If a patient dies and the death is reportable to the Crown Office and Procurator Fiscal Service, you should leave all equipment in place until you have discussed the case with the Procurator Fiscal. This factsheet gives you further information about what to do.
Equipment that is needed for other patients
If the patient has been connected to equipment that is needed urgently for other patients – for example, a respirator – you should take a photograph or make a sketch diagram before it is disconnected from the patient. The sketch or photograph may preserve forensic evidence that could be crucial to the Procurator Fiscal or later fatal accident inquiry (FAI) investigations. The equipment should not be disconnected or used again if it is possibly faulty or could be the subject of an investigation into a possible complaint or adverse event.
Equipment such as intravenous lines, drains, catheters, etc, should be left undisturbed. This is to preserve any forensic evidence, and to give the Procurator Fiscal’s pathologist the best opportunity for independent inspection and assessment of the case. The equipment may be relevant not only in cases of possible crime, but also in cases where the clinical management may be called into question. Examples of items that should be left undisturbed include:
- Endotracheal tubes
- Intravascular lines
- Feeding tubes
- Defibrillator pads
- Cardiac pacing devices
This list is not exhaustive.
If you think that any piece of equipment might be at fault, it must be left untouched and, if possible, sealed and stored in a locked room or cupboard. It can be then be examined on behalf of the Procurator Fiscal and/or the Health and Safety Executive for Scotland.
Sudden or violent death
In cases of sudden or violent death – for example, in the A&E department or where patients are brought in dead – clothing should be left undisturbed. Any item (eg, a knife, needle or syringe) should not be touched. It should be left for forensic examination and will be dealt with by the scene-of-crime police officer or the forensic pathologist. If it is necessary to remove clothing or equipment, you should make a careful note of this.
If there is anything you are unsure about, contact the Procurator Fiscal who will be able to provide you with further information. Each case is different and the facts of the case will assist in making the appropriate decisions.
It is essential that pacemakers and/or radioactive implants are removed before the body is taken away for cremation in order to avoid the risk of causing an explosion in the crematorium.