birth should be noted down.

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