A post-mortem examination will be necessary if;
- The cause of death is not known. Even if the cause is likely to be natural it is necessary to find out which disease or condition was involved.
- The cause of death may be unnatural.
- The deceased died in some circumstances of state detention.
Please be assured that the Coroner never requests a post-mortem examination without careful consideration. Where it seems likely that death was due to natural causes, we make every effort to trace a doctor who may be able to certify the cause of death.
Where will the post-mortem examination take place? Who will perform it?
In almost all cases the post-mortem examination will take place at Sunderland Royal Hospital (some exceptions apply, if your relative’s body needs to be moved between hospitals but we will tell you beforehand).
The post-mortem examination will usually take place and the body released for funeral within a week of the death but our office and your funeral director will keep you informed.
Post-mortem examinations are carried out by Consultant Pathologists (or trainees under the supervision of a Consultant Pathologist) who are employed by Gateshead Health NHS Foundation Trust and based at the Queen Elizabeth Hospital, Gateshead. When conducting post-mortem examinations however they do so on behalf of and at the direction of HM Coroner and not the Hospital Trust.
We should inform you that relatives at their expense are entitled in law to send a representative to observe the post-mortem examination. The representative must be a qualified medical doctor.
Specialist post-mortem examinations
If there are concerns about the Hospital Trust in connection with a death or if the complexities of a case are felt to be beyond the skills of the Trust Pathologist the Coroner may request an alternative, independent Pathologist to conduct the post-mortem examination.
If there are suspicious circumstances and the police are investigating the death then the Coroner will request a forensic post-mortem examination. This is a more detailed examination performed by a specially trained Pathologist.
Occasionally the Coroner may ask a pathologist who specialises in a particular organ, such as the brain or heart, to carry out the post-mortem examination. We may transfer the body to another local hospital for this or perhaps send only the organ in question. If the Coroner has ordered a specialist post-mortem examination on your relative, we will let you know and explain why.
What happens when the results come back?
When the post-mortem examination is completed, the Pathologist will report their findings to the Coroner and then one of three things will happen;
- If the post-mortem examination confirmed that the deceased died of natural causes the Coroner’s involvement will cease and paperwork will be issued to allow the death to be registered.
- If the cause of death could not be immediately identified and the pathologist is to undertake further tests the Coroner will commence an Investigation which may or may not include an Inquest. We expect to receive the pathologist’s report indicating the cause of death within 6 weeks but if there has been a specialist examination the results could take longer. We will keep you informed.
- If the post-mortem revealed an unnatural cause of death an Inquest will be opened and a date for pre-Inquest review and/or final hearing will be set in consultation with you.
How will we communicate with you?
The next of kin or alternative agreed point of contact for the family will be contacted by telephone by the Coroner’s Officer who will discuss post-mortem examination arrangements. The officer will call again immediately after the examination to explain the results and discuss what happens next.
If we are unable to trace or contact relatives after making reasonable efforts, we may need to request the post-mortem examination without notifying them.
Can I still view my relative's body/have an open casket?
The mortuary technicians are very careful and make every effort to ensure that the post-mortem examination does not affect your relative's appearance. When the body is dressed and lying in the Chapel of Rest, there are usually no visual signs that the post-mortem examination took place. Your funeral director will be able to give you advice on your personal situation.
Objections to post-mortem examinations and religious considerations
We know that some families object to an invasive post-mortem examination being carried out on their relative. We understand and respect the basis of these objections however we must also uphold the law and apply it fairly to everyone. The Coroner has the authority to make the final decision and if necessary can request a post-mortem examination even if the family does not agree. This is clearly a very difficult situation and we will do all we can to support you and minimise the delay to your funeral arrangements.
You may wish to consult the following guidance sheets issued by the Chief Coroner for further information regarding post-mortem examinations and prioritising cases in general;
Chief Coroner Guidance No. 32 Post-Mortem Examinations including Second Post-Mortem Examinations;
Can I appeal against the Coroner’s decision to order a post-mortem examination?
Families can, if they wish, make representations to the Coroner in writing. This can be done by email or by letter. If you let us know you plan to do this, we will not start the post-mortem examination until the Coroner has looked at the further information you have given and we have spoken to you about the reasons for the decision.
Is it possible to do a medical scan as an alternative?
In some cases, it is possible to determine the cause of death by post-mortem CT scanning. Scans are not always suitable or useful as they are better at showing some types of diseases than others. For example, scans are more likely to establish a cause of death in cases involving trauma, sudden deaths in those over 50 or those with a history of heart disease. In cases where there are suspicious circumstances or other specific considerations, the Coroner may need evidence that is gained from a full post-mortem examination so scanning will not be sifficient. Importantly, if the scan does not reveal the cause of death, an invasive post-mortem examination may still be necessary.
Post-mortem scanning takes place at a specialist centre and no charge will be passed to families.
Delays
It is very important that you do not confirm a date for the funeral or repatriation flight until the Coroner has completed his investigations.
There may be a well-intended desire to speed up the process by repeatedly phoning or visiting the office. While we understand the urgency that you feel, please be advised that this does not help. We will already be doing everything we can. We have found that the most practical way forward is for the family to designate one person to communicate with the office and we will keep them informed of all developments.