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Autopsy Service

General Information

Director of Adult Autopsy Service:  Jenny Libien, MD PhD

Director of Pediatric Autopsy Service:  Virginia Anderson, MD

Attending Pathologists on Autopsy Service:  

    • Virginia Anderson, MD

    • Carmencita Yudis, MD

    • Jenny Libien, MD PhD

    • Charles Shao, MD PhD

    • Jonathan Somma, MD

    • Raavi Gupta, MD

Division of Anatomic Pathology: 718-270-1669

Autopsy Resident pager:  917-218-4225 ( Monday to Friday 8am to 5pm )

Admitting Office:    A1-329,  x2863 or x2864  

Medical Examiner:   212-447-2030    

Frequently Asked Questions

What are the criteria for autopsy?

New York State law requires that the medical staff attempt to get permission for autopsy in all cases of unusual deaths and deaths of medical-legal and educational value. 

See B. Criteria for Downstate Medical Center, University Hospital of Brooklyn Autopsies for more information.

Does the death fall under the Medical Examiner's jurisdiction?

OCME will accept jurisdiction for, but not limited to the following: all forms of criminal violence, accidents, suicides, drugs contributed to by drugs or chemical overdose, fetal deaths in the absence of doctor or midwife, hospital stillbirths if there was maternal trauma or drug abuse, deaths during diagnostic or therapeutic procedures or from complications of these, deaths of all persons in legal detention, deaths due to disease, injury or toxic agents resulting from employment. Decisions on autopsy are made on a case by case basis.  Contact the OCME if you think the case meets the criteria (212-447-2030).   Document the call in the chart and include the name of the medicolegal investigator.

See A. Referrals to the Office of the Chief Medical Examiner for more information.

Who may give consent for the autopsy?

Consent for autopsy for non- medical examiner cases is granted by next-of-kin.

Telephone consent for autopsy is not permissible.  However, a next-of-kin who expresses his/her telephone consent to autopsy but is unavailable to sign a consent form, may give telephone approval to allow another relative to sign the consent form in his/her place.

Authorized signatures shall be obtained in the following list order of priority; authorization from persons lower on the list shall not be obtained if those who are higher on the list are available at the time of death.

1.  Spouse or registered domestic partner (no common law)                 

2.  Son or Daughter 18 years of age or over                 

3.  Grandchildren or other descendants            

4.  Either Parent

5.  Brother or Sister 18 years of age or over                   

6.  Grandparents

7.  Great grandparents, uncles, and aunts who are 18 years of age or over

8.  Other persons (18 or over)  entitled to share in estate of decedent

Where do I find a consent form?   

Get the forms from the Nursing Station Clerk, admitting, or from Autopsy-01 (click on link to the left to view document)

What if the next of kin needs to come to the hospital at a later time to sign the consent?

The admitting office can help coordinate the signature from next of kin.

Please encourage the next of kin to sign the consent soon after the patient’s death.  The utility of the autopsy is compromised by a long post-mortem interval. 

What must be included on the consent form?

The form, “Consent to Autopsy,” must contain the name of the deceased patient, restrictions to autopsy, if any, special examination, if any, the signature of the authorized next-of-kin and his/her relationship to the deceased.   The signature of a witness who is employed by SUNY Downstate Medical Center is also required.

How is the completed consent form submitted?

The signed consent must be brought to the Admitting Department for approval by the Director of Admissions to ensure that the consent is proper.  During off hours, the AOD will approve all requests for autopsy.  The Admitting Department can also help coordinate the signing of the consent by the next of kin if necessary. 

The Nursing Station Clerk will be responsible for putting the chart in order and having the chart and Consent for Autopsy delivered to the Admitting Department.  The chart  should be submitted to Admitting within 1 hour of the patient’s death. 

ADMITTING SHOULD BE NOTIFIED THAT THERE IS AN AUTOPSY REQUESTED.  THE CONSENT SHOULD NOT BE PLACED INSIDE THE CHART OR BEHIND THE CHART. 

