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The Coronial Admissions and Enquiries Office

The 24-hour Coronial Admissions and Enquiries (CAE) office is operated by the VIFM.

CAE staff work closely with families providing them with information and support throughout the initial investigation, particularly to those families who need to attend the VIFM in order to view the body of their family member for identification purposes. The CAE team who support the duty coroner and duty pathologist include senior nurses and medico-legal executive assistants. They are supported by forensic mortuary staff, administrative staff, forensic odontologists and forensic anthropologists.

Our nursing and administrative staff directly support coroners and pathologists in the earliest stages of the death investigation. This includes coordinating the initial stages of the coronial investigation and the collection of accurate legal and medical information. A part of the CAE role is to respond to medical enquiries from doctors and provide advice as to whether a death is reportable.

CAE staff will help if you want to see or spend time with your loved one and will talk to you about who will be the senior next of kin. Any communication about the coronial investigation will be made through that person or their chosen representative.

The role of CAE is to:

  • receive reports of deaths
  • take a person’s body into the care of CAE
  • coordinate identifying the person who has died
  • coordinate the medical investigation into a death for the coroner
  • release a person’s body for the funeral.

What to do following the death of a family member

We understand that there may be many questions following the loss of a loved one. Below are a number of resources that will help you negotiate the coronial process:

Coroners Court of Victoria – https://www.coronerscourt.vic.gov.au/families

Resources and support services for families – https://www.servicesaustralia.gov.au/death-loved-one

Support agencies – https://www.coronerscourt.vic.gov.au/families/support-services

Forms you may need

www.coronerscourt.vic.gov.au/forms-resources/find-a-form

Post Mortem Examination – An Explanation For Families

There are a number of medical processes that may be used to investigate a death. Only 10% to 20% of deaths are reported to a Coroner and just less than 50% of these deaths require a traditional autopsy. The Coroner is not a medical practitioner but a lawyer whose role is to investigate particular deaths that parliament has determined need an independent legal investigation.

This information is for families whose loved one has died and who may wish to understand more about post-mortem examinations and the types of investigation that may be required to determine how someone has died.

What is an autopsy?

An autopsy is a medical procedure that is carried out to find out as much information as possible about why your family member has died. It is conducted by a medical specialist known as a forensic pathologist to determine a range of information regarding a death. If a pathologist recommends an autopsy as part of the medico-legal investigation of a death, this recommendation will be discussed with the nominated Senior Next of Kin. In the end it is the decision of the Coroner as to what level of investigation will be undertaken and the Senior Next of Kin will be consulted regarding whatever the Coroner decides.

A pathologist may recommend an autopsy to determine:

  • The identity of the deceased person
  • When a person died, the nature and extent of any disease they suffered from recently, or may have suffered in the past
  • The nature and extent of any injury
  • The circumstances that surround how they died
  • The cause of their death
  • Information on natural disease or injury that has the capacity to contribute to preventing the death of another member or the community in related circumstances.

An autopsy can inform your family medical practitioner about the effects of medical treatment that have been provided, and it can also assist police in assembling the evidence required for criminal proceedings, if relevant.

The different types of post mortem examination

Prior to conducting a physical examination of the body, the preliminary stage of the medico­ legal death investigation involves:

  • The review of medical records
  • Statements and/or circumstantial information
  • Reports surrounding the death
  • Review of a post-mortem CT scan.

This preliminary information allows a pathologist to focus on the important issues that may be in doubt about what happened to the deceased.

Preliminary stage and Inspection and report

The physical examination of the body starts with a detailed external examination of the body, which is very similar to the external examination of a living patient. Scars and artificial marks such as tattoos are described, and these can assist with confirmation of identity.

Many internal diseases in the body are associated with changes that can appear in the skin, so that a detailed external examination of the body can be of considerable importance in focusing the subsequent internal examination.

An external examination may also include a CT scan that provides a detailed internal image and photographs, and limited toxicology testing to identify medications and illicit drugs. The panel that is able to be performed at this stage is limited and not exhaustive. The pathologist may also request further testing.

Following the completion of the preliminary examination, the pathologist will what a reasonable cause of death might be and come to a medical opinion as to whether a partial or full autopsy is required, or if a reasonable cause of death can be provided with the currently available information. The pathologist then provides the Coroner with this information/opinion. The Coroner then takes this information into account, along with legal aspects of the investigation process and any known wishes of families in coming to their decision of as to whether or not to direct an autopsy to be performed.

The Coroners decision to have an autopsy performed is communicated to the Senior Next of Kin, by the Coronial Admissions staff and you may either accept this decision or ask for a reconsideration of the coronial decision. You will have the opportunity to ask questions or to express concerns and it is important that your questions are answered before you decide what to do.

Autopsy

A pathologist conducts a full external and internal examination of the body. The internal examination is a surgical procedure that takes place in a mortuary environment using instruments that are the same as normal surgical instruments.

