AUTOPSY

NEGATIVE AUTOPSY

The gross and microscopic findings fail to reveal any apparent cause of death, along with the
other laboratory examination. In such cases the medicolegal examiner gives the cause of death as
‘Undetermined’.

INCIDENCE: In best centers of medicolegal examination the rate of negative autopsy ranges
from 2 to 10 percent of total autopsies.

CAUSES OF NEGATIVE AUTOPSY

1. Inadequate history A complete history of event leading to death should be obtained specially
when no positive postmortem change is present. Example: vagal inhibition, epilepsy, laryngeal
spasm, electrocution, death due to hyper sensitivity reaction, death due to drowning when
causing by laryngeal spasm.

2. Lack of proper external examination If the external examination is not made carefully the
cause of death may be missed. In death of drug addict the presence of new and old prick marks
may be missed on external examination.
Death from snake bite cannot be explained without proper identification of external lesion.
Death from electrocution demands a careful external examination so that the electric burns and
cause of death may not be missed.

3. Inadequate internal examination Two conditions most often be missed if careful internal
examination is not done, these are:
1. Air embolism
2. Pneumothorax

4. Insufficient histological examination If careless and insufficient histological examination is

done, microscopic lesions which account for death may be missed.

5. Inadequate pathologist`s training The training of doctors conducting autopsy is an important

factor.

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6. Obscure autopsy: The autopsy is termed as obscure, when there is no definite or obscure
cause of death. Obscure autopsy is a cause of negative autopsy.

Following conditions can go undetected leading to Obscure Autopsy:

a. Concealed Trauma: Injury to the cervical spine causing fracture dislocation and injury
to the spinal cord can cause instantaneous death without any obvious injuries.

b. Cardiac lesions: In blunt force injury to heart it may stop functioning without any
visible signs. Cardiac arrest can occur during or immediately following heavy exercises
in which there is increase in heart rate and systolic pressure with progressive ischemia
leading to cardiac arrest. Cardiac arrhythmias which may be precipitated by emotional
excitement can cause physiological asystole and may lead to death. Coronary spasm can
also lead to death without visible changes.

c. Reflex vagal Inhibition: This can be due to pressure on neck, blows on the larynx, chest,
abdomen and genital organs. It may occur during drowning, when the body is subjected
to very cold temperature .Any manipulation of external auditory meatus may also lead to
death due to vagal inhibition.

d. Lesions in CNS: Concussion, Epilepsy

e. Lesion n adrenals

f. Death from fear or shock