- Dr. John Sinard, Director
- Arthur Belanger, Manager
The Autopsy Section investigates disease by postmortem study of tissues and the clinical record. It is essential to the closing of a patient's record. It provides verification of diagnosis and therapy, as well as important epidemiological information, and is an important source of teaching material for pre- and post-graduate training. Hospital policy requires that an autopsy be requested on all hospital deaths. Results from autopsy investigation of deaths are directly incorporated into quality assurance programs in the hospital. The case mix reflects the combined general medical and surgical hospital plus tertiary care center that characterizes the Yale New Haven Medical Center. In addition, the residents on the service cover autopsies at Bridgeport Hospital (patients are transported to Yale), adding the case mix of a large community hospital to the experience, and cover the VA Connecticut Healthcare System autopsies (autopsies are performed at the VA), providing yet another unique patient population.
Autopsies are performed seven days a week, 365 days a year. A dedicated technical and clerical staff ensures the smooth running of autopsy services. A highly efficient laboratory staff assists residents in the timely evaluation of cases. Tissue sections are returned to house officers within 48 hours and turnaround time for special stains is the same as for surgical specimens.
Autopsies are performed primarily by AP-1 residents. For each patient autopsied, an attending pathologist assumes the responsibility for the diagnostic evaluation and clinical-pathological correlation. Provisional Anatomical Diagnoses are reported within 24 hours of the autopsy. The resident is encouraged to prepare cases for the Final Anatomic Diagnosis as soon as possible so that appropriate information can be given to clinical attendings and the family of the deceased.
Clinical teaching through the autopsy is encouraged. Peer teaching and medical student teaching are opportunities for the pathologist in training to learn teaching skills. House officers are expected to present autopsy findings at interdepartmental conferences. Pathology Assistants in training learn autopsy technique and gross pathology through interaction with the resident staff and technical staff. Appropriate specimens are triaged into the teaching collection.
An important function of an academic autopsy service is to process tissues for research purposes. This activity is coordinated by the Tissue Procurement Module of Yale Pathology Tissue Services. The autopsy service provides tissues to investigators following the approval of the research protocol by the Human Investigations Committee. Not infrequently in a tertiary care center such as Yale-New Haven Hospital, diagnostic evaluation and clinical research are synchronous and complementary.
A detailed manual describing the operation of the autopsy service, including the autopsy process, technical procedures, and the autopsy report, is provided separately to the house staff.