The postmortem examination prior to cremation:Still a necessary safety measure?

BACKGROUND: The postmortem external examination has repeatedly been the subject of political and medicolegal disputes. This study was performed to examine whether the postmortem external examination at the crematory provides additional benefits and to determine whether any differences in the quality of medical death certificates exist between hospital and non-hospital postmortem external examinations.

MATERIAL AND METHODS: All cases of death that had been examined within the context of a second postmortem external examination at crematories performed by medicolegal specialists from the Hamburg Department of Legal Medicine were analyzed during a 6-month investigation period.

RESULTS: A second postmortem external examination was carried out on 9981 decedents prior to cremation during the investigation period. In the interim, the second postmortem medical examiner did not release 474 bodies (4.7%) for cremation. Suspicion of death caused by trauma was the most frequent cause for delaying the release of the body. The quality of information stated on the medical death certificate was good in 112 certificates issued by clinicians (48.9%, n = 229) and in 51 issued by general practitioners (31.3%, n = 163).

DISCUSSION: This study verified deficiencies in the initial postmortem external examination. A postmortem external examination prior to cremation by a medical professional specialized in this field is currently an indispensable component for quality assurance.