Post 101 – What Happens in An Autopsy?

Apologies for being late – I’ve been very busy! Plus had computer issues 😦 Hopefully this is worth the wait!

Many of you have heard of the sudden tragic death of actor Paul Walker and his friend Roger Rodas. Paul was an actor known for the “Fast and Furious” film series.  The autopsy report was released this past Monday (1/6/2014) showing that he died of accidental “Combined Effects of Traumatic and Thermal Injuries.” I know this may have some interest among my past students. Some of my Cypress students are even in the mortuary science program there. Instead of dwelling and gawking on the death, we can use these reports as a learning tool to see what happens in an autopsy.

I was fortunate in my training to be taught by the same medical examiner who autopsied Elvis. He had a running joke about Elvis being alive that I can’t publicize here. 🙂

Background: Coroner vs. Medical Examiner

Same thing. They are both government officials. I remember someone telling me that a Coroner is elected and a Medical Examiner is appointed, but I can’t find confirmation of that today. The head of the Los Angeles County Coroner is a medical doctor. You might see his name on some of the autopsies below as Chief Medical Examiner. In Orange, San Bernardino, and Riverside Counties, the Sheriff is also the Coroner.

No matter what you call them, their department is responsible to investigate deaths and injuries that occur under unusual or suspicious circumstances, to perform post-mortem examinations, and in some jurisdictions to initiate inquests.

When does the coroner get involved?

Los Angeles County Coroner has a PDF that states: California State Government Code and Health & Safety Code require [sic] that the Coroner be notified whenever a person dies and their death is the result of criminal means or other unnatural causes. Additionally, certain other natural deaths fall under the jurisdiction of the Coroner simply because there either is no physician to sign a death certificate, or the physician is unwilling or legally prohibited from doing so.

Their reports are admissible to the court, and that’s when you hear about them too. They work in both the medical and legal fields.

Investigator

So they will investigate any unnatural death, including those that happen in the hospital. But many of you are more familiar with a crime scene and seeing a “Coroner” vehicle on TV. The investigators are the “CSI” of the department. They gather evidence, talk with witnesses and law enforcement personnel and make an initial examination of the body. You can see how systematic they approach the scene in several of the autopsy reports below from Los Angeles County – look for FORMS 1 and 3 (sometimes FORM 3 is just a narrative, without a number).

Autopsy

The investigator will take possession of the body and return it to the Coroner’s office. In Los Angeles County, the Coroner’s office is near the 5/10 interchange east of Downtown Los Angeles, near County USC Hospital. Orange County Coroner’s Office is in downtown Santa Ana near all the other government buildings.

Like on TV, they will keep the body in the refrigerator, about 41 degrees F, unless some decomposition has already started – then there might be a colder fridge. (Riverside County Coroner)

Before the dissection of the body happens (the actual autopsy), the body sometimes undergoes X-ray and other examinations – you’ll find some of these in LA County’s FORM 13 – consultation addendums in the autopsy reports below.

When it’s time for the autopsy, a pathologist will systematically cut the body and observe and remove organs. The organs are described and weighed. Sometimes pieces of it are cut off and preserved in jars or sectioned on to slides for further testing and observations. You can read about the autopsy narrative in LA County’s FORM 12. Usually the person doing the autopsy will have at least one assistant (maybe), and the autopsy rooms I’ve seen have a microphone hanging from the ceiling next to the surgical-quality lights that can be moved around.

There’s a pedal under the table the body lays on that the doctor can turn on/off the recording. He’ll use this as the basis for the autopsy narrative.

Specimens removed may be used for toxicology testing (under FORM 13) or other analyses.

I have included links to autopsy reports that are publically released and available from Los Angeles County Department of the Coroner. They make a good review of anatomical terminology and body systems, as that’s how they perform the autopsy and organize the report (look for FORM 12 for the doctor’s autopsy narrative).

Once done with the body, the coroner will release the body, usually to the funeral home. The coroner is allowed to assess costs for transportation and storage. They are usually passed along by the funeral service provider. For Orange County, this fee is $318.

Visiting Museums

For those of you who really are morbid, you can view dead bodies at Loma Linda School of Medicine – I understand it was closed for relocation to Centennial Complex, and due to re-open Fall 2013. But they

And the Bodies Exhibit is in Buena Park and the Luxor in Las Vegas. Be sure to look at online and student discounts.

See my prior blog on these Bodies exhibits.

Yes, LA County Coroner’s Office has a gift shop … http://www.lacoroner.com/

The PBS series Frontline has a program entitled “Post-Mortem: Death Investigation in America” that may be worth watching – http://www.pbs.org/wgbh/pages/frontline/post-mortem/?utm_campaign=homepage&utm_medium=proglist&utm_source=proglist

If there isn’t big news this week on anatomy, maybe I’ll talk about what organs can be donated at time of death. Be sure to check out the Prof Chang Twitter Feed: @prof_chang

References:

 

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