Office of the Chief Medical Examiner

The Forensic Autopsy

Overview

When someone dies suddenly, is found dead or is killed, family members and police investigators have many questions including: What caused the death? How did the person die? The forensic autopsy is the primary tool used to find answers to these concerns. The following guidelines provides important information for family members needing to know when, after a relative dies suddenly, the Office of the Chief Medical Examiner (OCME) needs to perform an autopsy and/or issue a death certificate.

What is a Forensic Autopsy?

A forensic autopsy is a series of tests and examinations performed on the body to determine the presence of an injury and/or to identify any disease that may have caused or contributed to the death. This internal and external test/examination is done by a forensic pathologist who has been specially trained to recognize patterns of injury, collect evidence and investigate the circumstances surrounding the death.

During a forensic autopsy, it is necessary to thoroughly examine the body as well as the internal organs. The incisions needed to weigh and measure the organs are made in a manner that allows the funeral director to conceal them for the viewing service and funeral. Additionally, special tests are performed to check for the presence infectious diseases, alcohol, and/or drugs. A typical forensic autopsy takes approximately 2-4 hours but may require additional time to complete these special tests. If these tests are needed, the death certificate will be issued with "PENDING" as the cause of death while the Medical Examiner obtains the test results. This allows the family to make arrangements for moving the body to the funeral home and to schedule the funeral/burial.

When is the Medical Examiner's Office Involved?

A death certificate must be completed by a doctor for all deaths before the body can be sent to the funeral home. When the person has a family doctor and dies from natural causes (i.e. the result of a disease), the doctor can complete the death certificate. But if the person is not under the care of a physician or the death appears to be suspicious or unusual (i.e. the result of injury), the medical examiner must be notified to begin an investigation and make sure the death certificate is completed.

The Medical Examiner will:

perform the autopsy using several types of tests to determine the cause of death
release the body to the funeral home following completion of the tests
complete the information on the death certificate regarding the cause and manner of death

Can Family Members Object and/or Prevent an Autopsy?

Before an autopsy can be performed in the instance of a non-medical examiner death (i.e. death during a hospital stay), the next of kin must grant permission. However, when state law requires the medical examiner to perform an autopsy, family permission is not required. A family may object to an autopsy because of religious beliefs, as stated in Maryland Statute §5-310(b)(2). In this case, the Chief Medical Examiner must review the matter and determine whether it is absolutely necessary to perform an autopsy over a family's objections. In such cases, the Medical Examiner's office will discuss the situation with family members. If, after careful review, the Chief Medical Examiner determines an autopsy is required, the family may ask the court to intervene and grant an injunction to prevent the procedure until a hearing can be scheduled. These legal proceedings may take several days and will delay the release of the body to the funeral director for burial. It is important for family members to inform the Medical Examiner's office immediately if they have any objection to an autopsy since most begin as soon as the body arrives at the Medical Examiner's office.

The Office of the Chief Medical Examiner of the State of Maryland was the first statewide Medical Examiners Office in the USA. Established in 1939, the Office investigates the cause of death in cases that fall under its jurisdiction as defined in the Annotated Code of Maryland, Health General Section