Emedinews:Insights on Medicolegal issues:Autopsy in deaths due to adverse events following immunization

• The doctor conducting the autopsy is duty bound to take samples for toxicological screening and should send them to forensic laboratory for toxicological/chemical examination
• The site of injection and the underlying tissue up to 2-3 cms (button size) with dermis and epidermis should be excised out. It should be preserved in a glass jar which should be filled two-thirds with saturated saline water. The specimens should be sealed, signed, labeled by the doctor/autopsy surgeon and should be handed over to police /investigating officer for further toxicological/chemical examination.
• The viscera for toxicological/chemical examination/ the following viscera specimen/biological samples should be collected for toxicological/chemical examination; 80 to 100 gms of liver, 80 to 100 gms of brain with meninges, whole of the stomach with gastric contents. If there are no gastric contents, a section of stomach should be sent. The upper part of small intestine about 30cm long with its contents Fragments from both adrenal glands, half of transverse section of kidneys, half of spleen. Blood 100 ml ideal / minimum 10 ml and urine 100 ml/ minimum 10 ml.
• All visceral specimens should be collected in separate containers - a wide mouthed bottle as prescribed - and saturated saline should be added as preservatives. The quantity of the saline should be sufficient to cover all the pieces of specimen viscera in bottle.
• The specimens should be sealed, signed, labeled by the doctor/autopsy surgeon and should be handed over to police /investigating officer for further chemical examination in a forensic lab.

(Contributed by Dr Sudhir Gupta)