If no foul play, doctors can declare cause of death without opening bodies

Now, doctors can declare the cause of death without cutting open bodies if they suspect no foul play, according to a state health department circular on Tuesday.

The health department recently formed a committee of HoDs of forensic medicine of government and private colleges to draft a standard operating procedure for handling bodies in the time of COVID-19.

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Dr Venkata Raghava, Department of Forensic Medicine, Bowring and Lady Curzon Hospital, told DH, “Previously, we would open up the body regardless of what we suspected. Now, if the doctors have no PPE, they can externally examine the body and declare the cause of death. In case of head injury, they are allowed to open up only the cranial cavity. If it is a suspected Covid-19 case or a confirmed COVID-19 case, and the doctor suspects no foul play, he can issue a cause of death certificate without opening the body.”

“If he believes injuries caused the death, without internal examination, he can give the cause of death,” he said.

Raghava pointed out that getting COVID-19 tests done in cities was not a problem but in rural areas, people have to travel at least 100 km to district headquarters. “It is mainly in district hospitals that swab tests are done,” he said.

“They have to travel with the body to the districts and wait for two days. A majority of the districts don’t have cold storage facilities,” he said.

“Post mortems can be done in private medical colleges, government medical colleges, district hospitals and taluk hospitals,” he said.

There are 48 cold storage units for preserving corpses in Victoria Hospital. Bowring diverts unidentified and unclaimed bodies to Victoria Hospital. “We are expecting some cold storage units to arrive by next week,” Raghava said.

Reduced burden

Since the lockdown began, the number of accident cases, suicides and murders had reduced but it is slowly increasing with the gradual increase in the movement of people, say doctors. Bowring Hospital, for example, did 20 autopsies in the last one
month.

What the circular says

In case of ‘brought dead’ cases where there is no suspicion, foul play or poisoning or no external injuries on the body, the forensic expert can issue the cause of death certificate saying: “Death due to natural causes cannot be ruled out, however the exact cause of natural death could not be commented due to existing circumstances (Covid-19 pandemic).”