Often, families approach me – as a Wrongful Death Lawyer – and ask if they should get an autopsy. The short answer is yes.
The reason it is important to always get an autopsy is because the facts and details from the autopsy will be critical in uncovering important information as to what occurred. This information, in turn, will arm your attorney in prosecuting a wrongful death lawsuit.
An autopsy is conducted by a medical doctor that specializes and studies causes of death. Usually, the doctor is board-certified as a forensic pathologist. If the pathologist is employed by a city, county or state, they are also called medical examiners or the “ME”. Medical examiners are employed to assist the police in murder investigations, and their principal task is to determine if the cause of death was due to some-type of criminal activity. Yet, since they are investigating the cause of death, medical examiners will often testify in civil wrongful death cases. Ideally, the medical examiner is free from bias, and thus does not favor the defendants over the plaintiffs.
Other pathologists work in hospitals. These doctors are either employees of the hospital or have a contractual relationship with the hospital, and thus, some type of relationship with the physicians on staff. This is unfortunate, because the best things about a forensic pathologist is their objectivity and absence of allegiance to protect the wrongdoers. Yet, many pathologists that work in hospitals are brave individuals that value the truth over all other considerations.
An autopsy is just additional testing. One of the key tests performed is the physical autopsy, or dissection. This means that the medical examiner surgically opens the body of the now dead patient. The pathologist then removes and evaluates the individual body organs, such as the lungs, liver, brain, and heart. The evaluation is conducted both on a macro level, i.e. what the organ looks like from the outside, but also at the microscopic level. What could not be evaluated when the patient was alive, because the testing or biopsy could have caused the patient’s death, now can be evaluated on a much deeper level.
Toxicology testing or screening is also a part of an autopsy. The toxicology report evaluates the chemical levels in the blood and, when possible, the urine. The toxicology tests for chemicals including alcohol, as well as legal and illegal drugs. The toxicology can also determine if a patient was taking too little or too much of their prescribed medication.
One of the complications of toxicology, when compared to blood testing when a patient is alive, is the effect of the body’s decay. In many movies and TV, they joke about a body exploding due to the buildup of carbon dioxide in a decaying body. Yet, the decaying can have less humorous effects, including the release of chemicals from the liver and spleen (the key organs responsible for detoxifying the body) into the blood system. This is called postmortem redistribution or after-death exchange of chemicals. Most medical examiners will draw blood from a patient’s legs to avoid complications of postmortem redistribution. In the alternative, they will rely upon a forensic toxicologist (a person that studies the effects of chemicals on the blood as the body decays) to determine and calculate the rate of decay, so that the test accurately reflects the chemical levels at the time of death.
Finally, the autopsy includes the pathologist looking and reviewing the medical records – ideally – from an objective perspective – to understand the course and treatment of the patient when the patient was alive.
A common misconception is that an autopsy is the same thing as a death certificate. They are not the same. The autopsy is a detailed study on the cause of death, the death certificate is an administrative procedure. Even if the death certificate is signed by a doctor, there is no further testing or investigation, and many times, the death certificates are signed a stack at a time. More often, the death certificate is completed by a coroner. A coroner is an elected official who does not have any specific medical qualifications.
Autopsies are extremely important in medical malpractice cases. If there is not a proper autopsy, the defendant doctors will come up with alternative hypotheses as to the cause of death. This is particularly true when the loved one is older. Older patients have more medical problems, and the greater the number of other medical problems, the easier it is to blame those problems as the cause of death.
Yet, autopsies are important in other situations where a loved one is killed. For example, in a motor vehicle collision, the defendant could argue that your loved one caused the collision, accusing the victim of having some type of impairment, such a medical condition or being drunk. The autopsy would “take away” those attempts to shift the blame.
Similar arguments may be made in the event that a loved one drowned or was involved in some type of boating accident. Defendants never take responsibility, and will look to blame someone else, usually the injured party, with allegations of drug abuse, or use of alcohol. In such situations, a toxicology report would reveal drug and alcohol levels.
Autopsies do not benefit plaintiffs over defendants. Rather, autopsies benefit both parties. Sometimes, the driver that is killed in a DUI was drinking. Likewise, sometimes folks die when they have heart attacks, seizures, or other reasons. In one potential medical malpractice case, the family told us their loved one died due to a fall, but on the autopsy, there was no blunt force trauma to the skull.
As such, the autopsy is one of the best ways to get objective and accurate facts as to the cause of death. However, there are still times that the autopsy leaves open the question of wrongdoing and fault. Worse, sometimes the autopsy report simply is wrong and leads to the wrong conclusion. Nonetheless, after litigating for over 20 years, I have found most autopsies more helpful than harmful. So, when in doubt, get the autopsy.