Gerichtliche Obduktionen nach Anhaltungen bei Feuerbestattungsleichenschau: Gegenüberstellung von Todesursache und Todesart vor und nach der Obduktion

According to the literature between 20% and 47.5% of the documented causes of death given on death certificates are inaccurate. Consequently, this raises significant concerns regarding the accuracy of mortality statistics. The discrepancy prompted us to lead an inquiry into the prevalence of errors on death certificates within the jurisdiction of the Institute of Forensic Medicine of Greifswald.

The analysis focused on cases of deceased individuals who underwent a forensic autopsy after being withheld from cremation following a second postmortem examination between 1 January 2013 and 31 December 2022. A total of 323 cases were considered for this study, wherein especially the cause and manner of death, as documented in the confidential section of the death certificates, were compared with the findings from the forensic autopsy.

The causes of death were categorized into specific groups to streamline the analysis.

During this 10-year period 2389 cases of deceased individuals were withheld from cremation, 323 deceased individuals underwent an autopsy, 54% were male, 46% were female and the average age at the time of death was 72 years. The most frequent manner of death, both before and after autopsy, was natural; however, in 44 cases the forensic autopsy revealed an unnatural manner of death, while the death certificate declared a natural one. Additionally, in three cases homicidal violence was revealed as the cause of death through forensic autopsy and one case had already received judicial clearance at the time of the second postmortem examination.

The most frequent cause on the death certificates was cardiac-related (n = 193) and the autopsy findings confirmed this in 64% of cases. Overall, for 47.7% of cases the cause of death stated on the death certificates was corroborated by the forensic autopsy findings. Furthermore, in 43% of cases the death certificates correctly stated the cause and manner of death. Without the crucial role of forensic autopsies, in 52.3% of cases an incorrect cause of death would have skewed the mortality statistics.

The second postmortem examination as carried out in Mecklenburg-Western Pomerania is an essential tool for uncovering previously undetected non-natural manners of death and a factor for improving mortality statistics. The second postmortem examination cannot be dispensed with.