Forensic pathology is a discipline principally concerned with the investigation of deaths, where a person has died in suspicious circumstances (i.e. manslaughter, murder, suicide or accident).The role of the forensic pathologist is to determine, by means of a post mortem examination, the cause of death and the circumstances surrounding the incident, which led to the death.
Forensic pathology services for the defence
In relation to criminal defence it is of utmost importance that the defence solicitor and counsel understand fully the content and implications of the post mortem report, if the alleged victim is deceased; or the implications of the medical report and photographs, if the alleged victim was merely injured.
As medical professionals however, pathologists are also best placed to comment on cases where the victim is not deceased but has instead sustained non-fatal injuries, which are suspected to be as a result of a violent crime or abuse.
Home Office registered pathologist
Forensic Equity is very proud to have a number of pathologists on the team, many of whom are Fellows of the Royal College of Pathologists and admitted to the Home Office Register of Forensic Pathologists.
Specialisms held within our department:
Paediatric pathology (Persons aged 13 and under)
Neuropathology (Brain & Nervous System)
Osteoarticular pathology (Bone and Joint)
Histopathology/Cardiovascular Pathology (Heart)
Ophthalmic Pathology (Eye Trauma)
Second Independent Post Mortem
Our team of Home Office pathologists are available at the request of the defence to conduct a second post mortem, also referred to as a defence autopsy or defence post mortem examination. This may for example, be on behalf of a defendant charged with murder where the body of the victim is used as primary evidence.
Home Office Circular No.30/1999, Noted:
“…The need in the interests of justice, to offer a defendant the opportunity to arrange an independent examination of the body …”
“… the right of a defendant to have the opportunity for the primary evidence to be examined on the directions of his legal advisers needs to be respected”.
This document has been superseded by the Chief Coroner's Guidance No. 32. Further information regarding the new guidance is below, but it should be noted the paragraph 60 states; "The Chief Coroner expects that the pathologist will produce a summary report to the coroner as soon as possible in order that the defence solicitor can make a decision as quickly as possible as to whether to make a request to the coroner to arrange a second PM examination".
Instructing us to conduct a second independent post mortem
Once one of our pathologists is instructed by the defence to investigate the alleged violent or suspicious death they will act as quickly as possible and aim to conduct their autopsy and independent examination within 5 working days.
Current guidance suggests that the defence must assess the need for any further post mortem and inform the coroner within 14 days of receipt of the preliminary post mortem examination report.
A second independent post mortem conducted by one of our Home Office registered pathologists could reveal new information or lead to a different interpretation regarding:
The estimated time of death.
Alternative medical cause(s) of death.
Determine whether any competing explanations for the death are consistent with the findings.
An understanding of the, or provision of an alternative, mechanism(s) of death.
Contribution of any underlying natural disease(s).
Assessment of other unusual findings such as positive toxicological results.
The reasons for arranging to have the primary evidence independently examined
The involvement of a second independent pathologist is to ensure that there has been no unwarranted emphasis on one of several possible interpretations of the significance of the findings at the first post mortem examination. In addition it should look to ensure that both positive and negative findings have been reported.
There may also be cases where there are immediate concerns as to the reliability, completeness and robustness of the findings of the first post mortem and where, therefore, there is the need for a second post mortem examination to be carried out.
Practice Guidelines of the Policy Advisory Board for Forensic Pathology make clear, that the opinion offered by a pathologist must be “objectively reached” and have “scientific validity”.
Linking all of the evidence
Together with their own autopsy findings, and before reaching any conclusions, our Home Office pathologists will look at all of the evidence which is presented to them in order that they may fully understand the circumstances of the death. This can and may include witness statements, police statements, defence statements and crime scene photographs. In addition they are very willing to answer specific questions posed by the defence counsel.
Our Home Office pathologists can:
Conduct a defence autopsy or second post mortem
Conduct a paper based review of an initial post mortem
Independently review and interpret witness statements, police statements, defence statements, post mortem photographs and crime scene photographs.
Forensically examine all of the evidence which is presented to us and answer specific questions put to us in counsel’s advice.
Provide a detailed forensic statement which details all of our findings together with comment on any other issues which we consider relevant to the defence case.
