Adult Autopsy

Autopsy & Fetal Losses

ON THIS PAGE:
Autopsy Services|Consent & Request for Autopsy|Identification of Bodies|Autopsy Handling & Transport|Release of Bodies|Autopsy Reports|References

Autopsy Services

Alberta Precision Laboratories (APL) provides adult autopsy services for the province of Alberta. Autopsies must be requested by a physician and must be consented to by the decedent's legally authorized representative (see Consent for Autopsy section below). Autopsies are performed with the utmost care and respect for the decedent, and endeavor to obtain answers to clinical questions that could not be answered during the decedent's life. Autopsy does not disfigure a body, and an open casket funeral can be held after an autopsy in most circumstances. Barring delays with consent, autopsies are typically done within 1-2 days of death, and do not delay funeral proceedings. Autopsies can be performed to adhere to specific religious requests, including expedited completion for burial prior to sundown. Autopsies are performed Monday to Friday. In Edmonton, autopsies may be arranged in advance for the weekend, under special circumstances.

In cases where the death is a notifiable death in accordance with the Fatalities Inquiries Act of Alberta, and the Medical Examiner does not require an autopsy to certify the cause and manner of death, an autopsy can be requested by a physician and performed with the consent of the decedent's legally authorized representative.

The autopsy service works closely with the Comprehensive Tissue Center (CTC) for the north and Southern Alberta Transplant Program for the south. If a decedent is a candidate for organ or tissue donation, and consent for donation is given, that will be completed prior to autopsy. It is only in rare circumstances that autopsy findings would be affected by organ procurement.

For patients or families interested in body donation for education, visit the University of Calgary Body Donation Program website for the south and University of Alberta Anatomical Gifts Program for the north. Note that body donation must be arranged prior to death, and autopsy precludes body donation.

For patients or families wishing to contribute to research into their disease, or to contribute to the general body of scientific and medical knowledge to enhance health care, the best option is to discuss the possibility of autopsy with the physicians providing care.

Consent & Request for Autopsy

The methods for completing the autopsy consent and autopsy request differ between requesting sites using Connect Care and sites not using Connect Care. For autopsy requests coming from a non-Connect Care site, an Autopsy Consent and Consultation Request form (20597) must be physically completed and signed by both the requesting physician and the legally authorized representative of the deceased. The form is available on the Alberta Health Services website by searching "Autopsy Consent and Consultation Request" and the APL Test Directory, Autopsy – Adult page.

The form physically accompanies the decedent to the performing autopsy facility. For sites using Connect Care, a Consent for Autopsy and separate Autopsy order are digitally completed in Epic by the requesting clinician. Using the Discharge as Deceased Navigator, the requesting clinician digitally completes all of the required death information and works with the legally authorized representative to digitally complete and sign the Consent for Autopsy. The digital Consent for Autopsy form should be printed and sent with the decedent to the performing autopsy facility.

Consent for Autopsy

Requires completion of the following two components by the legally authorized representative of the deceased.

  • Designation of the Legally Authorized Representative
    • Despite appointing power of attorney or selecting a next of kin prior to death, once an individual dies, the legally authorized representative follows the order listed on the form. It is only with consent from the legally authorized representative that the autopsy can be performed. For cases where the family is estranged or there are other factors, please call the local anatomical pathology laboratory and ask to speak to the autopsy pathologist on service.
    • The legally authorized representative gives consent for a complete or limited/partial autopsy. Except for unique circumstances (i.e. religious, cultural), all autopsies should be complete. Placing limits on the autopsy may impact the pathologist's ability to appropriately and adequately examine all components of the body, and to answer the clinical questions. A complete autopsy is performed in such a way to minimize disfigurement and allow for an open casket funeral.
    • The legally authorized representative is also asked to consent to, or to decline, retention of tissues and organs obtained at autopsy for education and research purposes. This refers to tissue taken in addition to those taken for diagnostic purposes. All research projects procuring tissue at the time of autopsy are approved by the APL research department and/or the regional research ethics board. Educational endeavors include procuring specimens for anatomy and pathology teaching for medical students, residents, and clinicians. 
  • Witnesses
    • Consent of the authorized representative must be obtained by the requesting physician and witnessed by a third party who can verify the identity of the person signing the form.
    • In person consent must be witnessed by one individual. Telephone consent must be witnessed by two individuals.
    • The physician obtaining consent cannot witness the consent.

