The mortuary

To perform an autopsy, a mortuary is needed. This incorporates not only body storage facilities but also a dissecting room or rooms, with a range of essential equipment and facilities needed to examine a body.

The organisational questionnaire was designed to gather information about the mortuary facilities available to pathologists who perform coronial autopsies. Some of the most relevant facility features that may have impacted upon the quality of autopsy reports were presented previously (e.g. how coronial autopsies are requested, evisceration of bodies, body and organ scales, facilities to process and store tissues and other samples etc.). The remaining data that were gleaned from the organisational questionnaire are presented in full in the appendix. Of note, there were three key recommendations that came out of such data which are presented here; they relate to:

  • Pathologist's clothing;
  • Infectious and serious communicable disease management;
  • Mortuary accreditation.

The data and commentary surrounding these recommendations are presented in the Appendix, but are also presented here in summary.

In 81% (156/193) of mortuaries, the pathologists wear proper dress (protective clothing over surgical scrubs), although in some mortuaries, protective clothing is worn over day clothes. NCEPOD hold that in all mortuaries, the pathologists should be wearing protective clothing over surgical scrubs and make the following recommendation:

Recommendation

Pathologists should wear protective clothing over appropriate scrub suits, not over their day clothes.

The number of mortuaries that were accredited with clinical pathology accreditation was assessed. Seventy three percent (140/183) of mortuaries were accredited (10 did not know whether they were accredited or not) and accordingly, the following recommendation is made:

Recommendation

All mortuaries should be quality accredited.

A surprising reluctance on the part of many mortuaries to examine bodies with known or suspected Serious Communicable Disease was found. The proportions of mortuaries that did not accept cases were respectively: for tuberculosis - 22% (42/192), hepatitis B - 30% (58/192), hepatitis C - 36% (69/191), HIV - 52% (99/191), CJD - 80% (154/189).

Recommendation

The approach to infectious disease management in mortuaries should be reviewed and standardised.