approach to fire deaths

When a fire results in a fatality, there should be a low threshold for treating the death as suspicious, in view of the frequency with which attempts are made to conceal a homicide by ‘burning the evidence’ – about 5% of fire deaths are due to homicide. Pathologists’ carrying out coronial autopsies may still be asked to examine bodies recovered from a fire, but it is prudent to approach each case cautiously, and consider the following;

·      Briefing – a fire investigator will be assigned to every fatal fire, and the pathologist should ensure that details of the case, including the results of scene investigations, the presence/ absence of accelerants, and the results of police enquiries etc are discussed with the relevant personnel before starting the post mortem examination. When the death is treated as suspicious, the forensic pathologist will have an initial briefing before making an examination of the scene

      Radiology - the need for post mortem radiology should be determined on a case-by-case basis; skeletonised remains should be x-rayed in order to exclude the presence of projectiles (e.g. a bullet in the head).

·        Post mortem examination – a careful external and internal examination is required in order to address the issues raised by the death (see ‘Aims of the pathological investigation’ below). Sample retrieval in a ‘routine’ coronial autopsy will generally include blood and urine (where available) for toxicology, blood for carboxyhaemoglobin estimation and tissues for histology.

·        Further investigations – the presence of alcohol (identified in 50-60% of fire deaths) and drugs of abuse/ prescribed drugs (particularly in young men), including ecstasy and benzodiazepines etc may provide an explanation as to how/ why the deceased met their death. When blood and urine are unavailable, alternative toxicological substrates include muscle or liver. Burning has no effect on the blood alcohol level.

·        Post mortem report – to include conclusions based on the pathological findings, and the results of the ‘further tests’, and an opinion as to the medical cause of death. These findings will then form the basis of evidence given at inquest (or in the criminal courts).