Many Marylanders and even experienced personal injury lawyers are unclear of the law and policies regarding autopsies in Maryland. Below, in question and answer format, is a clear and concise discussion to the most common questions:

Q: What is an autopsy?

A: An autopsy is a series of tests and examinations performed on the body and its internal organs to determine the presence of an injury and/or to identify any disease that may have caused or contributed to the death of a person where the cause is not apparent. Additionally, special tests are performed to check for the presence of infectious diseases, alcohol and/or drugs.

Q: Why are they performed?

A: In Maryland, a death certificate must be completed by a doctor for all deaths before the body can be sent to the funeral home. When the person has a family doctor and dies from natural causes, the doctor can complete the death certificate and an autopsy may be unnecessary. However, if the person is not under the care of a physician or the death appears to be unusual or suspicious in nature or State law requires it, the Office of the Chief Medical Examiner must be notified to begin an investigation and determine the cause of death so that the death certificate can be completed. Similarly, in some situations, a hospital or State-licensed physician may, with the permission of the decedent’s family, perform an autopsy.

Q: In Maryland, who decides if there will be one?

A: This answer depends on who the decedent was and the circumstances surrounding their death. In Maryland, an individual dying as a result of a homicide, poisoning, suicide, criminal abortion, rape, therapeutic misadventure, drowning, or dying in a suspicious or unusual manner, or a death of an apparently healthy individual or a case which is dead on arrival at the hospital shall be examined by the medical examiner in the Office of the Chief Medical Examiner in Baltimore. In addition, in the case of a firefighter who dies in the line of duty, or a person who suffers a fire-related death, Maryland law dictates that the medical examiner must conduct an autopsy. Lastly, if the decedent died in a State-funded or State-operated facility, and the death appears unusual or suspicious in nature, the death shall be investigated by the Office of the Chief Medical Examiner. By contrast, a State licensed physician or hospital pathologist may perform an autopsy, with permission from the decedent’s family, on “non-medical examiner cases”, such as a stillbirth or neonatal death, a hospital death in which the cause of death has been established by a hospital physician and is due to disease, or when a decedent is dead on arrival to the hospital but the physician who pronounces death has previously treated the patient. Finally, when the decedent has a family doctor and dies from a natural cause such as from a disease, the family or hospital doctor can complete the death certificate and an autopsy may not be necessary, unless requested by the family.

Q: Can the family or anyone else request or prevent them?

A: Before an autopsy can be performed in the instance of a non-medical examiner death (death during hospital stay), the next of kin must grant permission. However, when state law requires a medical examiner to perform an autopsy, family permission is not required. A family may object to an autopsy because of religious beliefs. In this event, the Chief Medical Examiner must review the matter and determine, usually after speaking with the next of kin, whether it is absolutely necessary to perform an autopsy over a family’s objections. If the Chief Medical Examiner determines an autopsy is required, the family may ask the court to intervene and grant an injunction to prevent the procedure until a hearing can be scheduled. This will, however, delay the release of the body to the funeral home.

Q: Who performs them? Where?

A: Autopsies that are conducted by the Office of the Chief Medical Examiner are either conducted by the Chief Medical Examiner, the Deputy Medical Examiner, an assistant medical examiner or a pathologist authorized by the Chief Medical Examiner to perform the autopsy. These autopsies are generally conducted in Baltimore or at some other facility authorized by the Chief Medical Examiner. By contrast, if the decedent has died in a hospital in a non-suspicious manner, a hospital pathologist or other State-licensed physician may, with the permission of the family, perform the autopsy.

Q: What is done during an autopsy?

A: During an autopsy, the forensic pathologists thoroughly examine the body as well as its internal organs. Additionally, special tests are performed to check for the presence of infectious diseases, alcohol and/or drugs. To the extent that any evidence is discovered that may assist the pathologist in determining the cause of death, that evidence is collected. A typical forensic autopsy takes approximately 2-4 hours but may require additional time to complete the various tests.

Q: Who pays for them?
A: If the autopsy is performed by the Office of the Chief Medical Examiner, there is no charge to the family. Tax dollars fund this service. Families may be charged a nominal fee of $30 for a copy of the autopsy report. If, however, the autopsy is requested by the family and is performed by a private physician at another facility, the family will likely have to pay for the costs of the autopsy subject to the rates of that physician.

Q: How long does it take for the autopsy report to be completed?

A: If the cause of death is established to a reasonable degree of medical certainty, the medical examiner who investigates the case shall file in the medical examiner’s office a report on the cause of death within 30 days after notification of the case. Importantly, however, because various tests may need to be performed on a person’s body, organs or blood, this time frame may be extended.

Q: Does the autopsy report become public record? Where are they kept?

A: The official medical examiner’s autopsy report is a public record and is generally subject to disclosure under the Annotated Code of Maryland, State Government Article §§ 10-611 et seq., unless the case is subject to an ongoing investigation, or another appropriate reason for denial of disclosure exists. The individual files of the Chief Medical Examiner, however, are not public records but rather are private medical records protected from disclosure.

The official autopsy report is maintained by the custodian of records of the Office of the Chief Medical Examiner.

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