Volume 67, Issue 6 pp. 2351-2359

ORIGINAL PAPER

Accuracy of forensic pathologists in incorporating post-mortem CT (PMCT) in forensic death investigation

Yohsuke Makino PhD,

Corresponding Author

Yohsuke Makino PhD

[email protected]

orcid.org/0000-0002-0025-5252

Department of Pathology, University of New Mexico, Albuquerque, New Mexico, USA

Department of Forensic Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan

Correspondence

Yohsuke Makino, Department of Forensic Medicine, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan.

Email: [email protected]

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Kana Unuma PhD,

Kana Unuma PhD

Department of Pathology, University of New Mexico, Albuquerque, New Mexico, USA

Department of Forensic Medicine, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan

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Kurt B. Nolte MD,

Kurt B. Nolte MD

Department of Pathology, University of New Mexico, Albuquerque, New Mexico, USA

Radiology-Pathology Center for Forensic Imaging, University of New Mexico School of Medicine, Albuquerque, New Mexico, USA

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Natalie L. Adolphi PhD,

Natalie L. Adolphi PhD

Department of Pathology, University of New Mexico, Albuquerque, New Mexico, USA

Radiology-Pathology Center for Forensic Imaging, University of New Mexico School of Medicine, Albuquerque, New Mexico, USA

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Yohsuke Makino PhD,

Corresponding Author

Yohsuke Makino PhD

[email protected]

orcid.org/0000-0002-0025-5252

Department of Pathology, University of New Mexico, Albuquerque, New Mexico, USA

Department of Forensic Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan

Correspondence

Yohsuke Makino, Department of Forensic Medicine, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan.

Email: [email protected]

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Kana Unuma PhD,

Kana Unuma PhD

Department of Pathology, University of New Mexico, Albuquerque, New Mexico, USA

Department of Forensic Medicine, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan

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Kurt B. Nolte MD,

Kurt B. Nolte MD

Department of Pathology, University of New Mexico, Albuquerque, New Mexico, USA

Radiology-Pathology Center for Forensic Imaging, University of New Mexico School of Medicine, Albuquerque, New Mexico, USA

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Natalie L. Adolphi PhD,

Natalie L. Adolphi PhD

Department of Pathology, University of New Mexico, Albuquerque, New Mexico, USA

Radiology-Pathology Center for Forensic Imaging, University of New Mexico School of Medicine, Albuquerque, New Mexico, USA

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First published: 06 September 2022

https://doi.org/10.1111/1556-4029.15131

Citations: 2

Presented at the 73rd Annual Scientific Conference of the American Academy of Forensic Sciences, February 15-19, 2021, held virtually.

The opinions, findings, and conclusions or recommendations expressed are those of the authors and do not necessarily reflect those of the Department of Justice.

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Abstract

Post-mortem computed tomography (PMCT) is now performed routinely in some medical examiner's offices, and the images are typically interpreted by forensic pathologists. In this study, the question of whether pathologists appropriately identify significant PMCT findings and incorporate them into the death investigation report and the cause and manner of death (COD and MOD) statements was addressed. We retrospectively reviewed 200 cases where PMCT was performed. The cases were divided into four categories: (1) full autopsy without radiology consultation (n = 77), (2) external exam without radiology consultation (n = 79), (3) full autopsy with radiology consultation (n = 26), (4) external exam with radiology consultation (n = 18). A radiologist (not the consult radiologist) read the PMCT images, and a pathologist (not the case pathologist) reviewed the case pathologist's post-mortem examination report in tandem to determine any PMCT findings omitted from the report. Omitted findings were classified into error types according to a modified Goldman classification including Major 1: Unrecognized fatal injury or pathology that would change COD and/or MOD, and Major 2: Unrecognized fatal injury or pathology that would not change COD and/or MOD. A total of 13 Major errors were identified (6.5%), and none definitively changed the MOD. All four Major-1 errors which could change the COD were found in Category 2. Of 9 Major-2 errors, 2 occurred in Category 1, 6 occurred in Category 2, and 1 occurred in Category 4. In conclusion, forensic pathologists who routinely utilize computed tomography (CT) interpret CT images well enough to reliably certify the COD and MOD.

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Volume67, Issue6

November 2022

Pages 2351-2359

This article also appears in:

The Path Forward – Forensic Sciences Response to the National Academies of Sciences Report 2009

Accuracy of forensic pathologists in incorporating post-mortem CT (PMCT) in forensic death investigation

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Accuracy of forensic pathologists in incorporating post-mortem CT (PMCT) in forensic death investigation

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