Where required, attend either the Crown court and / or the coroner’s court to explain the medical issues involved in the case.
Current Guidance from the Chief Coroner
There is a substantial benefit of carrying out imaging that more detailed review is possible at a later stage, particularly in a case of suspected homicide or where there may be state involvement in the death. Coroners should reflect on the value a scan, alongside the first examination, may bring to a forensic
case where there may be criminal proceedings. There may be considerable benefit. A scan will preserve evidence which can then be reviewed by others, including a second forensic pathologist.
It is important to note that, where a body has been subject to a first invasive PM examination (whether standard, additional or forensic), the body will often have been substantially disrupted, with organs removed. Therefore it is important for all involved to consider carefully and realistically what benefits can be gained from a subsequent invasive examination.
On the other hand, if an interested party wishes to instruct a second pathologist in order to review a scan or other electronic or other material from the first PM examination, then provided it can be done within the specified timeframe (28 days after the first PM examination), a coroner may have greater confidence in acceding to the request.
Undertaking a defence post mortem examination without examining the physical body
The opportunity for a defendant to request a further post mortem examination can be dependent upon how soon after the death he or she is charged. For example if they are charged after the disposal of the body.
If a defendant is not charged within 28 days of the discovery of the death, and therefore does not have a defence lawyer acting on his or her behalf during this 28 day period, the opportunity for a second independent examination is restricted to examination of the report from the initial post mortem, and any records retained in relation to it.
It is often possible however that conclusions and opinions can be drawn by examining the report, photographs, scans and associated items from the original / first post mortem.
Therefore should the body of the deceased by unavailable there may still be opportunity for us to re-examine the case and associated evidence and review the findings of the first post mortem in order to provide the defence with a second independent opinion and address any specific issues raised by counsel.
In relation to criminal defence, it is of utmost importance that the defence solicitor and counsel understand fully the content and implications of the first post mortem examination.
In addition to our Home Office pathologists we are privileged to have on the team one of the UK’s leading forensic neuropathologists whose work includes post-mortems and forensic brain examinations.
Other information to note regarding post mortems
Where a second post mortem examination is performed by a different doctor, we would expect the original pathologist to understand the need to share all information that he had obtained. If he did not, he would deprive the other doctor of the opportunity to decide for himself whether that information was relevant or not.
It is therefore essential that the defence obtain not just the preliminary post mortem report (which must be provided to the defence within 14 days of the initial examination) but also their full post mortem report. Please note that there may be a delay of 4-8 weeks between the preliminary and initial post mortem reports being available.
Defence practitioners are also encouraged to obtain the following additional information as quickly as possible thereafter:
The full initial post-mortem report (not merely a summary report or oral representation);
Photographic record of the post-mortem;
Any video recording of the post-mortem.
Defence autopsy time limits
Coroners have authority to retain a body in cases of suspicious violent death (murder, manslaughter, infanticide, and causing death by dangerous driving) for a period of up to 40 days from the death, with an option to apply to the Chief Coroner for a one off extension of a further 20 days should circumstances demand (e.g. following representations by the prosecuting authorities or the defence representative, or should additional suspects be charged with the offence).
The current guidance however limits the opportunity for defendants to request a second post mortem to 28 days.
Coroners have authority to retain a body for the purposes of:
A defendant or prosecuting authority to arrange/request a second post mortem.
In the event of no defendant being charged, a coroner commissioned second post mortem.
A third post mortem or additional tests in the event of discrepancies between the first two post mortems.
A defendant or prosecuting authority has the right to appeal to the Chief Coroner for further 20 day extensions to release of the body, but a compelling reason must be provided for the Chief Coroner to grant such a request. The coroner’s decision will be subject to judicial review.
Suspicious deaths are those where the cause of death or the circumstances surrounding the event are thought to be suspicions. It must therefore be examined in order to establish whether the death was manslaughter, murder, suicide, accident or indeed natural.
Forensic pathology consists of an examination of a body after death, in cases where the death is suspicious. The role of the forensic pathologist is to determine the cause of death and the circumstances surrounding the incident, which led to the death.
