procedure

Hospital Autopsy Procedure Dr. Nadia Giannakopoulos Medical Council June 20, 2019

Hospital Autopsies • Fatality Inquiries Act dictates which deaths must be reported to the medical examiner • If there are unanswered questions around the death (or ME office turns down autopsy), a hospital autopsy can be performed – Strict legal guidelines around obtaining consent

• RAH has a teaching autopsy service • Autopsies must be ordered by treating clinician – we don’t do “family requested autopsies”

FAQs About Autopsy • Incisions made during the autopsy will not be visible after the body is prepared for viewing • Partial autopsy can be performed (i.e. only specific organs, no brain, etc) – Can be appropriate for some cases

• Organs are returned to the body for burial – only small pieces of organs are retained for histologic examination • Not all questions can be answered at autopsy

How to order an autopsy • Ask the deceased’s legal next of kin if they would like an autopsy • If they would like an autopsy, complete Autopsy Consent and Anatomical Pathology Autopsy Consultation Request • Required documentation is sent to Admitting (06:45-14:45) or to ER Admitting (14:45-06:45) • Admitting notifies Pathology and sends paperwork to lab

Required Documentation • Complete Autopsy Consent and Anatomical Pathology Autopsy Consultation Request • Attending Physician’s Medical Certificate of Death • Patient Care Medical Records • Notice of Death (CH-0136)

Autopsy Consent Form • Insite

– Under Header “Teams” – Lab Services – Right side of page: Forms & Requisitions – Edmonton Zone: Autopsy Consent and Consultation Request Form

• https://www.albertahealthservices.ca/assets/ wf/lab/wf-lab-ch-0275-edmonton-zoneautopsy-consent-form-and-consultationrequest.pdf

Autopsy Consent Form • Legal next of kin must sign consent form • Designate complete or partial autopsy • Phone consent acceptable – Need second witness!

Autopsy Consultation Request • Must be signed by the ordering physician

– If incomplete and ordering physician is offshift, can lead to delays because we need to track down ordering Dr

• Must include some clinical history

– Ask your specific clinical questions

Attending Physician’s Medical Certificate of Death • Completed and signed by attending physician (done for all deaths)

Notice of Death • Nursing completes this form and sends to admitting (done for all deaths)

Questions About Autopsy? • If you are unsure about whether your clinical question can be answered by autopsy, call the pathology department and you can discuss with the Autopsy Pathologist • During the day, staff can page the Morgue Pager (445-5281) for assistance from the autopsy attendant about how to order an autopsy