The autopsy is a medical version that is performed to determine the cause of death, the scientific reason someone died to figure it out. A medical examiner or pathologist will work for it. Sometimes the autopsy is inconclusive. It often takes a toxicology report to determine if someone had drugs, alcohol, or another substance in their system and whether death is a homicide or natural accident, or suicide. That’s the manner of death, and that’s a legal distinction.
What really happens during an autopsy procedure? If you’ve been following the news surrounding the Michael Brown killing, then you’ve probably heard about the multiple autopsies that have been requested. The county medical examiner’s office did the first. The family requested the second, and the US Department of Justice conducted the third one.
Three autopsies is a lot to perform on a single body, so why are they doing this? What’s the point? Can additional autopsies provide new information? Sometimes, yes. This is a high-profile case, so, understandably, multiple autopsies might be warranted. For the most part, as long as the first autopsy was performed correctly, there’s no need for a second or third.
What is an autopsy?
Anatomical pathology technologists are trained to open the dead body, and they’re the people who work in the mortuary. They are known as forensic pathologists. The words autopsy and post-mortem are interchangeable. That’s because they mean the same thing. Autopsy comes from the Greek meaning “to see for oneself.” It means to open up the body, look inside and see the cause of death. The post-mortem is from the Latin means “after death.” So it’s an examination that’s done after death to find out why somebody died.
The vast majority of post-mortems in the UK are done for the coroner. The coroner is somebody with a legal qualification. And it is their responsibility to find out who died, how they died, when, and where they died. Around 500,000 deaths every year in England and Wales. And about 45% of those are referred to the coroner.
What happens during autopsy?
First, the examiner looks at the body clothes for any evidence of trauma, blood, or any signs of injury. Next, they remove the clothes to inspect the skin and physical exam further. X-rays may be taken to reveal what may potentially be inside broken bones and bullet locations. And examiners will take a further look at examining the organs in place before removing them and weighing them. This often includes the brain.
Autopsy procedure step by step
There is 2 process that follows during autopsy.
- Internal examination.
- External examination (Skull, Thorax, Abdomen).
There’s the external examination where they look at the outside of the body. And they try to find evidence of injury, disease, or anything that appears out of the ordinary. Anything on the body relevant to the case, like clothing, gunpowder residue, or DNA from another person, gets sent to a different lab for analysis. And everything is documented with photographs.
Then, there’s the internal examination where they cut the body open, starting at the shoulders and going down to the groin. In a standard autopsy, they’ll look at organs in the chest, abdomen, and pelvis. If other parts of the body are suspected to be involved in the person’s death, like the legs, arms or even the brain, then those also get inspected. The purpose of this is to examine the patient’s organs.
Many of the instruments used for the postmortem are not particularly specialized, like rib shears, scissors, knives, rib cages, rib fields, etc. There are a lot of steps involved, and forensic pathologists perform autopsies. And they’re generally split into two separate procedures.
Step 1, Personal identity of corps: Pathologists will first check the label to see who it is, weight, height, name, date of birth, and so on. And after that, if there is any clothing on the body, they take that off. They also cover the private parts. Now the dead body will be lying down on the table with the head elevated a little. And it’s time to clean the body. Then they inspect the body, such as where all the blood has settled. This is called lividity, and if you’ve watched TV crime shows, you’ll know that dead bodies will have purple parts where that blood has settled.
Step 2, Determination of cause and manner of death: The pathologist will collect the sample and preserve it safely. They check all vital signs because no one wants to bury a living person. The dead bodies can groan and move, but that’s just because gases are in the body and muscles harden during that period. It is called rigor mortis when the body goes stiff. To release gases, pathologists use something called a trocar, which looks a bit like a funnel. In mediacal term it is known as “cadaveric spasm”.
Step 3, Physical examination: The next step, Pathologists make sure the eyes are closed, either by using a skin-colored glue or eye caps that are skin-colored. No one wants to turn up to a casket and see a gaping mouth and wide-open eyes staring at them. Then they find the common carotid artery and drain the blood vessels. At the same time, they inject embalming chemicals into the arteries. They use an electric pump for this, which works kind of like the heart.
The blood comes out, and the fluid goes in. This process is all about preserving the body. There’s also cavity embalming, which first involves putting one of those trocars into the chest cavity and getting out all the fluids and gases. After that, a formaldehyde-based chemical embalming mixture will be put in those cavities. If there are some places where the chemicals haven’t been reached, they have the option of doing something called hypodermic embalming. It is just finding the right spot to inject the chemicals. In that case, cauterizing chemicals will be used to dry the wounds and bleach them.
