Current through Register Vol. 46, No. 19, March 20, 2024
(1)
Autopsy
required. A county medical examiner shall perform an autopsy or order
that an autopsy be performed in the following cases:
a. All cases of homicide or suspected
homicide, irrespective of the period of survival following injury.
b. All cases in which the manner of death is
undetermined.
c. All cases
involving imidentified bodies.
d.
All deaths of children under the age of two when there is not a clear cause of
death, including suspected cases of sudden infant death syndrome. A summary of
the findings of the autopsy shall be transmitted by the physician who performed
the autopsy to the county medical examiner within two days of completion of the
report. Autopsies performed on children under the age of two when the
circumstances surrounding the death indicate that sudden infant death syndrome
may be the cause of death or the cause of death is not clearly explained by
known medical history shall conform to Form ME-4.
e. All work- and farm-related deaths unless
there is an obvious natural cause of death.
f. All drowning deaths.
g. All deaths of commercial vehicle drivers
that occur during the performance of their job duties.
h. Deaths due to poisoning.
i. Deaths of airplane pilots who die as a
result of an airplane crash. The National Transportation Safety Board and the
Federal Aviation Administration should be contacted prior to the autopsy to
request specimen kit(s).
j. Deaths
due to a natural disaster, including tornadoes and floods.
k. Deaths in a prison, jail or correctional
institution or under police custody, where there is not a natural disease
process that accounts for the death.
(2)
Autopsy recommended. It
is recommended that a county medical examiner should perform an autopsy or
order that an autopsy be performed in the following cases:
a. Deaths of adolescents less than 18 years
of age when there is not a natural cause of death.
b. All cases which involve a motor vehicle
crash, imless it is a single motor vehicle accident with no potential for
litigation and there is an obvious cause of death or the injuries have been
clearly documented by hospitalization.
c. Rescinded lAB 3/29/06, effective
5/3/06.
d. Deaths from
suicide.
e. All pedestrian,
bicycle, motorcycle, snowmobile, boating, watercraft, three- or four-wheeler or
all-terrain vehicle fatalities.
f.
Deaths due to failure of a consumer product.
g. Deaths due to a possible public health
hazard.
h. Deaths due to drug or
alcohol abuse or overdose.
i.
Electrical- and lightning-related deaths.
j. Deaths from bums or smoke or soot
inhalation.
k. All deaths related
to exposure, such as hypothermia and hyperthermia.
l. All sport-related deaths, including but
not limited to deaths from auto racing and deaths resulting from injuries
sustained in football, basketball, baseball, softball, soccer, or other games
or sports.
(3)
Other deaths. For those deaths not listed in subrule 127.3(1)
or 127.3(2), a county medical examiner shall determine whether the public
interest requires an autopsy and may perform an autopsy or order that an
autopsy be performed. A countymedical examiner may consult with the state
medical examiner to assist in determining the need for an autopsy.
(4)
Performance of autopsy.
a.
Who may authorize.
Autopsies may be authorized by the state medical examiner, the countymedical
examiner for the county in which the death occurred or the countywhere any
injury contributing to or causing the death was sustained, or the county
attorney who would have jurisdiction in any criminal proceeding related to the
death.
b.
Who may
perform. An autopsy shall be performed by a pathologist trained or
with experience in forensic pathology, licensed to practice medicine and
surgery or osteopathic medicine and surgery in the state of Iowa and
board-certified by the American Board of Pathology, or under the direct
supervision of a physician with these qualifications. If an autopsy is
performed by a physician who does not satisfy these criteria and who is not
performing under the direct supervision of a physician who satisfies these
criteria, the physician shall submit a supplemental report with the Permit by
Medical Examiner for Autopsy, Form ME-3, which details the specific training,
education, and experience which qualify the physician to perform an autopsy.
The following cases/types of deaths shall be transported to the office of the
state medical examiner for autopsy unless otherwise approved by the state
medical examiner:
(1) Deaths of adolescents
through 18 years of age when there is not a known or preexisting natural cause
of death.
(2) All cases of homicide
or suspected homicide, irrespective of the period of survival following
injury.
(3) Deaths of children
under the age of 2 years if death results from an unknown cause or if the
circumstances surrounding the death indicate that Sudden Infant Death Syndrome
may be the cause of death.
(4) All
suspicious suicides.
(5) All
high-profile deaths including, but not limited to, deaths of elected officials
in municipal, state or federal government.
(6) All deaths of inmates occurring in any
institutions under the department of corrections as outlined in Iowa Code
section
904.102,
excluding those deaths that result from a pre-existing medical
condition.
c.
Permit required-Form ME-3. A medical examiner shall complete
the Permit by Medical Examiner for Autopsy, Form ME-3. All reasonable efforts
shall be made to complete the Form ME-3 prior to the performance of an autopsy
and to submit the form with the body of the decedent or to submit the form via
facsimile to the state medical examiner
(5)
Autopsy report. A
complete record of the findings of the autopsy shall be submitted to the state
medical examiner's office, the county attorney of the county where the death
occurred and the county attorney of the county where the injury contributing to
or causing the death was sustained within 90 days following the date of death,
unless unusual circumstances requiring further investigation or testing exist.
The report filed shall include all diagrams, transcriptions of the autopsy
observations and opinions, and toxicology reports.
(6)
Out-of-state autopsy.
The body of a decedent may be sent out of state for an autopsy or postmortem
examination only if the countymedical examiner certifies in writing that the
out-of-state autopsy or examination is necessary for any of the following
reasons:
a. A forensic pathologist practicing
in the state of Iowa is unavailable;
b. Requiring an in-state autopsy would cause
financial hardship; or
c. Requiring
an in-state autopsy would delay the funeral or burial more than three
days.
(7)
Retention and disposal of tissues, organs, and bodily fluids.
The office of the state medical examiner shall retain tissues, organs, and
bodily fluids as necessary to determine the cause and manner of death or as
deemed advisable by the state medical examiner for medical or public health
investigation, teaching, or research. Tissues, organs, and bodily fluids shall
be retained at a minimum for the time periods established by the National
Association of Medical Examiners and may be retained for a longer time period
at the discretion of the state medical examiner Tissues, organs, and bodily
fluids retained under this subrule shall be disposed of without the specific
consent or notification of the legal next of kin and in accordance with
applicable federal and state regulations including but not limited to
OSHA-recommended biohazard and blood-borne pathogen standards. The anatomical
material shall be removed from the laboratory premises through use of a
contracted, licensed, and bonded medical waste removal service to a medical
waste processing center for final disposition.
