Postmortem examination at crematories: experiences and forensic medical evaluations

Abstract

Cremation is the most common type of burial in Germany. Evidence is lost when cremating the body. Asecond postmortem external examination (postmortem external examination at the crematory) is required by law in almost all German federal states prior to cremation. This duty is often performed by alegal medical specialist.This article provides an overview of different, mostly legal, medical assessments of the postmortem examination at the crematory and reports on personal experience in postmortem external examinations at crematories.The second postmortem medical examiner detects formal, content-related, and in some cases serious errors on medical death certificates on aregular basis. In cases with indications for anon-natural death or uncertain identity of the body, the cremation is stopped and some cases are reported to the investigative authority. Indications of death caused by physical trauma or malpractice are the most common reasons for delaying acremation during the postmortem medical examination at the crematory. The percentage of delayed cremations is minimal (up to 5%). The second postmortem examiner reports approximately 0.5-2% of cases to the investigating authorities. The number of court-ordered autopsies of decedents that had been reported as being conspicuous has always been low (approximately 1%).Currently, the postmortem external examination by aspecialist postmortem medical examiner at the crematory remains avital prerequisite for identifying non-natural cases of death. Only ahigh number of autopsy orders can significantly improve the cause-of-death statistics of the postmortem external examinations at the crematory.