Request for Autopsy

Requires the following information from the requesting clinician:

  • A clinical summary of the case for the pathologist and the pathology team, including anatomical and radiological findings relevant to the autopsy, as well as pertinent laboratory data.
  • State problems or questions to be investigated and elucidated at autopsy. As medical autopsies are not required by law, clinicians must provide rationale for why the autopsy has been requested. The pathology team will endeavor to answer these questions specifically in the Autopsy Report.
  • Include any physicians and/or medical staff who would like to attend the autopsy or receive a report along with their contact information.
  • Any confirmed or suspected infectious disease that autopsy staff should be aware of prior to initiating the autopsy. Note that the presence of certain types of infectious diseases may alter how the autopsy is performed, cause limitations, or prevent the autopsy from occurring.
  • Physical or digital signatures by the requesting clinician, depending if the order is performed physically or in Connect Care. Wet signatures are not required for digital autopsy requests placed in Epic.

Identification of Bodies

Refer to the Alberta Precision Laboratories Test Directory:

Autopsy Handling & Transport

  • All bodies must be placed in a body bag for transfer and receipt to site performing the autopsy.
  • Charts, the Autopsy Consent and Consultation Request Form, and Notice of Death are sent to HIM (Vital Statistics) at the hospital site to be forwarded with the body. For Epic Autopsy requests, the digital Consent for Autopsy should be printed and sent with the body.
  • Infections do not necessarily preclude autopsies from being performed. Communicating that a body has a communicable disease allows the pathology team to take the necessary precautions to keep them safe and still obtain the answers to the questions at autopsy.
  • Infections known at the time of death should be listed on the Autopsy Consent and Consultation Request form (20597). For digital orders, known infectious diseases will be flagged in Epic, but any possible or suspected infectious disease should be specified in the order.
  • Special handling procedures must be followed for autopsies on bodies with known or suspected communicable disease. Refer to Bodies of a Deceased Person Regulation. Bodies with known or suspected Schedule 1 and Schedule 2 infectious diseases (as per Alberta Regulation 14/2001 Public Health Act) must be hermetically sealed bag/container and tagged with the appropriate Schedule 1 or Schedule 2 label, available on the AHS website. Autopsies may be limited at the pathologist’s discretion depending on the infectious disease. If you have questions regarding a specific communicable disease and how it may influence the autopsy, contact the local anatomical pathology department and ask to speak to the Autopsy Pathologist on service.

Autopsies from AHS Hospital Sites

The Health Information Management (HIM) department of the hospital where the death occurred is responsible for arranging the transfer of a body to the site performing the autopsy. HIM at the sending facility will notify HIM at the autopsy facility of the incoming autopsy. The receiving facility will be invoiced for transport one way. Capital Transport Service is used for transport from acute care facilities. 

Autopsies from Non-Hospital Sites

Autopsies will be accepted from deaths at home, nursing homes or other facilities. A medical autopsy can be performed for notifiable deaths in which the Office of the Chief Medical Examiner has performed or declined to perform a forensic autopsy. The HIM (patient registration) department of the facility where the death occurred is responsible for arranging transfer of a body to the site performing the autopsy. If the sending facility does not have a HIM or patient registration department, then the autopsy requestor notifies HIM at the autopsy facility of an incoming autopsy. HIM at the receiving facility will arrange transport. 

Release of Bodies

After an autopsy has been performed, the body is released by HIM (Vital Stats) at the performing facility directly to a funeral home or to the authorized representative with proper documentation from HIM and compliance with Laboratory Services guidelines.

The person authorized to pick up the body must show appropriate identification and sign for the release of the body.

Autopsy Reports

A preliminary autopsy report is issued within 3 business days of the date of autopsy. The purpose of this report is to summarize the clinical history, and to report the general findings at autopsy. If clinicians have any questions regarding either of these components of the report, they should call the reporting pathologist at their earliest convenience. The contact information for the pathologist is contained within the report.

A final autopsy report is issued within 60 business days of the autopsy and will incorporate the findings on the histologic sections taken at autopsy, and any other ancillary tests that were performed. Any specific questions asked at autopsy will be addressed in the final autopsy report.

Reports for CJD cases will have a longer turnaround time.

A third component of the report is the Neuropathology Autopsy Report. As the examination of the nervous system requires additional training and expertise, this component is performed and reported by a separate pathologist.

References

  • Care After Death - Adult and Pediatric Policy (#PRR-05)
  • Bodies of Deceased Persons Regulation
  • Fatality Inquiries Act