Rising Cases of Poisoning: Autopsies Under Scanner

In the wake of protests by the family of a Srinagar teacher who was allegedly poisoned, the procedure of investigations, evidence collection and autopsies in poisoning cases has come under scanner.
Rising Cases of Poisoning: Autopsies Under Scanner
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In the wake of protests by the family of a Srinagar teacher who was allegedly poisoned, the procedure of investigations, evidence collection and autopsies in poisoning cases has come under scanner. Standardized procedures need to be established and observed, as per experts.

Around 1000 cases of poisoning are reported at SMHS Hospital every year. In year 2012, 836 suicides were reported at the hospital as per records and since then the number is increasing, the doctors said. 

With rising incidents of poisoning cases in state, questions about the soundness of autopsies are being raised.

While family of the deceased teacher Saika Wanchoo has alleged that the doctor who had performed the autopsy had played foul, experts said that the protocol is well laid out for all autopsies.

Dr. Fareeda Noor, Head Department of Forensic Medicine at GMC Srinagar, said that visceral organs hold the clues in case of poisoning. "In case of suspected poisoning, we send samples of kidney, stomach, liver, spleen and other organs for forensics," Dr. Noor said. She added if the doctor, after preliminary examination and autopsy, does not find signs of poisoning, then these samples are not sent for these tests.

On the same note, Shakeel Ahmed, Scientific Officer at Forensic Sciences Laboratory in Srinagar said that visceral organs have tell-tale signs in poisoning. "Each poison has an affinity for a particular organ. The visceral organs are imperative to come to a conclusion vis-à-vis poisoning cases," he said.

However, some officials in FSL, seeking anonymity said that there is a wide gap between the rules and practice. "Doctors need to be trained in autopsies. Standards and protocols need to be adhered to in letter and spirit. However, such is not the case here," said an official in FSL. He added that many-a-times, either due to error of judgment, ignorance or some other constraints and motives, autopsies are but an eye-wash.

As per Encyclopedia of Forensic Medicine by Jason Payne James and Roger W Byard, in known or suspected cases of poisoning, or when toxicological/chemical analysis is deemed necessary by Medical Officer, viscera, including stomach with its contents, proximal small intestine with its contents and pieces of liver, kidneys and body fluids such as blood and urine are preserved and sent to government run forensic sciences laboratory for chemical analysis.

However, Dr. Urfan Wani, CMO who conducted autopsy of Saika Wanchoo, and who the family has alleged of foul play in conducting autopsy, said that he had followed the protocol that was in vogue in Kashmir. "We send 10 ml of blood, taken from heart and stomach with its entire contents, sealed at both ends for forensics in case of suspected poisoning," he said. He added that it was not his first case of autopsy and that 'all of us (doctors) follow this procedure'.

While the doctor claimed to have received FSL report and said that pathological report from GMC was also to be collected soon, he refused to reveal the findings. "Findings are confidential," he said.

This is not the first case wherein autopsy and investigations are being doubted by family. In past, medico-legal cases involving women and burn cases have not reached any conclusion due to laxity in investigations and autopsies. Last year, many such cases came to light in SMHS Hospital, however doctors said that not even preliminary investigations were carried out by the authorities.

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