Autopsies and plastic bags

[deschutes]

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A non-path MD friend was asking me about autopsies, never having seen one herself.

She seemed disturbed not so much by the fact that the organs were jumbled up when returned to the body cavity, but that they were jumbled up in plastic bags in the body cavity.

I am trying to recall my few autopsy experiences, and can't remember that particular aspect of the closure.

I guess the question she was asking is - why the plastic bags? (If this is standard procedure)

And while I'm at it - are pacemakers ever left in?

 

[adpitan]

A non-path MD friend was asking me about autopsies, never having seen one herself.

She seemed disturbed not so much by the fact that the organs were jumbled up when returned to the body cavity, but that they were jumbled up in plastic bags in the body cavity.

I am trying to recall my few autopsy experiences, and can't remember that particular aspect of the closure.

I guess the question she was asking is - why the plastic bags? (If this is standard procedure)

And while I'm at it - are pacemakers ever left in?

I suppose the plastic bio-hazard bags are utilized due to their construction and the fact they are unlikley to leak. The heavy duty plastic bio hazard bags are the standard procedure unless it is for an infant in which case I have utilized sandwhich bags. Don't ask, I don't know why that's just what we did. Yes, looking back I should have asked but I didn't.

In my experience pacemakers are not left in. The autopsies we did at the coroners office we always took them out but I can not recall exactly what was done with them. I just remember them being placed in a container in our storage room.

Hope this helps some.

 

[desmangt]

I suppose the plastic bio-hazard bags are utilized due to their construction and the fact they are unlikley to leak. The heavy duty plastic bio hazard bags are the standard procedure unless it is for an infant in which case I have utilized sandwhich bags. Don't ask, I don't know why that's just what we did. Yes, looking back I should have asked but I didn't.

In my experience pacemakers are not left in. The autopsies we did at the coroners office we always took them out but I can not recall exactly what was done with them. I just remember them being placed in a container in our storage room.

Hope this helps some.

We don't return the organs back to the body, instead we just sew them up. Pacemakers are always removed because cardiology can interrogate them to find out what happened. It's pretty cool.

 

[yaah]

About pacemakers - they are generally removed as has been said - they tend to get in the way. Plus, if there is an AICD you have to make sure it is turned off, just to be safe. I think I posted this before but we had to call down the EP people to turn off a guy's active AICD.

Where I did my PSF, we never returned any organs to the body unless it was a specific request. Everything taken out, then body is closed up, organs are cremated later when they are no longer needed.

But here, when we do the autopsy we save portions of all organs (sometimes an entire organ if it is important, like the whole heart in a cardiac patient) but everything else goes back into the plastic bag and then into the body where it is sewed up. I played a prank on one of the med students once and told them all the organs had to be put back in the proper place after I was finished with them, and that was his job. It almost worked. But what the diener told me is that the funeral home will just inject the embalming fluid directly into the bag. The bag is used because it can be messy and keeping organs in the bag keeps things as neat as possible. If the funeral home has to do a lot of work on the body and loose organs are bouncing around everywhere that is not very desirable.

I guess I would ask why anyone would want the organs back in their approximate location? The body is moved around a lot anyway and things are going to shift, plus all the leaking fluid and blood and ooze. The bag keeps things neat and tidy (at least as much as is possible). I remember remarking to the diener that in the future, when the aliens come, they may dig up a few bodies and find that some of them have a mess of organs inside a plastic bag in their abdomen and wonder just what on earth was going on here.

 

[adpitan]

We don't return the organs back to the body, instead we just sew them up. Pacemakers are always removed because cardiology can interrogate them to find out what happened. It's pretty cool.

From the coroners offices I have worked at here in Nor Cal the only portion we do not return are the sections we keep for histo.

 

[skoller]

From the coroners offices I have worked at here in Nor Cal the only portion we do not return are the sections we keep for histo.

Speaking of coroners, did you guys hear about the case in Colorado where the coroner ruled that a man's death after organ donation was a homicide? Apparently, the man shot himself in the head, was pronounced brain dead by two separate teams of doctors, and then had his organs removed for transplantation. The coroner, however, felt the criteria used to determine brain death were insufficient--mind you, this guy is NOT an MD, simply an elected official--and ruled that the donor's death was due to having his organs removed. Therefore, the doctors committed homicide! The coroner claims that his intent was not to have criminal charges brought against the medical personnel, but to draw attention to the lack of uniform criteria for brain death.

Seems more than a little crazy to me...Why do some states still have coroners instead of medical examiners? The system makes absolutely no sense.

 

[deschutes]

Informative responses, all.

I remember remarking to the diener that in the future, when the aliens come, they may dig up a few bodies and find that some of them have a mess of organs inside a plastic bag in their abdomen and wonder just what on earth was going on here.

If there were still recognizable organs by that point in time!

It sounded as if the resistance to the idea of a plastic bag in the dead person came about because it is "not natural" - probably the same reason some people just aren't comfortable with organ donation, and being buried missing a kidney, or something like that.

Don't shoot the messenger! 😉

My personal approach to organ donation is simple - if it's going to help someone, take it! And if I'm donating a heart, I don't see why I would hold back on a liver or some corneal tissue. I won't have much use for those things where I'm going anyway.

~
What did you guys use before there were sandwich bags?

 

[adpitan]

Seems more than a little crazy to me...Why do some states still have coroners instead of medical examiners? The system makes absolutely no sense.

I don't believe coroner systems are good at all. Unfortunately that is the bulk of what California has to offer. Fortunately for me the coroners that I worked with listened to what the ME Forensic Path had to say. Elected officials and Sheriffs have no knowledge and no business sticking their heads into the ME world. Hopefully in the next century or so people will catch a clue. However there are many, many small rural counties here that will never adopt such a thing because its "big city" and they don't have the funds for that type of thing...this is what makes them the best places to commit crimes or dump bodies because they are none the wiser, right?

 

[yaah]

The coroner system is used in many states and it does sound very suspect to me. When this system exists, anyone can be a coroner, I think all you need is a high school diploma and to get elected. We had a lecture from an ME who had worked with coroners and he said some of them were so terrible it was an embarrassment. He did say that many veteran coroners know very well what they are doing and do a good job. But the problem is that most of them are not doctors. And in this age of CSI, they are probably learning most of what they think they know from TV. Not a good thing.