How do I obtain a copy of an autopsy report in the state of Maryland?
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This is what I was able to find. Hope it helps.
A: GENERAL POLICY STATEMENT
The Department of Pathology encourages the Medical Staff to obtain autopsy authorization on deceased patients 1) to determine cause of death, 2) to establish a quality assurance mechanism to evaluate the accuracy of clinical diagnoses, and 3) to assess patient management and the results of medical/surgical therapy. However, it is recognized that performing an autopsy on every death may not be feasible. Cases in which an autopsy should be especially encouraged are:
death in which autopsy may help to expain unknown or unanticipated medical complications to the attending physician.
all deaths in which the cause of death or a major diagnosis is not known with certainty on clinical grounds;
cases in which autopsy may help to allay concerns of and provide reassurance to the family and/or the public regarding the death;
unexpected or unexplained deaths occurring during or following any dental, medical, or surgical diagnostic procedures and/or therapies, if jurisdiction has not been assumed by the Office of the Chief Medical Examiner of the State of Maryland (see section B.2.);
deaths of patients who have participated in clinical trials (protocols) approved by institutional review boards;
natural deaths occurring within 24 hours of hospital admission
obstetric deaths of natural cause
neonatal and pediatric deaths;
deaths in which it is believed that an autopsy would disclose a known or suspected illness that may have a bearing on survivors.
Postmortem examinations provide a valuable mechanism for teaching the pathogenesis and pathophysiology of disease entities and advancing medical knowledge. If an anatomic finding warrants an inspection of the organs by the clinicians or if specifically requested, the clinician will be notified by the pathologist. If attendance of the contacted clinicians is not possible at that time, every practical measure will be taken to preserve the organs of interest for a later review, when requested.
The performance of a postmortem examination requires a joint effort on the part of clinicians, nursing staff and personnel of the Pathology Department. Interdepartmental cooperation and an understanding of the correct protocol are essential.
B. ROUTINE AUTOPSY PROTOCOL
1. DETERMINATION OF MEDICAL EXAMINER JURISDICTION
The initial consideration should include an assessment of whether a post-mortem examination falls under the jurisdiction of the State of Maryland Office of the Chief Medical Examiner. This assessment is the initial responsibility of the attending clinician. If the attending clinician feels that the case may fall under such jurisdiction, he/she must contact the Investigator's Office at the Office of the Chief Medical Examiner (410-333-3271), before attempting to obtain autopsy permission from the family of the deceased.
In addition, the attending pathologist has both the prerogative and the responsibility to assess whether a case may fall under the Medical Examiner's jurisdiction, even if the case has already been reported by the clinician. The Medical Examiner has the authority to take custody of a body for postmortem examination in any case falling under his legal jurisdiction, regardless of the wishes of the next of kin.
The following categories of death are reportable to the Office of the Chief Medical Examiner regardless of where or when the initial injury event occurred:
Any death that occurs suddenly or unexpectedly, that is, when the person has not been under medical care for significant heart, lung, or other disease.
Any death suspected to be due to violence; that is suicidal, accidental or homicidal.
Any death suspected to be due to alcohol or drug intoxication or the result of exposure to other toxic agents.
Any death of a resident housed in a county or state institution. This refers to any ward or individual placed in such a facility by legal authorization.
Any death of a person in the custody of law enforcement officers.
Any death occurring in a nursing home or other private institution without recent medical attendance.
Any death that occurs unexpectedly during, in association with, or as a result of diagnostic, therapeutic, surgical, or anesthetic procedures.
Any death suspected to be involved with the decedent's occupation.
Any death which is possibly -- directly or indirectly -- attributable to environmental exposure, not otherwise specified.
Any death due to neglect.
Any stillbirth of 20 or more weeks gestation, unattended by a physician.
Any death of a pregnant woman, regardless of the gestation period.
Any death of an infant or child where the medical history has not established some preexisting fatal medical condition.
Any death which is suspected to be due to infectious or contagious disease wherein the diagnosis and extent of disease at the time are undetermined.
