Medical devices encountered at medico-legal autopsies

The medical devices are used in the diagnosis, treatment, prostheses, resuscitation, and monitoring of the patients. These range from relatively simple external objects to high-tech internal devices. These can guide pathologists towards the cause of death by indicating the organ system they belong to, when present in situ at autopsy.

The startling dearth of literature led the authors to retrospectively review various types of medical devices found in situ at autopsy. The devices were interrogated for information by analysis of the postmortem findings, inquest proceedings, and photography of each individual case autopsied at our institutes during a 15 year period from 2005 to 2019.

Various devices were found during autopsy including anaesthesiological devices such as endotracheal and tracheostomy tube; cardiovascular devices such as coronary stents, mechanical valves and defibrillators; dental devices such as dentures; gastroenterological devices such as nasogastric tubes and ileostomy/colostomy bags; plastic surgical devices such as breast implants; surgical devices such as sutures, slips, adhesive and mesh; neurological devices such as vetriculo-peritoneal shunts; neonatal devices such as umbilical cord clip; and orthopedic devices such as plasters, external/internal fixators, braces and slings. Conclusion - Device and procedural-related deaths do occur but as exception rather than a rule. Improper use or implantation, underlying natural disease, tissue reaction resulting in dislodgement or ineffective functioning of the device are more common situations. In our study, all the medical devices were instituted in the body to manage the pathological process or abnormal physiology. The failure of the devices occurred in its natural course and did not cause any additional complications.