Statistical Analysis of Postmortem Inspection Cases of the National Forensic Service Seoul Institute in 2017 / 대한법의학회지

This study provides a statistical analysis of 1,226 cases of death occurring in Area 8, Seoul Metropolitan Police Agency (Gangseo, Yangcheon, and Guro Police Stations) from January 1 to December 31, 2017. There were 427 postmortem inspection cases in Gangseo, 393 in Yangcheon, 377 in Guro, and 29 in other areas. The number of autopsy cases was 69 in Gangseo, 70 in Yangcheon, 86 in Guro, and seven in other areas. According to the postmortem inspection reports, there were 593 cases of natural death and 336 cases of unnatural death, while in 297 cases the cause of death was unknown. Of the 297 unknown cases, autopsy rates from each police station were as follows: 54 of 99 cases (54.5%) in Gangseo, 60 of 101 cases (59.4%) in Yangcheon, 67 of 93 cases (72.0%) in Guro, and in all four cases (100%) from other areas. Unnatural deaths included 215 cases of suicide, nine cases of homicide, and 64 accidental death, while 48 cases were undetermined. Among the unnatural deaths, the cause of death included 138 cases of hanging, 72 cases of falls from a height, and 32 cases of poisoning. Since this statistical study is based on actual postmortem inspection data for 1,226 cases of death in the eight areas of Seoul (excluding deaths from traffic accidents), it raises issues relating to the current postmortem inspection system, and can be used as reference material for a comprehensive overview of causes of death.

The Statistical Analysis on the Postmortem Inspection Cases of National Forensic Service Seoul Institute in 2015 / 대한법의학회지

Since March 1, 2015, the National Forensic Service Seoul Institute has commenced postmortem inspections at the death scene in agreement with the Korean National Police Agency. Included regions were mainly Seoul Metropolitan Police Agency Wide Area 8 (Gangseo, Yangcheon, Guro police stations), and several other areas. In total, 837 postmortem inspection cases from March 1 to December 31, 2015, were analyzed statistically. Of these, 168 were autopsy cases, and the rates were 20% (67 cases) in Gangseo Police, 14.5% (30 cases) in Yangcheon Police, and 22% (57 cases) in Guro Police stations. For 269 cases of “unknown cause of death”, the autopsy rates were 44% in Gangseo Police, 36% in Yangcheon Police, and 47% in Guro Police stations. For 82 cases of fall from height, autopsy rates were 17% (n=14). Of the 133 cases of hanging, 121 cases were classified as suicide at the scene with a 2.5% (n=3) autopsy rate. Twelve cases were classified as an undetermined manner of death at the scene with a 33% (n=4) autopsy rate. The distribution of the “manner of death” was natural death for 29% (n=250), unnatural death for 38% (n=318), and other and undetermined manner of death for 32% (n=269) of cases. Proportions of dispatch times were 49.2% (412 cases) during work hours (09:00-18:00), 15.7% (n=131) during evening hours (18:00-21:00), 13% (n=110) at night (21:00-24:00), 10% (n=88) at dawn (24:00-06:00), and 11% (n=96) during morning hours (06:00-09:00). The male to female sex ratio was 1.96:1 (556:281). These statistics are valuable for evaluation of postmortem inspections by experts.

The Statistical Analysis on the Postmortem Inspection Cases of National Forensic Service Seoul Institute in 2016 / 대한법의학회지

From January 1, 2016 to December 31, 2016, a total of 1147 postmortem inspection cases in Area 8, Seoul Metropolitan Police Agency (Gangseo, Yangcheon, and Guro police stations) were statistically analyzed. Autopsies were performed in 205 cases (17.9%), and the autopsy rates were 17.6% (75/426 cases) in the Gangseo police station, 9.5% (34/357 cases) in the Yangcheon police station, and 24.3% (82/337 cases) in the Guro police station. For 288 cases with an unknown cause of death, the autopsy rates were 70.0% (60/87 cases) in the Gangseo police station, 28.6% (26/91 cases) in the Yangcheon police station, and 63.1% (65/103 cases) in the Guro police station. For 65 cases due to fall from height, the autopsy rate was 7.7% (n=5). Of the 187 cases due to hanging, 155 cases were classified as suicide at the scene with a 4.5% (n=7) autopsy rate and 32 cases were classified as an undetermined manner of death at the scene with a 15.6% (n=5) autopsy rate. The distribution of the “manner of death” was natural death, 45% (n=516); unnatural death, 29.9% (n=343); and other and undetermined, 25.1% (n=288). Proportions of dispatch times were 50.9% (584 cases) during work hours (09:00–18:00), 13.8% (n=158) during evening hours (18:00–21:00), 13.4% (n=154) at night (21:00–00:00), 11% (n=126) at dawn (00:00–06:00), and 10.9% (n=125) during morning hours (06:00–09:00). The male-to-female ratio was 1.86:1 (746:401). These statistics are valuable for the evaluation of postmortem inspections by experts.

Differences in the Determination of Cause and Manner of 127 Natural Death Cases by Postmortem Inspection and Autopsy / 대한법의학회지

Medico-legal investigations in Korea depend mostly on postmortem inspection without autopsy. Both untrained physicians and experienced forensic pathologists may not be able to determine the cause and manner of death only by postmortem inspection. The aim of our study was to show the limitations of postmortem inspection by evaluating the discrepancy between the results of postmortem inspection and autopsy after natural death. The manner of death by postmortem inspection changed to unnatural death in 9.4% of the cases (12 cases/127 cases) after autopsy. The cause of death in most cases was consumption of alcohol, agricultural chemicals, and antipsychotic intoxication. The cause of death by postmortem inspection changed in 24.3% of the cases (26 cases/107 cases) among cases of confirmed natural death after autopsy. The positive predictive value of cause of death by postmortem inspection was higher for cardiovascular disease (79.0%) and lower for chronic alcoholism and/or chronic liver disease (28.6%). This study shows that forensic pathologists could make considerable errors in determining the cause and manner of death without autopsy and emphasizes the necessity to refine medico-legal investigations in Korea by introducing the limited autopsy with toxicologic study and supportive postmortem imaging.

About reform of autopsy system: focus into the limited autopsy / 대한법의학회지

The autopsy system in Korea is based on the Corpse Autopsy and Preservation Law which Articles 2 didn 't limit medical professors and medical examiners to perform autopsy. But according to the Medical practitioners Law Article 18, only a practicing physician can issue the certificate for postmortem inspec-tion. If an unnatural death is suspected, the postmortem investigation and autopsy should be performed according to the order of Criminal Procedure Code Article 222. The limited role of postmortem investi-gation in unnatural death and respective bodies of postmortem inspection and autopsy, which would cause the overflow of criminal autopsy. The detailed guide-line of unnatural death, should-be verified death cases, practical use of postmortem inspection including the blood and tissue sampling etc, unifica-tion of legislations regarding to autopsy system, the specific warrant of autopsy, which empowers the limited and full autopsy individually would be help to improve that distortion.