If there are big holes, pathologists use fillers such as plaster of Paris and then color the filler with a spray tan. Dead bodies aren’t always the sweetest smelling things globally, so they use powders to make them more pleasing to the olfactory sense.
Step 4, Opening of body cavities: Now, it’s time to open the body to examine the internal body parts. Pathologists make what’s called a “Y-Incision.” It is a Y shape starting from the shoulders that meet at the chest and goes down to the pubic area. Now the organs are exposed.
The next step is to make a series of cuts to sever certain parts of the body connected under the hood. It means disconnecting organs attached to the spinal cord, and it’s just a lot of snipping around. Once the snipping is done, the pathologist will then remove the organs. He’s going to kind of scalp, cutting from one ear, across the forehead, to the other ear, and around. That cut is divided into two parts, and those parts of the scalp will be pulled from the skull. When that cap comes off, it makes a kind of popping sound.
The brain is connected to the spinal cord, so that connection has to be severed. Once that’s done body can take it out. What’s taken out will now be analyzed. The body’s stomach contents will be examined, as will eye fluid, bile, urine, liver tissue, and blood tests will be done on top of that. The following important task is to reconstruct the body and sew it up. Every stage pathologist bears in mind that this is somebody’s loved one, and they may want to see them again afterward.
Step 5, Autopsy report: After all organs have been analyzed and the medical examiner has said the cause of death, those organs could take many journeys. Samples of the patient’s blood, urine, and other fluids are also collected and sent to a toxicology lab to look for evidence of drugs, alcohol, or poisonous substances in a person’s system. Anything else that’s left gets put back inside the body. They send back to the funeral home, at which point the family is issued an official autopsy report, as well as a certificate of death.
They might just be disposed of, or they might be preserved the body. Unfortunately, some bodies are pretty much beyond repair. They have decomposed so severely that there’s nothing to do to make them presentable.
In these cases, the pathologist will seal the body or body parts and refrigerate them in the morgue. That funeral has to be quick due to the stench of decomposition. In most cases, though, they can embalm the body, even if it’s in a bad state. As gruesome as the whole process is, forensic pathologists have to be very careful when performing autopsies. They’re required to make all of their incisions, such that an open casket funeral can still be conducted if the family wants it.
The most common cause of death ischemic heart disease. A blockage in those vessels is one of the hardest things to see on imaging. It can be only a couple of millimeters long, and the FIR departure can be only one or two millimeters wide. So that’s quite hard to see. A combination of imaging and perhaps with some targeted biopsies may be the post-mortem of the future on average.
Full autopsy process overview (During & After Autopsy)
First, pathologists remove the lungs and heart, then loosen the skin up to the chin to get at the tongue and throat without leaving visible marks. Next, they remove the liver, pancreas, stomach, and kidneys.
Finally, they take out the kidneys, bladder, bowels, and reproductive organs. Now that body is an empty cavity, the doctor turns their attention to organs and examines each of them in turn.
The doctor doesn’t find any obvious damage to many organs, so they take samples to analyze, including a toxicology screening. After the samples are prepared, the doctor carefully returns organs to the body, roughly where they belong, then carefully sews up incisions.
The doctor completes their report and releases the body to the funeral home. Two attendants arrive to transport the body to the funeral home. They load their body onto a stretcher and gather up clothes and personal belongings.
Then the dead body can be registered. The embalmer unwraps the body, then cleans it thoroughly with disinfectant spray. Then, they make a small incision in the groin and fill the body with formaldehyde.
Next, the embalmer makes another incision, this time under the ribcage, and inserts a metal suction tool called a trochar attached to a pump system into the chest cavity. Once the body is completely drained, the embalmer refills it with a liter of fluid, which saturates the organs and mitigates any nasty smells.
Now that the embalming is complete, it’s time to prepare the body for viewing. After a thorough cleaning, to dismay, the first item they put on their body is an adult diaper! This is meant to protect the coffin and clothes. Finally, they carefully place the body into the coffin.
How long does it take for one single autopsy to be completed?
A post-mortem takes probably about an hour to do it from start to finish. It takes longer to describe. A specialist can do some in 20 to 30 minutes if there’s a self-evident cause of death. It tends to be pretty quick post-mortems on thin people. They are faster than post-mortems on people who’ve got more fat.
As it’s easier to get at the organs when they’re not covered in layers of fat, and it can be not easy trying to dissect them out. For a fatty death body, a tricky post-mortem help to save time. They’ve had tubes, lines, and things in them that can take 3 or 4 hours.