Why a Post-Mortem?
Please note that the Coroner never orders a Post-Mortem without careful consideration, so where it is possible that death was due to natural causes we make every effort to trace a doctor who can certify this.
What happens?
When a cause of death is unknown or unnaturally occurring, and because the Coroner has a lawful duty to substantiate a cause of death, there is a legal requirement for a Post-Mortem to be carried out under Section 14 of the Coroners & Justice Act 2009.
This will happen if:
- The cause of death is clearly unnatural, e.g. following a fall or assault
- The cause of death is potentially unnatural, e.g. if it may be linked to surgery or exposure to asbestos
- 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 responsible for a death.
- The deceased died in custody or otherwise in the care of the State
When a post mortem is required, we will inform the person who has been identified as the point of contact on the referral document, however if we are unable to trace or contact them after substantial efforts, we may have to order the Post-Mortem without doing so.
Whilst we believe that it is not necessary; should you wish to, you have a right by law to engage an independent medical representative who can be present at the Post-Mortem. It is important however, that you are aware:
- All costs involved for the attendance and subsequent reports provided by any independent medical representative would need to be borne by yourself.
- We are not able to recommend any independent representatives.
- The independent representative would need to be a qualified and registered Doctor who is appropriately vaccinated.
- The identity of any representative would need to be provided to us well in advance of the Post-Mortem so that the Coroner can consider whether to grant permission for them to attend.
We cannot delay a Post-Mortem for representation to be found, so it is important that you get in touch with us immediately should you wish to engage an independent representative. If we do not hear from you, we will assume that representation is not required and will proceed with the Post-Mortem as scheduled with the Pathologist
Who will perform it?
The Doctor who will undertake the Post-Mortem (the Pathologist), is independently commissioned by; and works for the coroner, to whom the Pathologist reports directly. Their examination is independent from any Trust or organisation.
To assist the Pathologist to interpret their findings, we request an urgent medical history from the GP of the Deceased and are reliant on them to provide this promptly, without it we are unable to complete a Post-Mortem
Can I request a Pathologist the same gender as the Deceased?
We are happy to inform the hospital if you request this but neither they nor we can guarantee which Doctor will complete the examination.
Specialist Post-Mortem examinations
If a specialist Post-Mortem is required we will let you know and explain the reasons why, but If there are suspicious circumstances or if a potentially unnatural death takes place in custody, the Coroner will order a forensic Post-Mortem, which is a more detailed examination performed at Royal Oldham Hospital 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 so we may need to transfer the Deceased to another hospital for this.
Objections to a Post-Mortem
Some families object to a Post-Mortem examination and whilst the Coroner understands and respects the basis of these objections they must also uphold the law and apply it fairly to everyone. Ultimately the Coroner has the authority to make the final decision and if necessary can order a Post-Mortem even if the family does not agree, but we will do all we can to support you and minimise the delay to your funeral arrangements.
Can I appeal against the decision?
If a family want to appeal, then they can give their reasons to the Coroner in writing by email or letter, but it is important that you let us know straight away that you plan to do this, so that the examination doesn't take place until the reasons have been assessed by the Coroner and we have spoken to you about the decision.
Is there any way of speeding up the process?
We are unable to guarantee a set timescale for the completion of the Post-Mortem but we will inform the hospital if the family let us know they wish to hold a funeral as soon as possible. Whilst the examination will be performed as soon as practically possible it unfortunately still may not be immediately, due to the availablity of the Pathologists and the capacity of the examination facilities.
Should you require an update please have one point of contact only that communicates with the office and we will keep them informed of all developments.
Please do not confirm a date for the funeral or a repatriation flight until the Coroner has completed their investigations.
Is it possible to do an MRI or CT scan as an alternative?
In some cases, it is possible to determine the cause of death by medical scanning (this takes place at a specialist centre in north Manchester), however this is not always suitable beacuse there are many medical conditions that imaging techniques do not pick up. Your representative may be able to give you advice on whether there is a realistic chance of a scan being successful, but you do need to let us know if you would like to request this so the Coroner can decide if this is acceptable to them.
In cases where there are suspicious circumstances or other special considerations, the extra information gained from a full Post-Mortem is required, so scanning will not be sufficient.
If the Coroner accepts a scan would be suitable then families need to make their own arrangements and also pay for the scan themselves. We know that the Muslim and Jewish communities have representatives who can organise this for you and we can put you in touch with them if necessary.
Please be aware that if the scan does not reveal the cause of death, a full Post-Mortem examination will still be necessary.
What happens when the results come back?
When a Post-Mortem has been completed the Pathologist will provide a cause of death to the Coroner (if they are able to do so) and following a review of this:
- If it is a natural death and requires no further tests or investigations to be made the Coroner can provide release paperwork to enable the death to be registered and the Coronial investigaton closed.
- If no clear cause of death can be found and we are awaiting further test results or if the cause of death is unnatural then a Death under 'investigaton' or Coronial Inquest will be opened.