[Histonet] Policy bariatric patient for autopsy

Bob Richmond rsrichmond at gmail.com
Sun Nov 11 17:24:19 CST 2018


Well, it would have made a lot more sense if they'd said "morbidly obese
patients" but I suppose that political correctness must be observed.

If you don't have the equipment to do the autopsy safely, then you have to
refuse to do the autopsy. If your pathologist doesn't have the authority to
refuse the autopsy, then he may be putting his job on the line.

Similar to this problem is the issue of refusing an autopsy on a patient
with a hazardous infectious disease. Hepatitis and tuberculosis are the
most common problems (AIDS really isn't). I was in trouble once for
refusing an autopsy that didn't need doing, on a patient with hepatitis C,
when the autopsy facility consisted of an ancient embalmer's table. If CAP
offered any help here, I never heard of it.

Bob Richmond
Samurai Pathologist
Maryville TN

On Sun, Nov 11, 2018 at 4:27 PM Titus, Jennifer <
Jennifer.Titus at greenwichhospital.org> wrote:

> Yes, there is a relatively new guideline in the checklist regarding
> performance of bariatric autopsies, and you need a policy at your
> institution....
>
> **NEW** 08/21/2017
> ANP.34160 Safe Handling of Bariatric Patients Phase II
> There are written procedures for the special handling of autopsies on
> bariatric patients
> where the patient size could represent an occupational hazard to autopsy
> staff.
> NOTE: Individual institutions may set their own specific weight or BMI
> limits for application of the
> occupational health policy. Institutions may also choose whether to use
> special equipment for
> such patients and what type(s) of equipment to use.
> Evidence of Compliance:
> ✓ Written policy for handling of bariatric patients
>
> ________________________________________
> From: Bob Richmond via Histonet [histonet at lists.utsouthwestern.edu]
> Sent: Saturday, November 10, 2018 2:03 PM
> To: Histonet at lists.utsouthwestern.edu
> Subject: Re: [Histonet] Policy bariatric patient for autopsy
>
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>
>
>
> I don't understand Lorraine Smallwood's question:
>
> >>Can anyone give me info on the CAP inspection packet regarding policy for
> bariatric patient for autopsy? I am a new "Histonet" junkie so any help
> from the experts will be greatly appreciated.<<
>
> CAP inspections don't concern themselves with details of pathologic
> technique. Are you asking whether they have a policy for refusing autopsies
> on bodies so obese that the autopsy is difficult to do, or for performing
> the autopsy? Or a policy for what information to record in doing an autopsy
> on a patient who's had bariatric surgery?
>
> When I Googled "autopsy bariatric surgery" I found references for both of
> my questions.
>
> Bob Richmond
> Samurai Pathologist
> Maryville TN
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