The initial post mortem should involve a thorough examination of the body, both externally and internally. During this process anything at all unusual should be noted by the forensic pathologist, including amongst other things: injuries, scarring, discolouration. The post mortem report will then be released and can often constitute a significant proportion of the prosecution’s evidence.
However, occasionally, the forensic pathologist may have missed a crucial detail during the original post mortem examination, which could prove pivotal to the defence case.
Whether as a result of the defendant's testimony or other available evidence, if there is any reason whatsoever to suspect that the person died from something other than the alleged actions of the defendant (i.e. natural causes) or in a manner incompatible with the theory put forward by the prosecution, we would recommend that counsel request the services of our Home Office Authorised forensic pathologist, in order that they may carefully consider the results and conclusions of the original report.
Our forensic pathologist would take the following steps to review your client’s case:
Our first step would be to review the original report and findings, looking for any questions which may have been left unanswered or for processes which have been omitted.
If we have reason to believe that the report fails to address an issue or have cause to believe that the defendant's case may benefit from a second report (based on the original report or on a re-examination of the body) we can provide an estimate of costs suitable to legal aid funding if required.
Once we have received your instructions to proceed we would conduct the review proposed in our estimate and provide a detailed report of our findings commenting on all the points which may have been raised by the defence along with any other information which we feel may be relevant and important to the case.
Finally if called upon to do so our pathologist will provide robust testimony in relation to their findings at the criminal trial.
A review, by our forensic pathologist, of the post mortem findings or a second post mortem could reveal new information or lead to a different interpretation regarding:
Estimated time of death.
Alternative causes of death.
Other unusual findings.
Violent Crime including the Causation of Injuries
As medical professionals forensic pathologists are undoubtedly best placed to comment on criminal cases of violent crime where the victim is not dead, but has sustained injuries, allegedly from a violent attack or some form of physical abuse.
Criminal cases of violent crime will often involve two very different versions of events and it is essential for the defence case that all questions surrounding the event are robustly addressed and that the evidence is interpreted correctly.
Allegations of violent crime
Whether as a result of your client's testimony, other available evidence or eye witness accounts, if there is any reason to suspect that the victim sustained the alleged injuries in a way which differs from the account put forward by the prosecution then the defence counsel should request the services of our Home Office Authorised Forensic Pathologist.
How can our forensic pathologist assist in providing a defence case?
In relation to a case involving violent crime or alleged abuse, a review of the evidence could reveal information that supports the defendant’s version of events or re-affirms parts of the initial findings supporting the prosecution's case, or leads to alternative conclusions and questions which give reason to doubt the victim’s version of events.
These cases usually revolve around examination of photographs of the injuries sustained by the victim and possibly the defendant. It is the forensic pathologist’s task (based on photographic evidence, medical reports and eye witness accounts) to provide an opinion on whether the findings are consistent with the victim's or the defendant's version of events leading to the injury or whether they cannot say one way or the other.
Examples of questions critical to the defence case may include:
Were the wounds inflicted by a right handed or a left handed person?
What was the type and characteristics of the weapon used in the incident?
Are the injuries consistent with the version of events put forward by the prosecution?
Are the injuries consistent with the version of events put forward by the defendant?
How long ago were the injuries sustained?
Are there any alternative explanations as to how the injuries were sustained?
We offer expert forensic radiological opinion on ante-mortem and post-mortem cases. Often cases that involve violent crime will include radiography evidence. Our neuro radiologists can provide CT scan and X-Ray interpretation.
Our expertise relate to cranio-facial trauma, neck trauma, spinal trauma, post-mortem radiology and wound/injury profiling and wound age determination using pre-mortem or post-mortem radiology (ie. CT scans, MRI scans and X-rays performed pre-mortem and/or post- mortem) and human identification using these radiology techniques.
How can our neuro radiologists assist in providing a defence case?
These cases revolve around examination of X-rays or CT Scans of the injuries sustained by the victim and possibly the defendant. It is the forensic neuro radiologist's role to provide an opinion on whether the x-ray evidence is open to interpretation or whether the prosecution findings are the sole explanation.
Forensic Equity is very proud to have a number of forensic pathologists on the team, all of whom are Fellows of the Royal College of Pathologists and some who are also admitted to the Home Office Register of forensic pathologists.