After a properly conducted autopsy, small proportion of cases will not reveal a cause of death.

This is probably of the order of 2–5%. However, before the death is recorded as unascertained, it is important that appropriate ancillary investigations have been conducted. These tests include toxicology, microbiology and genetic testing where appropriate. The history and scene examination findings must be known. Labeled as NEGATIVE AUTOPSY

NEGATIVE AUTOPSY
• DEFINITION:
• The situation conducive to Negative Autopsy can be discussed under two main heads.

• (I). Factors/Lapses/Deficiencies contributing to Negative Autopsy:
• • • • Commencing Autopsy without proper history. Improper external examination. Faulty Internal examination. Failure of Histological & Toxicological examination

NEGATIVE AUTOPSY
• (II). Causes of Negative Autopsy:
• • • • • Very short fatal period. Trivial/Insignificant finding Reflex coronary spasm/Intense Laryngo spasm The condition not causing any organic change Indicators can not be detected current available techniques of investigation.

NEGATIVE AUTOPSY
• IN ALL SUCH SITUATIONS WHERE THE DOCTOR FEELS THAT ALL THAT SHOULS BE DONE HAVE BEEN DONE, HE IS FULLY JUSTIFIED IN GIVING THE MEDICAL CAUSE OF DEATH AS; • UN-DETERMINED

Hazards of Autopsy
• Every work has its own implicit hazards, so is the Autopsy. • Much concern about these hazards due to; • A) Recognition/Awareness of risks by the staff. • B) Increasing number of reported cases of infection among workers(medical/paramedics)

Classification of Hazards
• • • • MECHANICAL: ELECTRICAL: CHEMICAL: ULTRA VIOLET RADIATION BURNS:

• INFECTIONS:
• Category A; All viral infections. • Category B; All infectious diseases. • Category C; All other / miscellaneous

PREVENTIVE MEASURES
• • • • • • • Maintaining high standards of hygiene. Use of Protective clothing (Autopsy dress). Gloves (special mention). Instruments cleaned / dis-infected. Care of electrical points / equipment. Handling of dissection instruments. Proper Immunization of all staff.

Necropsy Wound
Cut sustained during Autopsy
• • • • • • • • Leave the work immediately Remove gloves Encourage free bleeding Wash thoroughly with soap and water Dip in strong solution of antiseptic. Apply clean, dry, aseptic dressing Immunization against Tetanus More serious then shift to Accident & Emergency

EMBALMING
DEFINITION OBJECTIVES COMPOSITION OF EMBALMING FLUID

EMBALMING
TECHNIQUE
Two entirely different techniques are applied on the same body I- INTACT BODIES: (A) Arterial Method
For compact tissues

(A)Trochar & Cannula
For hollow organs & cavities

II- DISSECTED BODIES
(A) Body cavities (B) Extremities

LIMITATIONS
The preservation is short lived

FORENSIC ARTEFACT
Any change caused or finding introduced into the body after death that is neither Physiological nor Pathological and is likely to lead to misinterpretation of Medico Legally significant Ante Mortem finding.

Wrong & erroneous interpretation
1- Cause/mode/manner of death 2- A/M or P/M nature of finding 3- Misleading the Investigations leading to wrong Judgment

4- Conviction of Doctor

CLASSIFICATION
I- Artefacts Before Death:
Resuscitation Artefacts.

II- Between Death & Autopsy:
Agonal Embalming Toxicological Due to Changes After Death 3rd Party

During Autopsy
Negligent opening of Neck Negligent opening of Skull Heat Haematoma