Autopsy/Post-Mortem Service

Post-Mortem Authorisation Form

In September 2006 the Scottish Government introduced a national authorisation form for post-mortem examinations. By law this is the only “consent form” that can be accepted. The authorisation form, together with two types of information leaflets and a summary form are contained within a distinctive dark blue sleeve for adults and a pale green one for children and infants.

The forms are available online through the Scottish Pathology Network.

Guidance for completing these forms can be found here: Hospital PM authorisation process

Current guidelines recommend that only senior medical staff should obtain authorisation. Junior doctors or ward staff should act as witnesses.

It is important that the authorisation form is completed correctly; otherwise the post mortem may not be carried out.

The nearest relative, or a nominated person must be given the top (white) copy and the other two copies (pink and blue) are retained.

The form is a legal document and must not be altered without the relatives consent. Any changes must be made by having all three copies together and only writing on the top white copy to ensure that all the forms are identical.

Post-Mortem Examination

Small samples of tissue, for histological purposes only, will be retained in every post-mortem to confirm macroscopic findings unless consent for this is withheld.

Detailed neuropathological examination of the brain is best done if the organ is first immersed in formalin for three weeks. If the patient has died due to a complex neurological disorder (e.g. MS, dementia, Parkinson’s disease) and it is considered that examination of the brain is very important, then specific permission to retain the brain after the post-mortem should be obtained and noted in section 2A and 2B of the authorisation form.

In cases where there is an infectious risk to those handling the body after death (i.e. pathologists, mortuary technicians, undertakers) e.g. deaths from tuberculosis, AIDS, hepatitis B or C etc. the body must be transported to the mortuary in a cadaver bag with “danger of infection” stickers attached and clearly visible.

In cases of “bodies donated to medical science” or any other issue, please contact the mortuary staff.

Authorisation forms are available from the mortuary offices during working hours and from the booking in areas in every mortuary.

Wards should arrange for collection/delivery of authorisation forms together with the summary and case records. Do not use internal mail.

All post mortems will be carried out within the mortuary at the Queen Elizabeth University Hospital, with all adult NHS post mortems being carried out on Tuesdays and Thursdays only.

On completion of the autopsy the pathologist will contact the requesting clinician and where practical invite them to come and discuss the findings in the mortuary at their earliest convenience. If the requesting clinician is unable to attend the mortuary, then a summary of the finding is provided via email.

A preliminary autopsy report is dispatched to the Consultant in charge of the patient within three working days of the autopsy. Case notes are normally returned with the full PM report within 3-4 weeks.

Copies of the final report, which includes histological findings, are sent to the patient’s GP and hospital consultant usually within two weeks (this can be longer if additional tests are required) of the autopsy.

Deaths must be discussed with the procurator fiscal under the following circumstances:

1. Uncertified death
2. Any death which was caused by an accident due to the operation of a vehicle, or which was caused by an aircraft or rail accident.
3. Any death associated with employment, by accident, industrial disease or poisoning.
4. Any death due to poisoning (coal gas, barbiturate, etc.).
5. Any death where the circumstances would seem to indicate suicide.
6. Any death where there are indications that it occurred under an anaesthetic.
7. Any death resulting from an accident in the home, hospital or institution or any public place.
8. Any death following abortion.
9. Any death apparently caused by neglect (malnutrition).
10. Any death occurring in prison or a police cell where the deceased was in custody at the time of death.
11. Any death of a new-born child whose body is found.
12. Any death (occurring not in a house) where the deceased’s residence is unknown.
13. Death by drowning.
14. Death of a child from suffocation (including overlaying).
15. Where a death occurred as a result of smallpox or typhoid.
16. Any death as a result of fire or explosion.
17. Any sudden and unexplained death.
18. Any other death due to violent, suspicious or unexplained cause.
19. Deaths of foster children.
20. Any complaint concerning care or treatment of the deceased noted by nursing or medical staff.

Do not issue a death certificate until the case has been discussed with Fiscal.

If the Fiscal decides to instruct a post mortem, the body will be removed to QEUH Mortuary. Fiscal post mortems are carried out 5 days per week.

A pacemaker or other metal containing cardiac device must be removed from a body prior to cremation. This can be done by the technical staff in the mortuary at the QEUH provided that written consent from relatives for removal and retention has been obtained and delivered to the QEUH mortuary prior to the body being released to the funeral director. This service is not generally available at other mortuaries. If the pacemaker has not been removed the MCCD must indicate that a pacemaker is in situ.

Clinicians wishing to view remains should phone the mortuary staff to arrange a time to visit the mortuary and conduct a viewing.