Introduction

Not everyone who dies in Victoria is admitted to the Victorian Institute of Forensic Medicine. Only those people whose death occurred in greater metropolitan Melbourne and whose death is reported to the coroner are admitted. Some deaths in rural and regional Victoria are admitted to VIFM; however most are admitted to a regional hospital closer to where the death occurred.

These deaths include unexpected, sudden or traumatic deaths or deaths where the cause is not known. In 2009 there were 3,084 people admitted.

All deceased admitted to VIFM undergo a preliminary examination by a forensic pathologist who provides the coroner with information and advice about whether an autopsy is necessary. The majority of forensic autopsies are conducted where people have died from unexplained natural disease, suicides, accidents, where the circumstances of the death are unknown, or where homicide is suspected.

What Happens When a Death Occurs

In general terms the following process occurs:

A death occurs and an ambulance or police are called. The death is reported to the coroner. The deceased is transported to the Institute by a funeral director.

A CT Scan of the deceased is performed. This is just like an x-ray in a hospital and sometimes rules out the need for an autopsy. It is also useful for cultural or religious reasons as some cultures are not in favour of autopsies.

A pathologist examines the deceased and the CT scans, as well as available records and police reports, and advises the coroner as to whether an autopsy is necessary.

The deceased’s family may then be contacted by the nurses at the Donor Tissue Bank of Victoria (DTBV) to see if the family of the deceased would like to donate tissue such as skin, heart valves, bone or corneas for transplantation. Some families do not wait for the DTBV to call, but initiate contact themselves, or inform Coroner staff of their wishes when speaking to them.

A series of examinations are conducted employing such disciplines as pathology, radiology, histology, molecular biology (DNA), microbiology, odontology, anthropology and toxicology.

The forensic pathologist then produces a report bringing together the various strands of the Institute’s work and provides this to the coroner.

The coroner then decides, taking into account other information as well, whether or not to conduct an inquest.

Ultimately, it is the coroner’s responsibility to formally conclude, based on the Institute’s advice and other information, who the deceased is, how death occurred and the cause of death.

Deaths reportable to the coroner include those that are:

• Unexpected deaths, for example, under anaesthesia;
• Violent or unnatural deaths, for example homicide, suicide, accident or injury,
• If a person was ‘held in care’ prior to death, for example in police custody or in prison;
• Deaths where a doctor is unable to sign a death certificate;
• If the identity of the deceased is unknown.

What is an Autopsy?

An autopsy is a thorough medical examination of the deceased, externally and internally, employing techniques similar to a surgical operation.

During the autopsy the major organs of the body are removed for examination by the pathologist, and specimens such as blood and tissues for scientific analysis are taken.

Specimens may be tested to determine the identity of the person, to detect infection or the presence of drugs or poisons.

Once the post-mortem examination of the body is complete, a forensic technician prepares the body for release to the funeral director. The release requires both the pathologist and the coroner’s agreement beforehand.

What is the Purpose of an Autopsy?

The aim of an autopsy is to discover information which may assist with conclusions about:

• The identity of the deceased person
• The nature and extent of any disease the deceased has
• The cause of the death
• The circumstances of the death and how the death occurred
• The existence of natural disease that could affect other members of the family or members of the community.

An autopsy is also a public health procedure. The results of the autopsy can inform treating medical practitioners about the disease(s) present in the deceased and about the effects of medical treatment. In forensic cases, the results of autopsy can assist police and the courts in assessing evidence in criminal proceedings.

Given the value of the autopsy for public health and the administration of justice, it is essential that the results of an autopsy are recorded in considerable detail.

This is usually done by the pathologists preparing an autopsy report which is a written description of the autopsy findings and includes the pathologist’s comments regarding the autopsy findings and the medical cause of death. This medical cause of death is usually adopted by the coroner.

Please note:

This brief summary is not intended to be a complete description of the role of the coroner in death investigation. If further information is required, please visit the Coroners Court of Victoria website: http://www.coronerscourt.vic.gov.au/

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