British Medical Journal Letters - 7 September 2004

[This version of the report has been edited by Dr Robert N Moles
Underlining where it occurs is for editorial emphasis]

Dr Allan Cala homepage
List of Australian, UK and USA miscarriage of justice law reports
Article: Australian law on miscarriages of justice
Article: UK law on miscarriages of justice
Article: USA law on miscarriages of justice

Source: http://bmj.bmjjournals.com/cgi/eletters/329/7465/527-a#73410

ALLAN D CALA, FORENSIC PATHOLOGIST, ADELAIDE, SOUTH AUSTRALIA

This article tells us something many have suspected for a very long time. When UK forensic pathologists bragged about the "good old days" of 30+ autopsies on some "busy" days, it comes as no surprise to know that coronial autopsies may not be as thorough nor as accurate as hospital autopsies in ascertaining cause of death, or meticulously describing the pathology in each case. Dissections take time, and time is money. When the temptation exists to do a fast autopsy for the same fee as a more detailed and time consuming one, and with the pressure of another 8 autopsies or more to do for that day, quality will undoubtedly suffer. Short cuts will be taken to ensure a quick "turnaround time" for the coroner, but is it right, and are we doing the best thing by the deceased or their relatives?

Somehow, I doubt it.

Allan Cala FRCPA, Forensic Science Centre, 21 Divett Place, ADELAIDE SA 5000, AUSTRALIA

Competing interests: None declared

TIM LYONS, Director Forensic medicine, Newcastle NSW, Australia

Sadly salary scales here dictate that forensic pathology does not have the financial attractions of other medical specialities where pay may be several times higher.

This has led to an increased pressure on individual pathologists to undertake more and more cases. I believe we should all heed Dr Cala's comments- but what is a fair mixture of cases per pathologist. There seems to be some variance in opinion here in Australia with case loads varying from less than 200 to more than 500 cases per pathologist. Most would agree that 250-300 cases for a jobbing staff specialist is a fair work load that allows the production of good quality coronial autopsies (less if you have administrative duties)

As regard to quality of reports I see no harm in either internal and/or external audit of reports. However, it is imperative that the auditors are fully aware of the requirements of a good quality report. Therefore this should be organised by forensic pathologists for coronial cases and anatomical pathologists for hospital cases.

I look forward to thoughts, ideas and comments

Dr Tim Lyons [MbChb, MD, FRCS(ed), FRCPath, FRCPA, DMJ(forensic), DipAvMed]

Competing interests: None declared

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