The Admitting Department will contact the Pathology Department. Pathology will pick up the consent and the chart before the Autopsy will begin.

Please call Pathology directly if you have specific questions that you would like addressed by the autopsy.  Giving your contact information will also allow the pathologist to invite you to attend the autopsy and related conferences and communicate important autopsy findings. 

Who signs the death certificate when there is an autopsy?

The Admitting Representative will fill in the top (clerical) part of the death certificate.  The pronouncing physician will sign the TOP portion of the death certificate. 

THE PATHOLOGIST WHO HAS PERFORMED THE AUTOPSY WILL COMPLETE AND SIGN THE BOTTOM SECTION OF THE DEATH CERTIFICATE ( #26-32, Parts I and II, including the cause of death)

Is there a charge for the autopsy?

Autopsy is a service that the hospital provides, free of charge, to help us answer any questions that the next of kin or the doctors might have about the patient’s  disease or the care he/she received.

Will the autopsy delay funeral arrangements? 

The autopsy need not delay any funeral preparations. 

Can the autopsy be limited?

The consent authorizes the removal, examination and retention of organs and fluids.  Limitations may be placed on both the extent of the autopsy (which organs may be removed) and on the retention of organs (if requested all organs can be returned to the body).  However, limitations may compromise the usefulness of the autopsy (partial autopsies give partial answers).  

How long will it take to get the results of an autopsy?

A preliminary anatomic diagnosis is issued within one working day.

The final report is usually issued within 4 to 8 weeks. Some cases are more complex and the final report may take longer to complete.

A.  Referrals to the Office of the Chief Medical Examiner

The Office of the Chief Medical Examiner has jurisdiction over all deaths occurring under the following circumstances:

  1. All forms of criminal violence or from an unlawful act or criminal neglect.
  2. All accidents (motor vehicle, industrial, home, public place, etc.)
  3. All suicides
  4. All deaths which are caused or contributed to by drug and/or chemical overdose or poisoning.
  5. Sudden death of a person in apparent good health
  6. Deaths which occur unattended by a physician and where no physician can be found to certify the cause of death.  In this context, “unattended by a physician” means not treated by a physician within thirty-one days immediately before death.
  7. Deaths of all persons in legal detention, jails or police custody, including any prisoner who is a patient in a hospital, regardless of the length of hospital stay.
  8. Deaths which occur during diagnostic or therapeutic procedures or from complications of such procedures.
  9. When a fetus is born dead in the absence of a physician or midwife.  Stillbirths in the hospital need not be reported to OCME unless there is a history of maternal trauma or drug abuse or the case has some other unusual or suspicious circumstance.  Neonatal deaths from prematurity and its complications must be reported if the premature delivery was caused by maternal trauma or drug abuse.

Hospital deaths from natural causes, in which a diagnosis has been made with reasonable medical probability, despite the fact that the patient survived less than 24 hours in the hospital, need not be reported to OCME.

The physician who pronounces the patient’s death in cases fitting any of the categories listed above in A1 should not ask the family for permission to conduct an autopsy.  Instead, the physician should call the Office of the Chief Medical Examiner at (212) 447-2030 and speak to the Medical Examiner on Duty, who has the authority to decide whether or not the Office of the Chief Medical Examiner will accept the case.

Whether or not the Medical Examiner accepts the case, the physician obtains the ME’s case number and the medicolegal investigator’s name and records it in the patient’s medical record.

If the ME accepts the case, the physician fills out UHB Form 2005, “Medical Examiner’s Hospital Report,” which is available in the Admitting Office. 

If the ME refuses a case, the physician records that fact in the patient’s medical record, along with the medicolegal investigator’s name and, if provided, the ME case number, and should seek permission from the patient’s next-of-kin to perform an autopsy, according to the procedures in Sections C. and D. below

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B. Criteria for Downstate Medical Center, University Hospital of Brooklyn Autopsies

New York State law requires that the medical staff attempt to get permission for autopsy in all cases of unusual deaths and deaths of medical-legal and educational value. 

