Despite Covid-19 risk, doctors doing autopsies in hundreds

Amid the raging pandemic, doctors risked their safety to do post-mortems on bodies in cases of unnatural deaths, ignoring a health department circular in May to issue cause of death certificate by mere external examination where they do not suspect foul play.

Data from the City Crime Record Bureau (CCRB), seen by DH, has revealed that Bengaluru reported more than 400 unnatural deaths every month since May and police have taken the bodies for post-mortem to government and private hospitals. Victoria Hospital alone did 998 post-mortems during this period.

Forensic medicine specialists said lung secretions were highly infectious even though the RT-PCR test of the nasal swab done within six hours of death showing negative for Covid.

CCRB data shows 465 UDRs (Unnatural Death Reports) in May, 480 in June, 460 in July, 476 in August and 429 in September.

“The (Health Department) circular leaves it to the doctor’s discretion,” said a doctor from the Department of Forensic Medicine at Bowring hospital. “The doctor is responsible for the cause of death certificate he signs. Doctors wear PPE while doing post-mortem.”

In rural areas where health facilities are scarce, the cause of deaths certificates are given without opening up the body. Unlike Victoria, Bowring hospital does not perform autopsies if the body tests positive for Covid. “From May to October, 270 bodies of unnatural deaths had been brought to the hospital,” the doctor added.

In cases of hanging, the body arrives later than six hours and the RT-PCR test would show negative for Covid. “Due to rigor mortis (stiffening of the body muscles), a swab cannot be taken from the throat. Chances are that the nasal swab is negative, but when we open up the chest we might be exposed to highly infected lungs,” the doctor said.

A forensic medicine expert at Victoria Hospital said the hospital did 1,919 autopsies from January 1 till now. The number was 921 in April alone.
“Many cases are brought dead and brought dead cases are considered medico-legal cases (MLCs),” the doctor said. “We do an autopsy in all MLCs to know whether it is a natural or unnatural death.”

The doctors have performed post-mortem even on Covid dead cases since the police do not want to take a risk. In some cases, even partial autopsy was done. “For instance, in cases of hanging, merely based on the ligature marks on the neck the doctor can say examination is deferred where he suspects no foul play,” the doctor said.