Post Mortem Examinations

What is a post-mortem examination?

A post-mortem examination is a medical examination of a body after death in order to find out the cause of death.  The Coroner will never order a post-mortem examination without careful consideration. Where it is possible that a death was due to natural causes the Coroner will make every effort to first trace a doctor who can certify this.

A post-mortem examination may, but will not always, involve an internal examination of the body (known as an autopsy). Sometimes there can be a scan of the body instead.   On other occasions only blood and urine samples need to be taken for toxicology (drug and alcohol) testing.  

The deceased will be released to a funeral director as soon as possible after the post-mortem examination.  If further tests and investigations are needed to determine the cause of death then sometimes very small samples of blood or body tissue or a body organ will need to be kept after the body has been released. You will be given options to decide what happens to any tissue that has been taken.

Will I be told if a post-mortem examination is to happen?

When a post-mortem examination is required, we will inform the person who has been identified as the point of contact for the bereaved on the referral document, however if we are unable to trace or contact them after substantial efforts, it may be necessary to go ahead with the post-mortem examination without doing so.

Who will perform the autopsy?

The doctor who will undertake any autopsy will be a pathologist who is independently commissioned by and works for the Coroner. The pathologist reports directly to the Coroner and their examination is independent from any NHS Trust or other organisation. To assist the pathologist to interpret their findings, we usually will request the person’s medical records from the relevant GP or hospital.

Specialist post-mortem examinations

Occasionally, the Coroner may ask a toxicologist or a second doctor who specialises in a particular organ (such as the brain or the heart) to carry out an additional examination or tests after the initial post-mortem examination.   In such cases the final post-mortem examination results may be delayed whilst these extra investigations take place.

Where there are suspicious circumstances or if a potentially unnatural death occurs in custody, the Coroner may order a forensic post-mortem examination, which is a more detailed examination performed by a specially trained Home Office Forensic Pathologist. 

If a specialist post-mortem examination is requested we will let you know this and explain the reasons why.

Will I be told the post-mortem examination result?

The pathologist who conducts the post-mortem will provide a written Report for the Coroner.  As soon as practicable the Coroner’s Officer will usually telephone the agreed point of contact for the bereaved and let them know the cause of death given by the pathologist. The bereaved and other Interested Persons are also entitled to be given a copy of the post-mortem examination Report if they wish. 

What happens after the results come back? 

Once the post-mortem examination results are received the Coroner will consider the findings:

• If the deceased was not in custody and it is considered to be a natural death the Coroner will provide release paperwork to enable the death to be registered and the Coronial investigation will be closed
• If the cause of death is considered to be unnatural or was a death in custody an Inquest must be opened
• If no clear cause of death can be found and we are awaiting further test results then either the coronial investigation will be continued or an Inquest will be opened. 

When an Inquest is not required

If the post-mortem examination reveals a natural cause of death and there is no other reason to open an Inquest the Coroner’s involvement will cease at this point. A Coroner’s Officer will call the family contact to explain the cause of death and how to make an appointment to register the death and obtain the final death certificate.  

We will need to know which funeral director will be looking after the arrangements in order for the Coroner to provide a Mortuary Release form.  This permits the funeral director to collect your relative and take them into their care at their earliest opportunity.  If there is to be a cremation the Coroner will also provide the appropriate paperwork to the funeral director.  If there is to be a burial you will be provided with the necessary paperwork for this by the Registrars when you register the death.   

Can I object to an autopsy?

Whilst the Coroner understands and respects that some families would prefer to avoid an autopsy the Coroner has a legal duty to establish the cause of a person’s death.  The Coroner must uphold the law and apply it fairly to everyone.  Ultimately the Coroner has the authority to order an autopsy even if the bereaved do not wish this to happen. However we will do all we can to support you at this time and minimise any delay to your funeral arrangements.  

Is there any way of speeding up the post-mortem examination process?

We are unable to guarantee a set timescale for the completion of the post-mortem examination.  Whilst the examination will be performed as soon as practically possible its timing is dependent upon the availability of the pathologists and the capacity of the examination facilities.

It is therefore important that you do not confirm a date for the funeral or a repatriation flight until the Coroner has completed their investigations.

Can my own doctor attend the post-mortem examination?

Whilst we believe that it is not necessary, should you wish to, Interested Persons have a right by law to engage an independent doctor who can be present at the post-mortem examination.  It is important however, that you are aware:

• Fees for the attendance of an independent doctor cannot be met by the Coroner’s Service
• The person must be a qualified and registered doctor
• The Coroner’s Service are not able to recommend any doctors to you
• The identity of any independent doctor would need to be provided well in advance of the post-mortem examination so that the Coroner can consider whether to grant permission for them to attend.

It is important that you get in touch with us immediately should you wish to engage an independent doctor. If we do not hear from you, we will assume that representation is not required and will proceed with the post-mortem examination as scheduled.

Inquests with no post mortem examination 

Whether a post mortem examination is required is case dependent. On occasions the Coroner decides that an Inquest to look into the circumstances of a death is necessary, but a post-mortem examination is not required.

These are cases where the cause of death is clear, and not in dispute, but where the death is, or may be, unnatural. For example, the death of a person due to a brain bleed (haemorrhage) diagnosed in life following a fall or a person with and industrial lung disease such as mesothelioma diagnosed by a biopsy during their lifetime.  

If you have any queries please raise them with the Coroner’s Officer who can talk through the process with you.