Any death occurring under suspicious circumstances.
Any death in which there is a doubt as to whether or not it is a Medical Examiner's case should be reported.
If any of the following words/phrases appear on the death certificate, contact the office of the Chief Medical Examiner: accident, addiction, adverse reaction, alcohol, asphyxia, aspiration, at work, bite, burns, cut, ethanol, exposure, fall, fire, fracture, gunshot, homicide, ingestion, injection, injury, intoxication, misadventure, neglect, overdose, paraplegia, poisoning, post-operative (post any treatment/intervention), quadriplegia, sting, suicide, toxicity, uncertain, undetermined, unknown, use, and/or wound.
The following are excerpts from the State of Maryland Postmortem Examiner's Law and Regulations Governing Medical Examiner Cases:
"Medical Examiner's case" means any death which is the result, wholly or in part, of a casualty or accident, homicide, poisoning, suicide, criminal abortion, rape, therapeutic misadventure, drowning, or a death of a suspicious or unusual nature, or of an apparently health individual, or a case which is dead on arrival at the hospital.
Medical Examiner's case does not mean:
A stillborn or a neonatal death, or emergency room or hospital death in which the cause of death has been established by the hospital physician and is due to disease, and free of evidence of criminal or accidental nature.
A case in which the patient is dead on arrival at the hospital and the physician who pronounces death has been in previous attendance on the patient; or
A death which occurs in a hospital within 24 hours of admission, merely because the death occurred within 24 hours
In the case of any anesthetic death occurring in Maryland, the hospital in which death occurred shall notify immediately, by telephone, the Chief Medical Examiner or a Deputy Chief Medical Examiner or Assistant Medical Examiner.”
2. REQUESTING A HOSPITAL AUTOPSY
a. GENERAL INFORMATION
Autopsies are generally performed from 8:00 a.m. to 5:00 p.m. Monday through Friday.
Monday through Friday, autopsies will be performed on the same day that authorization is obtained, provided that all required items are received and that the examination can be started before 2:00 p.m.
No autopsies will be performed on Saturdays and Sundays or on major holidays occurring Monday through Friday, except under the most extenuating circumstances and only with the approval of the on-call pathologist.
All autopsies requested must have a properly completed authorization (Authorization for Autopsy Form). Instructions for completing the Authorization for Autopsy Form are provided below.
A routine autopsy includes examination of the neck, thoracic, abdominal, and pelvic organs, as well as the central nervous system. This extent of examination should be explained to the family member (next-of-kin) authorizing the post-mortem examination. If there are any restrictions or limitations, these should be clearly stated in the autopsy authorization form.
The clinical staff (e.g. clinical physicians, nursing staff) should not promise release of the body at a specified time. Information concerning estimated autopsy completion time and release of body may be obtained by the family or funeral director from the Pathology Office (410-521-5910).
A valid permission, documented on the "Authorization for Autopsy" form (see sample at the end of this section), constitutes the most important administrative prerequisite for this procedure. This form is available at the nursing units, Registration Office, Emergency Department and the Department of Pathology. It is the responsibility of the attending physician to discuss the decision for autopsy with the next-of-kin. The attending physician must also obtain the authorization from the next of kin. The attending physician may designate a Hospitalist or Physician Assistant to discuss the autopsy and obtain consent for autopsy.
The consent must be obtained from the next of kin (closest surviving relative), who is legally responsible for assuming custody of the deceased and providing arrangements for disposition of the remains.
In the case of an adult death, the responsible individual is either the spouse, oldest child of legal age, parent, sibling, or a person acting as a representative of the decedent under a signed authorization of the decedent, in that order of priority. At times, there may be no surviving blood relatives or appointed legal guardian. In the absence of any of the above persons, any other individual willing to assume responsibility to act as the authorizing agent for purposes of arranging the final disposition of the decedent’s body may authorize an autopsy, after attesting in writing that a good faith effort has been made to no avail to contact the aforementioned next-of-kin.
In the case of a deceased chil