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FM 2.19 Anaesthetic and Operative Deaths

The document outlines the definitions and classifications of anaesthetic and operative deaths, emphasizing the importance of determining the cause of death through autopsy and forensic analysis. It details the procedures for post-mortem examinations, including specimen collection for toxicological and histopathological analysis. The document also highlights potential causes of death related to anaesthesia and the significance of proper technique and equipment in preventing such fatalities.

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264 views15 pages

FM 2.19 Anaesthetic and Operative Deaths

The document outlines the definitions and classifications of anaesthetic and operative deaths, emphasizing the importance of determining the cause of death through autopsy and forensic analysis. It details the procedures for post-mortem examinations, including specimen collection for toxicological and histopathological analysis. The document also highlights potential causes of death related to anaesthesia and the significance of proper technique and equipment in preventing such fatalities.

Uploaded by

Charan
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PDF, TXT or read online on Scribd
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FM 2.

19
ANAESTHETIC &
OPERATIVE DEATHS
Dr. Viswakanth B
Introduction to terminologies
Anaesthetic Death

Definition: Death occurring within 24 hours of administration of


anaesthesia due to its direct effect or remote effect (Complications).

Remote effects time period : Within 2 weeks.


Examples
1. Patient X dies on OT while under the effect of anaesthesia COD
to be decided whether he died due to already existing illness or due
to effect of Anaesthetic agent / surgery by PME & Lab
Investigations

2. Patient X undergoes full surgery under GA Dies during the


recovery period from Anaesthesia COD to be decided again

3. Patient X undergoes full surgery under GA Aspirates during


recovery period develops Pneumonia and Dies 2 weeks later due to
subsequent complications COD to be decided again.
Classification of Deaths during Anesthesia
1. Death during administration of anesthesia but not due to the
Anaesthetic agent

2. Death directly due to Anaesthetic agent or procedure of


administration
Death during administration of anesthesia but
not due to the Anaesthetic agent (Examples)
1. The injury or disease process which necessitated the surgical
intervention is serious enough to cause death and the anaesthetic agent
was merely a precipitating factor.
Death directly due to Anaesthetic agent or
procedure of administration
1. Inexperience
2. Equipment failure
3. Inadequate anaesthetic administration
4. Excessive anaesthetic administration
5. Adequate anaesthetic administration but develops Malignant
hyperthermia.
Significance of Autopsy in Operative Deaths
In operative deaths the Forensic Pathologist must determine the
following at autopsy

1. Whether death was due to the effects of anaesthesia.


2. Whether death was due to the previously existing injury or disease
where anesthetic agent merely was a precipitating factor.
3. Whether there was defect in anaesthetic or surgical technique.
Procedure of PME in Operative Deaths
1. Obtain detailed history and information of anesthetic
procedure, operative technique
External Examination
2. Resuscitation measures and intubation may induce artificial
artefacts at external examination.

3. Surgical and anaesthetic devices such as endotracheal tubes,


needles or catheters should not be removed before taking X-ray of
dead body.
4. After X-ray of dead body they can be removed.
_____________________________________________________
5. During Internal examination, Pneumothorax and Air embolism
must
be looked for.

6. All organs must be washed, weighed and dissected as per standard


dissecting procedure.

7. Necessary specimens must be collected for laboratory analysis.


Viscera for Toxicological Examination
1. Blood – 50 ml With liquid paraffin as preservative

2. Alveolar air By puncturing Lung under water with needle and


syringe and capping the syringe under water

3. One Lung Ligated and Cut at Hilum and preserved in nylon bag.

4. Liver – 500 gms


5. One half of Each Kidney

6. Skeletal Muscle – 10 gms

7. Mesentric Fat – 10 gms

8. Brain – 100 gms

9. Urine – 10 ml
11. Drug Vials

12. Injection needles and syringes


Dispatch Method
• All above are packed labelled Sealed Handed over to the IO
Along with Sample seal and Requisition letter to Director of FSL
along with the PME report.
Specimens for Histopathology
1. Brain – Most Important

2. Heart

3. Lung - One

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