Bridget Dolan QC and Michael Walsh have been advising the Senior Coroner for Preston and Lancashire on the legal aspects of setting up an innovative, radiologist-led, non-invasive post mortem “digital autopsy” service in Lancashire, as described in this article from the Health Service Journal.

Innovations in post-mortem scanning techniques, including the use of targeted coronary angiography,  mean that a technique that was in the past mainly used as an adjunct to a traditional autopsy examination can now wholly replace the need for evisceration of the body. [1] [2]  As CT scanning alone can now provide a cause of death in 90% of cases this has now become the first-line investigation for coronial post mortem examinations in Lancashire.   

In co-operation between the local NHS Trusts, the Local Authority and a private provider, this "free at point of delivery" digital autopsy service is staffed by NHS personnel (including consultant radiologists & pathologists, specialist forensic radiographers and specially trained APTs). The service  is provided at a less than cost or cost neutral expenditure when compared to traditional post-mortems.   In the first three months of operation, over 90 per cent of scans established the cause of death thereby avoiding 415 invasive post-mortems.

The comfort and benefit delivered to bereaved families by the knowledge that an accurate cause of death has been identified without resorting to evisceration of the body is considerable and not to be underestimated.

 

[1]        Diagnostic accuracy of post-mortem CT with targeted coronary angiography versus autopsy for coroner-requested post-mortem investigations: a prospective, masked, comparison study. Rutty et al, Lancet 2017; 390: 145–54.

[2]   Postmortem CT Angiography Compared with Autopsy: A Forensic Multicenter Study.  Grabherr et al.  May [2018] Radiology  https://pubs.rsna.org/doi/10.1148/radiol.2018170559