The full internal examination requires the pathologist to carefully removes the internal organs and the brain and examine them thoroughly before returning them to the body.

As well as visually inspecting the individual organs, small samples of tissue (biopsies) are taken for histology, (examination under the microscope). Some pathological examinations may also require small tissue samples to be taken for analysis or the involvement of other pathology specialists such as neuropathologists, toxicologists or pediatric pathologists. In a limited number of circumstances there may be a request from the pathologist and coroner for retention of an organ to allow for further examination. In circumstances where this is required the family is consulted and appropriate arrangements made for respectfully dealing with the organ following the more detailed examination.

Partial Autopsy

A partial autopsy involves the pathologist conducting a full external examination but limiting the internal examination to specific areas or organs. A partial internal examination includes the pathologist carefully removing these specific internal organs and examining them examination before directly returning them to the body.

Advantages of autopsy

  • An autopsy provides one of the best ways to establish the cause of death. It can provide valuable information to courts in both criminal and civil (compensation)matters and assist treating doctors who may need the results of an autopsy to be able to treat family members who may be at risk of suffering from similar medical conditions
  • In the absence of an autopsy, in some cases there may be medico-legal questions in relation to criminal matters or civil claims for compensation that are unable to be adequately addressed.

Disadvantages of autopsy

  • An autopsy is not always able to provide a specific or unequivocal cause of death. However, the report of a full autopsy is able provide a detailed record of the medical examination and the findings.
  • A full and detailed examination may delay funeral plans for some families who require a rapid internment or cremation.
  • An autopsy involves incisions and suture lines. In most circumstances the sutures will not be visible after your relative is dressed and an autopsy does not prevent embalming taking place or inhibit the viewing of the deceased as part of funeral arrangements.

Collection of samples during autopsy

During an autopsy, body fluids and tissues may be collected for specialist toxicological or histological analysis.

Toxicology testing is designed to indicate the presence or absence of particular drugs, poisons or chemicals. This analysis may be very significant in reconstructing how the death occurred, and in many cases, may reveal the cause of death.

Depending on the types of drugs or poisons that maybe involved, it can take many weeks for the analysis of these fluids and tissues to be completed. In some cases, rapid toxicological analysis of blood samples can be performed and in certain cases this rapid analysis is a critical component of the preliminary examination.

Tissue biopsies are also collected for examination under the microscope (histology) to help determine the cause of death and the nature and extent of any disease or injury that may be relevant to the cause of death.

The Autopsy Report

The completion and review of all of the scientific and medical tests can take from 12 to 20 weeks, depending on the complexity of testing required. An autopsy report is then completed by the pathologist that contains the results of the autopsy findings together with the results of any specialist tests that have been undertaken.

Family – Frequently Asked Questions

The administrative and nursing staff of the coronial admissions office will contact the family shortly after a death to help work out who is the senior next of kin. They will explain the first steps in the coronial process to the family and answer any questions that the family may have. If you have not received a phone call within 48 hours or would like immediate information you can call the coronial admissions office at any time on 1300 309 519.

The nursing and administrative staff at the CAE will communicate directly with you and will usually request information to assist the investigation, such as:

  • Any known medical history of your family member
  • Any issues you would like the Coroner to investigate
  • Information on who will organise the funeral (this does not need to be provided immediately- only when you and your family is ready)
  • Your family’s views on whether an autopsy should or should not be conducted.

One of the responsibilities of the coroner is to confirm the identity of the person who died. In most cases this is by visual recognition at the place of death by someone who knew the person. If identification is not completed at the place of death, an appointment will be made with a family member to attend the VIFM to view the deceased and confirm their identity. When the family attend VIFM for a viewing they will be greeted by the nursing staff in a waiting area. The staff are available to answer questions about the coronial process and will explain what will happen during the viewing. reception. The viewing takes place in a small room with the deceased behind glass, covered in a sheet with only the face uncovered.  The nurse will be there throughout to support the family at this difficult time.

The best place to view your family member is at your nominated funeral home. If this is not possible, a time may be arranged for a viewing to take place at the VIFM. This needs to be by appointment in order for us to give you the appropriate support.

When a family attends VIFM for a viewing they will be greeted by the nursing staff in a waiting area. Firstly, we will answer any questions about the coronial process and will explain what will happen during the viewing reception. If the viewing is for the purposes of identification, a family member will be asked for their identification, such as a drivers licence. Following the viewing they will then be asked to sign a Statement of Identification. The viewing takes place in a small room with the deceased behind glass, covered in a sheet with only the face uncovered.  The nurse will be there throughout to support the family at this difficult time.

In most circumstances, all personal possessions that are received by the VIFM are given to the family nominated funeral directors.

