Section - Procedures for Obtaining Autopsies or Submitting Materials for
having an autopsy performed at the NIH Clinical Center by the Postmortem
Section of the Laboratory of Pathology
In general, any patient
who has been seen at the NIH for any reason is eligible for an autopsy
done by the Laboratory of Pathology. In addition, non NIH patients with
diseases of significant clinical or basic research interest may have an
autopsy done at the NIH if permission is obtained from the Chief of the
Postmortem Section and the sponsorship of a principal investigator at the NIH. For an in-patient death or the death of an NIH or
non-NIH patient outside the NIH:
1. Upon the death
of an in-patient or notification of the death of an NIH patient outside
the NIH, obtain a Death Packet from Admissions.
2. If the death falls within the jurisdiction of the Maryland State Medical Examiner, the Medical Examiner must be consulted prior to obtaining permission for autopsy. In general, patients who die from accidental causes, who arrive at the Clinical Center and are pronounced Dead On Arrival, or who die in association with a therapeutic procedure may fall under the jurisdiction of the Medical Examiner.
3. The Death Packet
contains all of the necessary forms and instructions for having an autopsy
performed on an NIH patient.
4. The NIH follows
the State of Maryland's guidelines for consent to post-mortem examination.
Permission from next-of-kin must be obtained even if the patient had a
stated desire for an autopsy. The following is exerpted from the Annotated
Code of Maryland, Section 5-501.
Consent for postmortem
(a) In general - Consent
for a postmortem examination of a body by a physician is sufficient if
the consent is given as provided in this section.
(b) Persons authorized
to consent --
(1) The consent may be given by any one of the following
persons if that person, whether alone or with another, has assumed control
of the body for its final disposition:
(i) A parent;
(ii) A spouse;
(iii) A child;
(iv) A guardian;
(v) A next of kin; or
(vi) In the absence of these persons, any other person.
(2) If a person does not assume control of a body under paragraph (1)
of the subsection, the consent may be given by the State Anatomy Board.
(c) Form of consent--The consent may be in the form of:
(1) A written document;
(2) A telegram; or
(3) A recorded telephonic or other recorded message
5. The patient may
be transferred to the morgue from the nursing unit to await either autopsy
or transfer to the responsible funeral home. The body must have proper
identification (toe tag, wrist band) or the autopsy will not be performed.
6. Once permission
for autopsy has been obtained, a member of the clinical care team should
contact the pathology resident who will be assigned to the case, so that
the clinical history and the questions to be answered may be reviewed
with the pathology resident. The name and contact information of the pathology
resident responsible for a new case may be obtained from the Surgical/Autopsy
Pathology office (6-2441) during normal working hours. During weekday
evenings and on weekends or holidays the resident on-call is responsible
for performing autopsies. The name and contact information may be obtained
through the NIH Page Operator.
7. The autopsy will
be performed when the body, chart and permission have all arrived in the
Laboratory of Pathology. Autopsies are begun routinely from 8:30 AM to
4:00 PM, Monday to Saturday and from 8:30 AM to 2:00 PM on Sundays and
Holidays. Permission to perform an autopsy outside these times should
be obtained from Dr. David Kleiner, Chief, Postmortem Section, Laboratory
of Pathology. He can be reached by page (102-10333), by work phone (301-594-2942)
or through the resident on-call.
Submission of Outside
Materials for Review by the Postmortem Section
In general, the Postmortem
section accepts materials for review or second opinion on patients who
have died and have had an autopsy performed elsewhere.
1. The materials submitted
may consist of tissue specimens, fixed or frozen, paraffin tissue blocks
or stained slides. A cover letter or outside autopsy report identifying
the materials should accompany the request for review. Copies of chart
information, patient history summaries and laboratory data are helpful
and should be made available to the Laboratory of Pathology.
2. The materials and
any associated paperwork should be brought to the Surgical/Autopsy Pathology
Office (Building 10, Room 2B50, 496-2441). A tissue examination request
form should be filled out by the submitting physician. Frozen or Fixed
tissue should be brought in sealed containers within an uncontaminated
3. The secretaries
in the office will assist the submitting physician so that the case is
appropriately handled and accessioned. The case is assigned to the resident
pathologist on the postmortem service for that month.
4. If surgical or
cytopathology materials are submitted with the autopsy materials, they
will be separated and submitted to the appropriate section in the Laboratory
Last Updated 1/12/2009 2:42:49 PM