To satisfy this requirement, it is recommended that autopsy be requested in the following types of cases:

  1. Deaths in which the cause of death or a major diagnosis is not known with reasonable medical certainty on clinical grounds.
  2. Deaths in which an autopsy may help to allay concerns of the family and/or the public about the death to provide reassurance to them regarding the same.
  3. Deaths which are unexplained or unexpected, following dental, medical or surgical diagnostic procedures or therapies, and which are not accepted for autopsy by the Medical Examiner.
  4. Deaths of patients who participated in clinical trials approved by an institutional review board.
  5. Deaths in which the Medical Examiner is called but declines the case.
  6. Deaths in pregnant females.
  7. All neonatal and pediatric deaths.
  8. Known or suspected deaths arising from environmental or occupational hazards.
  9. Deaths which may have genetic implications for the surviving family members.

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C.  Guidelines for Obtaining and Documenting Autopsy Consent or Refusal

When a patient dies, the pronouncing physician is responsible for seeking consent to autopsy, which must be in writing [fax is acceptable] and on the UHB form “Consent to Autopsy” in the manner described in Section D below, “Documentation of Consent to Autopsy.”

In seeking the next-of-kin’s consent to autopsy, the physician may use all or part of the following language, which has been recommended by the American College of Pathologists, if the physician finds it useful:

“The patient’s other doctors and I think that the cause of death was _____________.  It is your privilege to have an autopsy performed, if you choose.  This is a service that the hospital provides, free of charge, to help us answer any questions that you or the doctors might have about his/her disease or the care he/she received.  It is important to help us learn more about [this disease] for the sake of patients in the future.  The autopsy need not delay your funeral preparations, and even a complete autopsy will not disfigure the body, should you want a viewing.  Would you like us to perform an autopsy?.” 

When seeking consent for autopsy, the physician should refer to the following list in order of priority to determine the family members who are authorized to consent.  Authorization from persons lower on the list may not be obtained if those who are higher on the list are available at the time of death.  For family members who have the same relationship to the deceased patient, it is preferable for both or all to sign the consent to autopsy, unless they are estranged or unavailable to sign.  Telephone consent for autopsy is not permissible.  However, a next-of-kin who expresses his/her telephone consent to autopsy but is unavailable to sign a consent form, may give telephone approval to allow another relative to sign the consent form in his/her place.

  1. The spouse or domestic partner who has registered a domestic partnership;
  2. The children, 18 years of age or older;
  3. The grandchildren, 18 years of age or older;
  4. The parents;
  5. The brothers and sisters, 18 years of age or older
  6. The grandparents;*

*Great grandparents and uncles and aunts who are 18 years of age or older; and

Other persons, 18 years of age or older, who would be entitled to share in the estate of the decedent

If there is doubt as to who constitutes next of kin, or if there appears to be none, call or page the Hospital Director of Admissions or the Risk Manager or the Administrator on Duty.

If there is disagreement among next of kin who bear the same family relationship the Ethics consultation service may be consulted to attempt to mediate the dispute.

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D. Documentation of Consent to Autopsy

The form, “Consent to Autopsy,” must contain the name of the deceased patient, restrictions to autopsy, if any, special examination, if any, the signature of the authorized next-of-kin (see B.) and his/her relationship to the deceased.   The signature of a witness who is employed by SUNY Downstate Medical Center is also required. 

  • This signed consent must then be brought to the Admitting Department for approval by the Director of Admissions to ensure that the consent is proper.  During off hours, the AOD will approve all requests for autopsy.

The physician who pronounces the patient as having expired is also responsible for writing a brief note in the patient’s medical record.  This note should include the date and time of death, family member who was notified of the patient’s death (or efforts made to notify a family member) and status of a request for autopsy.  The physician’s pager number should be included to allow the autopsy pathologist to communicate with the physician before and after the autopsy.  

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