Medical examinations are carried out on all deceased persons and every person admitted to the mortuary will undergo a radiological examination in the form of a whole body CT scan. Depending on the circumstances of the death, the Coroner may only require an external examination of the deceased combined with other tests. However, an internal examination or autopsy may still be required in some cases. Today less than 50% of medical investigations involve a full autopsy.

A Forensic Pathologist will undertake the medical examination or the autopsy on the deceased person. A Coroner establishes the identity of the person who died, the cause of the death and, in some situations, the circumstances surrounding the death or fire.

Your nominated funeral director will confirm with your family when your loved one has been released by the coroner into the care of the funeral director.

Your family can make contact with a funeral director at any time. The funeral director will then liaise with you and also with the CAE to assist in the planning of funeral arrangements.

The Coroner provides the Registrar of Births, Deaths and Marriages with information about the cause of death so the death can be registered. When the death has been registered it is the Registrar of Births, Deaths and Marriages who issues the death certificate.

For more information please refer to the Coroners Court of Victoria website https://www.coronerscourt.vic.gov.au/

Family Health Information Service

The VIFM Family Health Information Service contributes directly to the health of the community in Victoria. While the coronial death investigation process is undertaken with the primary purpose of investigating the cause and circumstances of an individual’s death, it may also uncover previously unknown medical conditions that may have a genetic basis and therefore be significant to the healthcare of surviving family members.

When a medical condition is identified, the case is referred by the forensic pathologist to the VIFM Family Health Information Service nurse who then contacts the senior next of kin to offer explanation of the condition.  The family will also be forwarded a letter in plain language suitable for sharing with family members or taking to their GP.  In some circumstances, the service facilitates a referral to an external genetic health service or other medical specialist. Our nurses work with families to collect background information, including the medical history of both the deceased individual and their family to enable medical specialist follow-up and when requested, release of samples suitable for genetic testing.  

Awareness of these previously unknown health risks enables families, with the help of clinical specialists, to plan a healthcare strategy to prevent premature illness or death among those family members at risk, and to maximise family health and welfare.

What Do Families Need to Know?

In some cases, following a relative’s autopsy, a Family Health Nurse may contact family members to discuss potential genetic health issues.

Identifying an Undiagnosed Disease

The pathology investigation into a death often uncovers a range of previously undiagnosed and unrecognised disease processes which may or may not have contributed to the death but may indicate a genetic susceptibility to a particular disease that may be shared by other family members.

Referrals

When a previously unknown medical condition is identified by a pathologist during the medical examination the patient is referred internally to a specialist nurse from our Family Health Information Service.  Our nurses then contact families to explain the findings to them and to collect background information including the medical history of both the deceased individual and their family.  This enables us to identify where it may be important to offer genetic testing and to ensure appropriate samples for DNA analysis are obtained and stored.

Where appropriate we will facilitate the referral of families to an external genetic health service or other medical specialists and act as a clinical liaison to:

  • Contact the senior next-of-kin to offer family health information
  • Confirm information in writing and provide plain language information suitable for sharing with family members
  • Discuss family medical history
  • Provide medical specialist referral where required.

Resources for Health Related and Family Support Information

The Health Translations Directory

The Health Translations Directory is an initiative from the Victorian Government of Australia. The Health Translations Directory provides direct links to reliable translated health resources produced in Australia hosted on third-party websites.

http://healthtranslations.vic.gov.au/

The Cancer Council Victoria

The Cancer Council Victoria provides detailed information about all cancer types, cancer treatments and prevention, as well as support services.

http://www.cancervic.org.au/about-cancer/cancer types

The Better Health Channel

The Better Health Channel website provides health and medical information to help people understand and manage their health and medical conditions.

https://www.betterhealth.vic.gov.au/

The Heart Foundation

The Heart Foundation website provides comprehensive information about cardiovascular disease, currently the major cause of death in Australia.

For general information click on: https://www.heartfoundation.org.au/

For information on how your heart works and heart attack
symptoms: https://www.heartfoundation.org.au/your-heart/how-your-heart-works

Dementia Australia

Dementia Australia provides a wide range of resources for patients, families and health professionals.

https://www.dementia.org.au/

Diabetes Australia

Diabetes Australia provides a valuable source of information, advice, advocacy and programs.

https://www.diabetesaustralia.eom.au/

Asthma Australia

Asthma Australia provides comprehensive information and resources for asthma sufferers.

https://www.asthmaaustralia.org.au/national/about-asthma

Mental Health Support

There are many online resources dedicated to mental health conditions, wellness and support:

https://www.beyondblue.org.au/
https://kidshelpline.com.au/
https://www.sane.org/
https://www.lifeline.org.au/

Coronavirus (COVID-19) Victoria

https://www.coronavirus.vic.gov.au/

Epilepsy Foundation

https://epilepsyfoundation.org.au/

For more information on the coronial process, please refer to https://www.coronerscourt.vic.gov.au/families